Older patients and dialysis shared decision-making. Insights from an ethnographic discourse analysis of interviews and clinical interactions.

Objective: To describe and analyse the perspectives and communication practices of kidney clinicians and older patients (aged 60 +) during collaborative education and decision-making about dialysis.

Methods: This qualitative study drew on pluralistic data sources and analytical approaches investigating elicited semi-structured interviews (n = 31) with doctors (n = 8), nurses (n = 8) and patients (n = 15), combined with ethnographic observations, written artefacts and audio-recorded naturally-occurring interactions (n = 23, education sessions n = 4; consultations n = 19) in a tertiary Australian kidney outpatient clinic. Data were analysed for themes and linguistic discourse features.

Shared decision making in chronic kidney disease: a qualitative study of the impact of communication practices on treatment decisions for older patients.

Background: Effective interpersonal communication is critical for shared decision-making (SDM). Previous SDM communication training in nephrology has lacked context-specific evidence from ethnographic analysis of SDM interactions with older patients considering treatment options of end stage kidney disease (ESKD). This study explores communication strategies in SDM discussions in nephrology, specifically focusing on older patients considering dialysis as kidney replacement therapy (KRT).

The ACCELERATE Plus (assessment and communication excellence for safe patient outcomes) Trial Protocol: a stepped-wedge cluster randomised trial, cost-benefit analysis, and process evaluation.

Background: Nurses play an essential role in patient safety. Inadequate nursing physical assessment and communication in handover practices are associated with increased patient deterioration, falls and pressure injuries. Despite internationally implemented rapid response systems, falls and pressure injury reduction strategies, and recommendations to conduct clinical handovers at patients' bedside, adverse events persist.

Improving patient-centred care through a tailored intervention addressing nursing clinical handover communication in its organizational and cultural context.

Aims: To increase the quality and safety of patient care, many hospitals have mandated that nursing clinical handover occur at the patient's bedside. This study aims to improve the patient-centredness of nursing handover by addressing the communication challenges of bedside handover and the organizational and cultural practices that shape handover.

Design: Qualitative linguistic ethnographic design combining discourse analysis of actual handover interactions and interviews and focus groups before and after a tailored intervention.

Clinicians' accounts of communication with patients in end-of-life care contexts: A systematic review.

Objective: Communication between patients and end-of-life care providers requires sensitivity given the context and complexity involved. This systematic review uses a narrative approach to synthesise clinicians' understandings of communication in end-of-life care.

Methods: A systematic, narrative synthesis approach was adopted given the heterogeneity across the 83 included studies.

Training in communication and interaction during shift-to-shift nursing handovers in a bilingual hospital: A case study.

Aim: To explore the perceptions and practices of nurses on handovers.

Background: At handover, accountability must be transferred to ensure a consistent quality of patient care. Studies highlighted unstructured handovers as a major factor contributing to critical incidents.

Pre- and post evaluations of the effects of the Connect, Ask, Respond and Empathise (CARE) protocol on nursing handover: A case study of a bilingual hospital in Hong Kong.

Aims And Objectives: To evaluate (a) the perceived effects of the training provided to nurses under a standardised Connect, Ask, Respond and Empathise (CARE) protocol; (b) the ability to enhance the effectiveness of the ISBAR checklist; (c) any increase in nurses' spoken interactions and/or improved comprehension of the patient conditions upon the transfer of responsibility.

Background: Nursing handover is a pivotal act of communication with effects on both patient safety and risk management. Previous studies of critical incidents have highlighted ineffective communication, including a lack of interaction and incomplete and unstructured handovers, as a major contributor to patient harm.

Nurses' perceptions of mandatory bedside clinical handovers: An Australian hospital study.

Aims: The research explores (a) nurses' views of the change to mandatory bedside handovers, and (b) these nurses' perceptions of their skills in managing this new practice in an Australian hospital.

Background: In Australia, nursing bedside handovers are now considered essential in many hospitals, although most nurses received minimal training at the time this policy was instituted. This research establishes a unique quantitative tool to investigate nurses' views of, and self-reported actions related to, bedside handovers.

Benefits of Health Care Communication Training for Nurses Conducting Bedside Handovers: An Australian Hospital Case Study.

Background: This study aimed to examine the effects of communication training on nurses' ability to conduct bedside handovers in hospital.

Method: Of the 26 participating nurses, 13 had recently completed specialized training in bedside handovers using the Connect, Ask, Respond, and Empathize (CARE) and Past, Present, and Future (PPF) of the patient journey and condition protocols for health care communication. The other 13 nurses did not participate in this training.

Health professional-patient communication practices in East Asia: An integrative review of an emerging field of research and practice in Hong Kong, South Korea, Japan, Taiwan, and Mainland China.

Objective: To provide an integrative review of literature on health communication in East Asia and detail culturally-specific influences.

Methods: Using PRISMA model, search of PubMed, PsychInfo, Web of Knowledge, ERIC and CINAHL databases were conducted for studies between January 2000 and March 2017, using the terms 'clinician/health professional-patient', 'nurse/doctor-patient, 'communication' and 'Asia'.

Results: 38 studies were included: Mainland China, Hong Kong, Japan, South Korea, and Taiwan.

Exploring the scope of communication content of mechanically ventilated patients.

Purpose: Ineffective communication during mechanical ventilation (MV) and critical illness is distressing to many patients. This study aimed to describe the scope of communication content of ventilated critically ill patients.

Materials And Methods: We performed a prospective qualitative interview study in a multidisciplinary intensive care unit.

Speak-up culture in an intensive care unit in Hong Kong: a cross-sectional survey exploring the communication openness perceptions of Chinese doctors and nurses.

Objectives: Despite growing recognition of the importance of speaking up to protect patient safety in critical care, little research has been performed in this area in an intensive care unit (ICU) context. This study explored the communication openness perceptions of Chinese doctors and nurses and identified their perceptions of issues in ICU communication, their reasons for speaking up and the possible factors and strategies involved in promoting the practice of speaking up.

Design: A mixed-methods design with quantitative and sequential qualitative components was used.

Complexities of emergency communication: clinicians' perceptions of communication challenges in a trilingual emergency department.

Aims And Objectives: To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department.

Background: Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context.

Contrasting discourse styles and barriers to patient participation in bedside nursing handovers.

This paper applies qualitative discourse analysis to 'shift-change handovers', events in which nurses hand over care for their patients to their colleagues. To improve patient safety, satisfaction and inclusion, hospitals increasingly require nursing staff to hand over at the patient's bedside, rather than in staff-only areas. However, bedside handover is for many a new and challenging communicative practice.

Factors affecting communication in emergency departments: doctors and nurses' perceptions of communication in a trilingual ED in Hong Kong.

Background: This study investigates clinicians' views of clinician-patient and clinician-clinician communication, including key factors that prevent clinicians from achieving successful communication in a large, high-pressured trilingual Emergency Department (ED) in Hong Kong.

Methods: Researchers interviewed 28 doctors and nurses in the ED. The research employed a qualitative ethnographic approach.

A resource for teaching emergency care communication.

Background: Communication in emergency departments (EDs), often between several health professionals and patients and relatives, is a major cause of patient complaint and error; however, communication-skills teaching for medical students largely focuses on individual clinician-patient interactions.

Context: We developed and implemented an evidence-informed online resource, Communication for Health in Emergency Contexts (CHEC; http://www.chec.

Communication in Hong Kong Accident and Emergency Departments: The Clinicians' Perspectives.

In this article, we report findings from the first qualitatively driven study of patient-clinician communication in Hong Kong Accident and Emergency Departments (AEDs). In light of the Hong Kong Hospital Authority's policy emphasis on patient-centered care and communication in the public hospitals it oversees, we analyze clinicians' perceptions of the role and relevance of patient-centered communication strategies in emergency care. Although aware of the importance of effective communication in emergency care, participants discussed how this was frequently jeopardized by chronic understaffing, patient loads, and time pressures.

The International Charter for Human Values in Healthcare: an interprofessional global collaboration to enhance values and communication in healthcare.

Objectives: The human dimensions of healthcare--core values and skilled communication necessary for every healthcare interaction--are fundamental to compassionate, ethical, and safe relationship-centered care. The objectives of this paper are to: describe the development of the International Charter for Human Values in Healthcare which delineates core values, articulate the role of skilled communication in enacting these values, and provide examples showing translation of the Charter's values into action.

Methods: We describe development of the Charter using combined qualitative research methods and the international, interprofessional collaboration of institutions and individuals worldwide.

Clinical handover as an interactive event: informational and interactional communication strategies in effective shift-change handovers.

Clinical handover -- the transfer between clinicians of responsibility and accountability for patients and their care (AMA 2006) -- is a pivotal and high-risk communicative event in hospital practice. Studies focusing on critical incidents, mortality, risk and patient harm in hospitals have highlighted ineffective communication -- including incomplete and unstructured clinical handovers -- as a major contributing factor (NSW Health 2005; ACSQHC 2010). In Australia, as internationally, Health Departments and hospital management have responded by introducing standardised handover communication protocols.