Improving Communication and Workflow Among Advanced Practice Providers and Nurses on Nightshift in an Intensive Care Unit

Problem Statement: There is often a lack of streamlined communication on nightshift among the reduced care team in acute care settings. The absence of organized collaboration and shared decision-making contributes to strained professional relationships between the advanced practice provider (APP) and the nurse. Purpose: Nightly provider-nurse bedside rounds were implemented in a 21-bed cardiovascular intensive care unit (CVICU) using a goal sheet to improve communication among the APPs and nurses. Methods: A pretest-posttest design in which surveys were used in this quality improvement (QI) project to determine perceptions of communication between APPs and nurses. Inclusion Criteria: All APPs and rotating shift or nightshift nurses in the CVICU. Exclusion Criteria: Nurses who work dayshift and nurses on orientation were prohibited from participating. Analysis: The pre- and post-intervention subscales of the survey (perception of collaboration, perception of workflow, and perception of communication) were examined with Analysis of Variance (ANOVA) for nurses and APPs. Results: Improvement in the mean values of all subscales from both samples was noted. Significant improvements were identified in the collaboration subscale among APPs (P = 0.01) and nurses (P = 0.01). Significant improvement was found in the workflow subscale (P = 0.0004) among nurses, but not among APPs. There was no statistical significance in the communication subscale for either group. Conclusion: The implementation of provider-nurse bedside rounds utilizing a goal sheet on nightshift in the CVICU improved the perception of collaboration, workflow, and communication among both samples