During the last year, nurses have experienced extreme stress, with one study of over 1200 nurses reporting 71% experienced psychological distress, 50% depression, and 44% anxiety (APNA Issue Brief, 2020). Those at greatest risk include nurses treating COVID-19 patients, young in age, female, history of mental challenges or traumatic events, and lack of coping skills (APNA Issue Brief, 2020). Another study reported 64% of nurses had experienced acute stress disorder, placing them at risk for post-traumatic stress disorder (Shahrour & Dardas, 2020). Nurse leaders must anticipate these mental health challenges and promote wellness and resilience. A compassionate culture can improve the overall physical well-being of our employees, increase employee retention, reduce burnout, and positively impact the patient experience. Compassion is inversely correlated with burnout and positively correlated with workforce well-being (Lown et al., 2019). Research has also shown empathy and compassion associated with better adherence to medications, decreased malpractice cases, fewer mistakes, and increased patient satisfaction (Lown et al., 2019). Our aim statement was to implement empathetic communication tactics into standard daily work in the acute care service line to increase nurse communication HCAHPS domain score to 81.0 (75th percentile ranking) by April 30, 2021.
Using evidence-based practice, the acute care service line (7 inpatient units, 222 medical/telemetry beds, 4 COVID-19 containment units) within an urban academic level-one hospital implemented empathetic communication techniques that increased resiliency of our team and increased nurse communication HCAHPS domain scores above goal. A compassion campaign, “Compassion Before Action,” was initiated in October 2020, providing education on empathetic communication to the team through daily team huddles. During this month, the team also had a self-compassion weekly activity to engage the team and increase their well-being. The team then started adding empathetic tactics into standard daily work. Beginning with a compassionate connection in which each team member had a goal to make one compassionate connection with each patient daily. In December 2020, we established empathetic communication tactics into bedside shift report, had skills labs, and trained champions to mentor and coach the team. In January, purposeful rounding was incorporated, and empathetic tactic training occurred with patient care technician champions. Nurse leader rounding was utilized to hardwire the practice of compassionate connection, and charge nurses, supervisors, and nurse managers were trained in this skill.
The team set the goal of 81.0 for nurse communication HCAHPS domain to reach the 75th percentile. Baseline data from July to October 2020 showed an average score of 77.75. Post-implementation data from November 2020 to April 2021 showed an average score of 81.96, with five of six months being above goal post-implementation. We also had an engagement survey during this period, which resulted in 85% engagement and an increase from the previous engagement survey. The survey also resulted in a 4.34 of 5 engagement rating, indicating the strong resiliency of our team. The project is now being shared across the system as a best practice. This evidence-based implementation improved patient experience and preserved resiliency by building a culture of compassion.