The Importance of Effective Communication in Healthcare

1 Case Study – The Importance of Effective Communication in Healthcare Communication is an important healthcare tool. It enables healthcare providers to share the health information of their clients with other team members. Effective communication ensures patients receive quality care that achieves better outcomes and improves safety (Vermeir et al., 2015). However, hospitals continue to record cases of ineffective communication resulting in poor patient outcomes. This discussion highlights a case in which ineffective communication almost led to the death of a 51-year-old morbidly obese man with diabetes and a history of sleep apnea who had presented in the hospital with a detached retina that required surgery.

Case description The preoperative evaluation report revealed the patient had a 4-day history of productive cough and intermittent shortness of breath. He was diagnosed with acute bronchitis and given antibiotics and a bronchodilator. The anesthesiologists did not perform a respiratory assessment but noted the patient had acute bronchitis and sleep apnea.

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2 Surgery was performed during the day, and the patient was admitted overnight for close monitoring due to his sleep apnea. The patient was transferred to the wards after stabilizing.

However, the floor nurse was not given any report or mention of the patient’s sleep apnea. At about 8.0pm, the patient complained of eye pain and was given Demerol by one of the unit nurses. After some time, the patient vomited and complained that the pain had not relented.

Although there was an order for the unit nurse to contact the physician if the patient developed persistent eye pain, the nurse did not comply with this order. Instead, the nurse assumed that the patient had expelled the pain medication and administered another dose of Demerol (IM) and an antiemetic. The nurse only contacted the physician after the patient complained of persistent severe eye pain. The physician ordered another type of antiemetic and pain medication. The patient’s level of comfort increased and he was encouraged to lie. However, after two hours, he seemed lethargic with cool, moist skin. His blood sugar was tested and found to be 278. The unit nurse was concerned about the patient and asked the charge nurse to assess him. The charge nurse assumed that the pain medications had taken effect and did not contact the physician. At 2.00 am unit nurse checked the patient and realized he had no pulse or respirations. The patient was resuscitated but had to be transferred to the ICU. Resolution Care for the patient was impeded by the nursing staff’s limited awareness of his medical condition. The nurses were unaware of the history of sleep apnea, recent acute bronchitis and use of continuous positive airway pressure. The hospital administrator encouraged the nursing staff to ensure key information about a patient’s medical history is effectively communicated to all receiving caregivers. This information is critical in decision-making. The administrator also noted that the patient was casually admitted based on numerous erroneous assumptions. The unit

3 nurse did not comply with the order to contact the physician immediately after the patient developed severe eye pain. Failure to comply with the physician’s orders, as pointed out by Cullati et al. (2019), is a significant contributor to inadequate care and poor patient outcomes.

The patient was given excess narcotics that almost killed him. Casual admission of patients is dangerous especially if nurses do not follow specific notes and orders. Nurses should effectively communicate with the charge nurse and relay any information regarding the patient deterioration of the physician (Khowaja-Punjwani et al., 2017).

4 References Cullati, S., Bochatay, N., Maître, F., Laroche, T., Muller-Juge, V., Blondon, K. S., ... Nendaz, M. R. (2019). When Team Conflicts Threaten Quality of Care: A Study of Health Care Professionals' Experiences and Perceptions. Mayo Clinic proceedings. Innovations, quality & outcomes, 3(1), 43–51. https://doi.org/10.1016/j.mayocpiqo.2018.11.003 Khowaja-Punjwani, S., Smardo, C., Hendricks, M. R., & Lantos, J. D. (2017). Physician-nurse interactions in critical care. Pediatrics, 140(3). https://doi.org/10.1542/peds.2017-0670 Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., ... & Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice, 69(11), 12571267. https://doi.org/10.1111%2Fijcp.12686