Prepare this assignment as a 1,500-1,750-word paper using the instructor feedback from the previous course assignments and the guidelines below.

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.
The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed qualitative, quantitative, and mixed methods research critiques on two articles for each type of study (four articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Use the "Research Critiques and PICOT Question Guidelines – Final Draft" document to organize your essay. Questions under each heading should be addressed as a narrative in the structure of a formal paper. Please note that there are two new additional sections: Outcomes Comparison and Proposed Evidence-Based Practice Change.

General Requirements

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Qualitative Essay:

Alexandra Benjamin
Grand Canyon University
Professor Stella Nwokeji
June 12, 2022
Communication Perspectives Regarding Patient Care

Communication plays such a significant role with healthcare. Communication refers to exchanging information with the help of different mediums such as body language writing and speaking. In the world of medicine effective physician patient communication patient communication is vital to receive favorable health outcome. Increase patient satisfaction compliance and overall health status can be achieved through communicating. It has been estimated that about 27% of the medical malpractice is the result of communication failures. In this paper I will be discussing negative, positive, and effective communication throughout patient
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care. For staff working in the hospital how does the team communication education compare to know team communication education impact the patients’ perspectives of their experience during their hospital stay.

Poor communication between physician and nurses has been identified as a contributor to adverse events for hospitalized patients. Several factors may contribute to poor communication. Poor communication relationship between nurses and physicians may the lay proper nursing care. Level of education can impact the patient’s understanding with their care. Also, ineffective communication can cause the patient to not have autonomy and questions answered properly. Lack of building patient rapport may cause the patient to not fully absorb patient education overall risk in the patient to being admitted into the hospital and have an infective perception with their level of care. The significance of communication is key to assist the patient to gain and manage their care at home effectively. The purpose of my essay is to provide an overall knowledge to develop tools to improve patient communication to help lower the risk of readmitting for the same problem. My objective is to educate and reinforce patient autonomy for the patient to have an overall better outcome.
My two questions that can tie in both articles are; How can we reinforce patient autonomy? What ways can nurse, and care staff build rapport with the patient to help assist the care?
My first article supports the peacock question because to understand the view and perceptions of the person’s patient’s experience is by effective rounding activity in the care delivery process for communication the second article discusses how ICU nurses lack empathy towards the patient’s family when they have a low experience with these types of patients and do
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not have a rapport with the patient or family. Both situations can have a negative perspective and impact on the patient level of care because ineffective rounding can cause the nurse not to have an effective information relevant to their care, lack of building a rapport with the family member and the patient through communicating can also cause both the patient and the family members to have a negative perspective. (Manojlovich, M., Harrod, M., Hofer, T.P. et al, 2020).
The first article will describe the positive ways and steps to reinforce effective communication. My second article will describe the negative communication perspective for an ICU nurse with a low experience level and ways to increase better rapport overall having a better communication to benefit the patients and family’s perspective (Manojlovich, M., Harrod, M., Hofer, T.P. et al, 2020). Some interventions related to both articles to have the most effective communication and good perspective from the patient is to first have good bedside report and for ICU patients having the families on the phone while the nurse reports to another nurse can assist them to be more involved in the patient’s overall care. Second, reviewing the patient’s labs test and plan of care and writing them on the board can encourage the patient to build their autonomy. The first article uses qualitative study using interview focus group shadowing and observational data collected as part of a larger project designed to understand how communication can facilitate or stop communication between nurses and physicians on the general care units (Manojlovich, M., Harrod, M., Hofer, T.P. et al, 2020). A focus analysis using this data was conducted to explore the patient’s care starts the focus to understand communication practices between physicians and nurses. The second article also uses qualitative descriptive design using focus group interviews and in-depth individual interviews. No rounding or shadowing were involved in the second article. The one benefit the first article has will give an overall picture due to the several ways to collect the necessary data. The one limitation in the
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first article is that there is no limitation, all the methods will provide an improved picture. Exploring these factors that influence communication during patient care rounding may provide insight to achieve better rapport helping the goal of identifying key opportunities for improving communication between healthcare providers. On the second article the one benefit is the one-on-one perceptions of what the family is thinking the one limitation is because these patients are in a lower level of cognitive ability due to the medication as prescribed there is no way to get the actual patient’s perspective. (Yoo HJ, Lim OB, Shim JL, 2020).

Results in the first article revealed the three factors complexity cognitive load and social context that are interactive dynamically to influence communication practices during the outside of patient care rounds. Organizational complexity created barriers to nurse participation in rounds that stop communication with the consequence that the cognitive load for physicians and nurses was increased later in the day for the two groups by using behaviors relating to the social context physicians tried to build relationships with the nurses to encourage communication and this ended up improving the nurse participation in rounding. However, when the physicians did not seek to build relationships with the nurses there were missed opportunities for communication during rounding and at all other times. Interdisciplinary rounding also benefited the patient’s perspective that their care is important to the whole team. Related to the social context we found that both nurses and physicians identified social interactions and building rapport as contributing to better communication and relationships. For the second article after analyzing the communication experiences of the 16 critical care nurses three major themes emerge facing unexpected communication difficulties learning through trial and error and recognizing communication experiences as being essential for care. The second article was
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schemes based on Travelbee’s human to human relationship model, that explains human to human connection developmental stage. In this study communication between patients and their families and experience nurses increase human to human collections leading to a genuine caring relationship (Yoo HJ, Lim OB, Shim JL, 2020).
The implications of the two studies in nursing care practice are that building a rapport and having fluid communication can ensure the patient and the patient’s family member a positive perspective on patient education and patient care.
Two ethical considerations in conducting research are first maintaining honesty while collecting this data and second refrain from doing harm is important. Honesty and fairness are important to communicate with individuals, and refrain from doing harm. Both articles took both ethical considerations very seriously, both articles protected the patient and the staff performing the study privately and protected their confidential information on their diagnosis and their plan of care. Patient confidential information is meant to be protected especially if they do not consent for their information to be disclosed (Manojlovich, M., Harrod, M., Hofer, T.P. et al, 2020).
Patient care rounding is a critical point in this care delivery process because during rounds up-to-date information is reviewed and latest information that informs the patient care is revealed through communication. Although these nurses felt discouraged by the unexpected communication difficulties with patient and their families, they recognize that they could address these difficulties by improving their communication skills over time through experience and learning. They realize that empathy, physical interaction, and active listening with the patient and her family enabled meaningful calm communication and have gradually learned that effective communication is so important in providing nursing care.
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Manojlovich, M., Harrod, M., Hofer, T.P. et al. Using Qualitative Methods to Explore Communication Practices in the Context of Patient Care Rounds on General Care Units. J GEN INTERN MED 35, 839–845 (2020).
Yoo HJ, Lim OB, Shim JL (2020) Critical care nurses’ communication experiences with patients and families in an intensive care unit: A qualitative study. PLoS ONE 15(7): e0235694.
Leape LL, Shore MF, Dienstag JL, et al. Perspective: a culture of respect, part 1: the nature and causes of disrespectful behavior by physicians. Acad Med. 2012;87(7):845–852.

Quantitative Essay:


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Alexandra Benjamin
Grand Canyon University
Professor Stella Nwokeji

As I discussed in my last essay communication plays such a priority role in nursing care. Skillful communication helps the healthcare providers to assemble rapport with their patients, solicit critical health information and work effectively with the interdisciplinary team, and the public. Communication is the most critical component of our work with patients. It is the cornerstone of the interaction with patients and people. A good and effective exchange between patients helps them see what the other person thinks, sees and what he or she feels. It helps people understand each other better and brings people closer. Even though communication sounds easy sometimes it is not so easy at all communicating may be time consuming and sometimes as a healthcare professional redundant but speaking and obtaining information can surprisingly help the patient throughout their hospital stay. For staff working in the hospital how does team communication education compare to not having team communication and education impact the patient’s perspective of his or her experience during the hospital stay?
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In the first article it discusses the significance of patient participation throughout their care. In the progressing healthcare systems in which the patient is often required to self-managed care needs to focus on participation in care. Not professionally managing the care during already risky care transitions further increases the adverse care outcomes. Patients’ participation while in their hospital stay increases their autonomy and prevents errors. Management has many roles in the organization which is why developing communicating and managing staff members is key to have an easy flowing system. Management is like a signature in a valid contract, it must be there (Naylor et al., 2018).

My second article discusses how important effective communication can optimize effective nurse to nurse hand-over and to determine the effect of the handover quality on the patient’s outcome especially if the patient is going into surgery or going home. Both articles relate to my PICOT question because primary good management and participation can ensure a smooth framework so that nurses can build rapport and focus on the handoff. Communication is important to give other nurses assuming care a FYI on patient’s situation, history, patient concerns the goals throughout the hospital stay. Having both resources, good self-care management and effective hand off can optimize the patient’s perspective on their level care. So, intervention type both articles is affected communication and preventing a delay in the patient optimal level of patient care.

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Some interventions that both the articles are tied it is effective communication and preventing delaying care provide the patient an optimal level to which can overall give a positive view on their care.
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Based on the first article the method that was used was the PRISMA method. The PRISMA method ensures patient participation and management in traditional care. Quantitative studies in which the patient participation was assessed and measured. For the second article cross-sectional, quantitative design, with two points of measurement, using a questionnaire to investigate personnel’ experiences with patient handovers (Naylor et al., 2018).
The way these two articles are similar because they both are the quantitative set of angles are in achieving the most effective communication. Using the PRISMA on the first article will help the quality and the review and allow the readers to assess strengths and weaknesses. One limitation in using the PRISMA permits replication of both. (Halabi et al.,2020).
After reading the second article, a benefit of the cross-sectional study. Because of this method, the study requires no means. One limitation to the study is that it is not effective when the entire population is involved. On the first article there were twelve studies with different multidisciplinary areas which identified the efforts based on understanding and improving patient self-management of care during transitions. Numerous similar studies were experimental, and the care interventions ensured a more secure patient and family care hospital setting. An array of measurements was used to quantify the patient participation (Halabi et al.,2020).

Factors of patient participation and basic care include received levels of self-efficiency confidence and skills to participate in care. For the second article there are no significant differences between the transferring receiving in the pre- and post-implementation study regarding age or years of experience. An example of an effective rapport is when a patient is on a new floor with all her medication available for that patient, the nurse is aware of the patient’s chief complaint and past medical history (Naylor et al., 2018).
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This is a good example of an effective hand off because when you hand off it should be a continuation of care. If there is a pause in care, it can delay their necessary needs. But two implications of these two articles are achieving effective rapport and encouraging autonomy which can help the patient with their care. These studies both had different ethnic considerations such as the first article had no specific ethnic considerations while the second article was based on the principles of voluntary participation. Consent was not required for both articles (Halabi et al.,2020).
Encouraging patients to participate is important to ensure that the patient understands
that is expected with their plan of care. Although communicating takes time and effort it is important to encourage active listening and patient participation to engage the patient in self-care. As a healthcare professor, improving communication between your patient and interdisciplinary team can have a positive effect on the patient’s perspective regarding their plan of care.

Leonardsen A-C, Moen EK, Karlsøen G, Hovland T. A Quantitative Study on Personnel’s Experiences with Patient Handovers between the Operating Room and the
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Postoperative Anesthesia Care Unit before and after the Implementation of a Structured Communication Tool. Nursing Reports. 2019; 9(1):8041.

Andrea Bailey, MSN, RN, FNP-BC, Jennifer Mallow, PhD, RN, FNP-BC, and Laurie Theeke, PhD, FNP-BC, GCNS-BC, FAAN. Perceived Self-Efficacy, Confidence, and Skill Among Factors of Adult Patient Participation in Transitional Care: A Systematic Review of Quantitative Studies. 2022

Halabi, I. O., Scholtes, B., Voz, B., Gillain, N., Durieux, N., Odero, A., Baumann, M., Ziegler, O., Gagnayre, R., Guillaume, M., Bragard, I., Pétré, B. (2020). “Patient participation” and related concepts: A scoping review on their dimensional composition. Patient Education and Counseling, 103(1), 5–14.


For staff working in the hospital how
does team communication education compare to not having team communication and education impact the patient’s perspective of his or her experience during the hospital stay?




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