Introduction
The topic of the paper chosen for the analysis is the communication between nurses during the shifting of responsibilities for caring for patients when transferring them from the ICU to the general ward. The paper by Bunkeborg et al. (2017) focuses on conducting qualitative research to analyze the communicational methods used during patients’ shifts. The question of nurses’ communication from different wards is a highly researched area (Fathi and Simamora, 2019). However, the analyzed research is focused on estimating the risks of inefficient communication in transferring patients with multi-morbidity. The proforma used for the analysis is the one provided in the checklist. This methodology allows the estimate of the paper to be more appraised and critically focuses the review on the most vital aspects of research.
The primary purpose of choosing this topic is to highlight the importance of efficient nurse communication as the inquiry of high-quality treatment. The report aims to evaluate the current conditions in which the nurse’s communication exists and identify possible problems and further developmental areas. It is essential to define the aspects which are vital to consider in the scope of the review. Patients with multi-morbidity need to be specifically attentive care when transferring. The multi-morbidity is a widely-spread condition, especially among the elderly (Aggarwal, Patel and Woolford, 2020). Miscommunication during the transfer of the patient can sometimes be for such patients fatal. Therefore, exploring the methods of treating particular diseases and practical communication issues is vital. By ensuring high-quality communication between nurses, the safety of the multi-morbid patients during transfer from the ICU to the general ward may be increased.
Analysis
Title, Keywords, Research Strategy, Hypothesis, and the Authors
The title is comprehensive, including most aspects necessary for understanding the topic of research. The major problem that can be highlighted is the avoiding mentioning that the research is focused on multi-morbid patients, which raises the topic’s importance. Adding such details can make the tile challenging to comprehend. Therefore, the word choice of the authors can be justified. However, the first impression of the topic is vital for the reader to make a general impression. Thus, it would be more rational to add the class of patients and delete the type of study in the title. The title reflects all aspects of the article besides the population issue.
The keywords need to be more sufficient in the scope of such detailed research. The authors describe the key terms in the background context section, which focuses on the issues of communication and multi-morbid patients. For example, the term communication is explicitly defined and researched by providing the theoretical background. The terms that defined the methods of the analysis, such as context analysis and ethnographical approach, are also clarified. All terms are clearly defined and addressed. The authors of the research believe that the problem of communication between the nurses during handing over the patients is not well-researched which is the primary reason for choosing this specific topic. The information regarding the multi-morbid patients, the ethnographical study, and the types of wards can be added for the more widespread coverage of the academic topics. The authors are representatives of Denmark’s institutes devoted to conducting health research. Other information related to the major or experience of the authors needs to be provided. The authors provide no obvious hypothesis, but it is implicitly stated that the primary aim is to check whether the communication is damaged.
Abstract
The abstract is informative, combining all the significant findings and methodology of research. Such a massive abstract allows the reader to understand all the inquiries of the research. Moreover, the abstract compensates for the lack of mention of multi-morbidity patients in the article’s title. Therefore, the general quality of the abstract is high, making the paper more comprehensive thanks to the details mentioned in the abstract. The abstract is accurate, corresponding to the content of the research.
The Introduction
The introduction to the paper is relatively short and informative. The author focuses primarily on stating why ensuring high-quality communication during patient transfer is vital. Through such a description, the importance of the communicational adjustment is highlighted. At first glance, the introduction seems uncomprehensive due to not covering all the aspects of the topic and theme. However, this is compensated for later in the background and context part.
Background Review
The background and context section opens with the definition of the communication process, which seems irrelevant to the research question. Further descriptions of the types of nursing communication, such as face-to-face and through documentation, are directly related to the topic. The literature review also directly relates to the topic despite the issue of multi-morbidity. The authors only highlight the increased risks to the patients in the ICU department. The authors also provide an analysis of possible recommendations related to the education of nurses through communication. Moreover, the importance of documentation during such transfers is also emphasized. Therefore, this section provides sufficient background information regarding the topic. The only drawback is the lack of information related to the multi-morbid patients’ risks related to ICU and general ward care responsibility shift.
Ethics
The research has a well-defined section related to ethical considerations. The authors state that all information provided was confidential. It is worth mentioning that the means of bias-protection are not defined. The authors conducted the observation and interviews, which creates the chance of biases occurring. The author may be at risk of developing apophenia being focused on the research. This is an emotional state when people perceive the connections between some things or phenomena that are not meaningful initially (Buetow, 2019). As a result, general problems with bias protection are present in work.
Methodology: Sample and Data Collection
The sample included nurses from two wards. The procedure was separated into two stages: observation and interviews. The authors chose their selection among the employees of the university hospital’s departments. As mentioned earlier, the study is qualitative, which stipulates using the focused ethnographic approach to observing and interviewing the participants. The primary aim of the researcher was to identify the problems in communication among nurses. The focused ethnography allowed the authors to focus on societal issues (Hodgson et al., 2019). The observations were conducted based on the clinical handover cases of patients with multi-morbidity. The methodology included the observation of the principles based on which the nurses from different departments communicate and the focus group interviews. The interviews included questions related to the nurses’ perception of the documentation and the central communication issues professionals face.
Data Analysis
The data collected during the discussion included the two interviewers to collect the richer data from nurses. It is difficult to state that the research has a particular data collection methodology because the researcher primarily noted the observations and answers of the nurses. For the data transcription, the authors applied content analysis (Bunkeborg et al., 2017). Such a type of analysis allows for identifying the particular patterns in the recorded communication between the research participants. Thus, content analysis is a highly suitable method for the current research. The authors applied the coding method as a data analysis tool, which helped them divide the collected data into several categories and analyze each separately. What is advantageous for the research methodology and design is the attention to the minor details of communication between nurses, such as greetings during the handovers, body language, and others. Such an approach allows for estimating the communication from a more honest perspective, avoiding the possible nurses’ biases during the interviews. The authors avoided the nurses’ biases, leaving the issue of the researchers’ biases unaddressed. Therefore, the potential biases of data analysis can occur.
Results
The results were separated into two distinct groups: the observational and focus group interviews. The first part of the analysis showed that nurses do not use medical records, which increases the risks of medication error occurrence. Firstly, the different departments’ nurses use verbal communication. The second part of the results included the interview data of the ICU and general ward nurses related to many subcategories of communication. The analysis provided by the authors sufficiently defines the problematic areas of communication between burses.
Moreover, the analysis shows which areas are to be improved. For example, the lack of documentation usage leads to the increased risks of patient safety of multi-morbidity patents’ safety. Such problems as the lack of schedule management and time were also discovered as the most significant issues when handling patients (Bunkeborg et al., 2017). At the same time, the observational part is significantly smaller than the analysis of the interviews. It is more rational to analyze more details during the observational practices. However, such an information distribution can be related to the need for more authors’ experience in real-life practices, which can result in less information being noticed. As a result, interviews were more informative for the authors than practical observations. Such a situation does not significantly affect the research’s quality or validity. The part of the observation is a subsidiary element that strengthens the data nurses provided during the interviews.
Discussion, Recommendations, and Conclusion
The discussion section combines all the theoretical and practical research results. The significant inquiries vital for the researchers are the differences in the perception of the patient’s needs by the ICU and general ward nurses, the need for more documentation (replaced by verbal communication), and the insufficient knowledge transfer. The practical implication of the results gained requires efforts on the administrative and management levels to ensure the shared goal policy when handing patients from one ward to another (Bunkeborg et al., 2017). The final recommendation is to implement special nursing training into postgraduate education. The recommendations are valuable from the perspective of high clothing and the scale of the problem.
The research highlights the need for more communication between the ICU and general ward nurses. The attention to such details helps to change the focus from the clinical practices and put special attention to the issues of shared goals and management practices. Considering the drawbacks, the issue of multi-morbid patients needs to be covered more adequately. The population is chosen to emphasize the higher risks of transportation and handing over caring responsibilities. However, the discussed problems can be associated with any patient’s transportation to the other departments. It is obvious that multi-morbidity is implemented to increase the urgency of the issue, but as a result, the population needs to be more specific and fully covered in the scope of the research. The conclusion is quite comprehensive and short, conditioned by the vast Discussion section, which summarizes all the research results, including the literature review.
Limitations
The provided author’s limitations for the work need to be revised. It is mentioned that the nurses’ experience can affect the research results. However, there needs to be more information related to the effect of the practitioner’s experience on the quality of communication and the development of shared aims. Moreover, as is mentioned in the Ethics section of the current analysis, no bias protection mechanism has been implemented. The researchers who conducted observations were responsible for the further analysis. The issue of nurses’ biases related to patients’ characteristics needs to be addressed. The attitude of nurses can affect communication and even documentation provisions (Bickle, Lok and Martin, 2022). However, this topic is an appropriate sphere for additional research. Many other aspects can harm communication and prevent the formation of shared aims (Agarwala et al., 2019). In other words, the analyzed article is the first step in researching this topic.
Conclusion
The overall quality of the article could be better despite some drawbacks in the structure and ethics. The most valuable aspect of the work is to attract special attention to the communication of the nurses from different departments. The clinical managers and health care administrations must consider the results, which should be centered on advancing the culture of shared values. Using the article’s findings, the quality of care can be increased, guaranteeing a higher level of patient safety. The authors’ findings show that there are significant problems in nurses’ communication when handing over patients related to documentation reports and the different perceptions of nursing responsibilities.
In general, I support the research’s results and recommendations. Shared values are one of the essential inquiries that nurses should obtain during their education and apply in practice (McArthur and Schmidt, 2017). Only through efficient communication can the structured handover of patients be achieved. Structured handover interventions allocate verbal and electronic data to ensure the most efficient care (Bukoh and Siah, 2019). The mentioned recommendations are primarily related to the training and education of nurses, which should be implemented at the administration level. However, as a nursing practitioner, I can use the study’s results to be more attentive to the verbal and documented information provided for the handover of patients. Various approaches, such as problem-based learning, can help students and nurses improve communication and patient safety (Li et al., 2019). The article encourages further research in the field of nurse communication. However, the spheres to be researched are primarily related to the impact of inner biases, which can affect the communication between nurses, harming the quality of care.
Reference List
Agarwala, A. et al. (2019) ‘Communication: is there a standard handover technique to transfer patient care?’, International Anesthesiology Clinics, 57(3), pp. 35-47.
Aggarwal, P., Patel, H. and Woolford, S. (2020) ‘Multi-morbidity and polypharmacy in older people: challenges and opportunities for clinical practice’, Geriatrics, 5(4), pp. 70–85.
Bickle, K., Lok, J. and Martin, K. (2022) ‘Investigating the impact of cognitive bias in nursing documentation on decision-making and judgement’, International Journal of Mental Health Nursing, 31(4), pp. 897–907.
Buetow, S. (2019) ‘Apophenia, unconscious bias and reflexivity in nursing qualitative research’, International Journal of Nursing Studies, 89, pp. 8–13.
Bukoh, M. and Siah, C. (2019) ‘A systematic review on the structured handover interventions between nurses in improving patient safety outcomes’, Journal of Nursing Management, 28(3), pp. 744–755.
Bunkeborg, G., Hansen, B. and Holge-Hazelton, B. (2017) ‘Handing over patients from the ICU to the general ward: a focused ethnographical study of nurses’ communication practice’, Journal of Advanced Nursing, 73, pp. 3090–3101.
Fathi, A. and Simamoram R. (2019) ‘The influence of training handover based SBAR communication for improving patients’ safety’, Indian Journal of Public Health Research & Development, 10(9), pp. 1280–1285.
Hodgson, C., Luig, T. and Rashid, M. (2019) ‘Ten tips for conducting focused ethnography in medical education research’, Medical Education Online, 24.
Li, Y. et al. (2019) ‘Effectiveness of problem-based learning on the professional communication competencies of nursing students and nurses: a systematic review’, Nurse Education in Practice, 37, pp. 45–55.
McArthur, E. and Schmidt, B. (2017) ‘Professional nursing values: a concept analysis’, Nursing Forum, 53(1), pp. 69–75.