Today, safety and patient satisfaction (O’Daniel & Rosenstein, 2008).

Today, nurses rely on patient care technicians to assist in providing patients the best care possible.  Ineffective communication between registered nurses and patient care technicians plays a critical role in having improved information flow, effective interventions, enhanced employee morale, improved patient safety and patient satisfaction (O’Daniel & Rosenstein, 2008).   The purpose of this paper is to introduce the issue of ineffective communication between registered nurses and patient care technicians.  This has been identified within my health care delivery system through the evaluation of a Strength, Weakness, Opportunity, and Threat (SWOT) analysis, urging the need for change and quality improvement.  My literature review will support this issue by providing research on the importance of having effective communication within a clinical practice setting, the barriers to effective communication and the effects ineffective communication has on the quality of patient care.  I will also identify ways to improve the communication process between RNs and PCTs, to promote staff satisfaction and high-quality patient care.Review of LiteratureThe Importance of Effective Communication Effective communication between RNs and PCTs has been assumed within my work environment.  There is effective communication between RN to RN and PCT to PCT.  However, the communication between RNs and PCTs is lacking.  Management has failed to provide any type of formal training or assessment in this area.  Issues dealing with communication tend to be disregarded and considered unimportant.  Several studies (Kalisch, Hyunhwa & Rochman, 2010; Leonard, Graham & Bonacum, 2004; Stewart & Hand, 2017) found that effective communication is crucial for the delivery of high quality, safe patient care.  According to Leonard et al. (2004), “Communication failures are an extremely common cause of inadvertent patient harm” (p. 85).  Miscommunication has been a contributing factor in the inaccuracy and slipups that occur in health care delivery (Stewart & Hand, 2017).  According to Leonard et al. (2004), given that there are most likely going to be differences in communication style between the two groups, ensuring the use of good communication can help the nursing team deliver accurate, effective nursing care.  Barriers to Effective Communication Ineffective communication between RNs and PCTs can be the result of barriers preventing the handoff process.  The barriers encountered by the nursing staff that threaten handoff communication are discussed in several studies (Clarke & Donaldson, 2008; Kalisch & Xie, 2014; Stewart & Hand, 2017).  The handoff communication between RNs and PCTs can be insufficient when information that is being passed is of poor-quality, untimely or not made clear.  “Common barriers to effective handoff communication include the hierarchical nature of health care, organizational culture, differences in the practiced communication style of healthcare professionals, lack of a standardized process, and an increasingly complex care environment” (Stewart & Hand, 2017, p. 297).  The Effects of Ineffective CommunicationNursing Staff Outcomes.  Ineffective communication between RNs and PCTs can lead to low job satisfaction, the intent to leave and high employee turnover.  Kalisch et al. (2010), found a relationship between job satisfaction and having effective communication with co-workers.  Additional findings by Kalisch et al. (2010) showed that nursing staff on an acute care unit, who had effective communication, felt that their work environment was less stressful.  It is important for RNs and PCTs to report when there is a communication problem, making sure to avoid putting the blame on any one individual.  Patient Outcomes.  “Approximately 80% of serious medical errors are believed to result from faults in communication between caregivers” (Sadule-Rios et al., 2017, p. 344).  According to Kalisch & Xie (2014), ineffective communication leads to missed nursing care, such as placing a bed alarm on, checking a blood sugar, turning a patient, obtaining a lab specimen, keeping track of urine output or rechecking vital signs.  This can contribute to adverse health outcomes, such as falls, pressure ulcers or infections. Strategies to Promote Change With the assistance of a SWOT analysis evaluation, the issue of ineffective communication between RNs and PCTs has been identified within my health care delivery system.  There exists a need for change and quality improvement.  According to Skinner, Hanning, Sutherland, Edwards-Wheesk, & Tsuji (2012), “A SWOT analysis could be used to both plan and evaluate strategies in the same community” (p. e168).  Multiple strategies will be developed to promote changes to improve this communication issue.  Conducting a baseline survey on my unit would help obtain some preliminary information about the issue.  According to Murphy (2004), “When surveys do reveal weaknesses in a business segment, a deep dive can be exactly the right tool to use.  It zeros in on what is actually happening in that part of the business and helps determine what needs to be done.  Unlike an investigation, it does not search for individuals involved in specific wrongdoing; it constitutes a broader review of a troubled business unit” (p. 2).  The deep dive technique will be used to gain valuable insights into the communication and relationship patterns between RNs and PCTs.  The next part of the strategic plan is to use the data findings to promote a standardized handoff report process among the RNs and PCTs within my work environment.  “The transfer of essential information and the responsibility for care of the patient from one health care provider to another is an integral component of communication in health care. This critical transfer point is known as a handoff” (Friesen, White & Byers, 2008, p. 2-285).  The SWOT analysis that I conducted revealed that handoff shift report has been successful between RN to RN and PCT to PCT.  However, there is lack in communication when it comes to handoff between RNs and PCTs.  According to Kalisch (2009), “Both nurses and nursing assistants pointed to a lack of a joint report at the beginning of the shift and few contacts or debriefings during the time they are working together, despite the fact that they are caring for the same patients, side by side” (p. 490).  Having a standardized handoff shift report can help reduce the errors in patient care that are caused by insufficient communication.  “Embedding standardized tools and processes, appropriate assertion, and can effectively bridge the differences in communication style between nursing staff” (Leonard et al., 2004, p. 90).  ConclusionHaving effective communication does not always lead to successful teamwork between staff.  There are barriers that can hinder teamwork and cause a lack in communication, leading to missed nursing care and unintended patient harm.  Developing communication that supports mindful awareness, valued information and trusting relationships, is critical for increasing safe patient outcomes.  Formal training and assessment in this area has been overlooked.  Nurse leaders need to begin using techniques such as SWOT analysis and deep dive to supplement strategic planning.  The strategic plan that will be used within my health care environment involves forming a standardized handoff report between RNs and PCTs.  Ultimately, creating a caring practice environment with better teamwork, staff satisfaction and patient safety.