Assessing Nurse-Patient Communication in Emergency Department Settings at Riverside General Hospital

Thesis Abstract

Effective nurse-patient communication in emergency department (ED) settings is critical for ensuring quality care, patient satisfaction, and positive health outcomes. Despite its importance, inadequate communication remains a pervasive challenge in many hospital environments, often leading to misunderstandings, reduced patient trust, and compromised safety. Riverside General Hospital's ED has reported concerns regarding communication effectiveness, prompting a systematic assessment to identify strengths, weaknesses, and interventions for improvement. This study aims to evaluate the quality, frequency, and determinants of nurse-patient communication within the ED at Riverside General Hospital, with specific objectives to measure communication effectiveness, explore nurses' and patients' perspectives, and identify factors influencing communication performance. The research adopts a convergent mixed-methods design, integrating quantitative survey data with qualitative interviews to obtain a comprehensive understanding of communication dynamics. The study population comprises all nurses working in the ED (estimated at 150) and adult patients (approximately 300) who received care over a three-month period. A stratified random sampling technique will select 120 nurses and 180 patients to ensure representativeness. Quantitative data will be collected through structured questionnaires a Nurse-Patient Communication Satisfaction Scale (NPCSS) for patients and a Communication Skills Checklist (CSC) for nurses, both validated through pilot testing for content validity and reliability coefficients exceeding 0.85. Qualitative data will be obtained via semi-structured interviews with 15 nurses and 15 patients, aimed at capturing experiential insights and contextual factors influencing communication. Data analysis will employ descriptive statistics to summarize demographic and communication variables, while inferential analyses include multiple regression to determine predictors of communication satisfaction among patients, and independent samples t-tests to compare perceptions across different demographic groups. Qualitative data will undergo thematic analysis following Braun and Clarke's methodology, with coding facilitated by NVivo software, aiming to identify recurrent themes pertinent to communication challenges and facilitators. The study will be guided by Samuelom's Interaction Framework and the Transactional Model of Communication, providing theoretical lenses to interpret findings. Expected findings suggest that nurse communication style, workload, patient literacy levels, and environmental factors significantly influence communication effectiveness. It is anticipated that discrepancies exist between nurses' self-perception of communication skills and patients' actual experiences, highlighting areas for targeted training. The study also expects to reveal that effective communication correlates positively with patient satisfaction scores and perceived quality of care. This research contributes to knowledge by providing empirical evidence on nurse-patient communication specifics within the ED context, particularly in a tertiary hospital setting in a middle-income country. It offers an analytical framework for understanding communication barriers and enablers, complemented by evidence-based recommendations for policy and practice improvements. The main conclusion underscores the necessity of implementing communication skills training tailored to ED realities, optimizing nurse staffing to reduce workload-related deficits, and fostering an environment conducive to open dialogue. Recommendations include the development of structured communication protocols, continuous professional development programs, and patient-centered communication strategies. The findings also prompt further research into intervention efficacy and cross-institutional comparisons, aiming to strengthen emergency care practices and enhance overall patient outcomes at Riverside General Hospital.