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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. Design: A pre‐ and post evaluation study involving a questionnaire survey before and after the 3‐hours training. Methods: Forty‐nine randomly selected bilingual nurses with no previous professional development experience in handover communication were trained according to the CARE protocol, and their perceptions of nursing handovers were assessed before and after training using questionnaire. The STROBE checklist is used (See File S1). Results: Training of the CARE protocol improved key areas of the handover process. All participating nurses exhibited significant improvements in their perceptions of effective handover from before to after training. Particularly, improvements were observed in the interactive frequency and quality and completeness of the presented patient information per handover. Conclusions: The nurses reported a deeper understanding of their perceptions of handover after a patient‐centred intervention, a better quality of interactions (e.g., querying and checking by incoming nurses), a greater focus when managing handovers and a more complete and comprehensive transfer of information between nurses. Relevance to clinical practice: CARE protocol‐based training yielded significant improvements in nursing handover practice. [ABSTRACT FROM AUTHOR]

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. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication. Design A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview. Methods Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis. Results Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a consultation. Conclusion The findings reveal that the quality of communication in this Hong Kong emergency department is compromised by specific factors inherent in the linguistic complexity of Hong Kong emergency departments. These factors include the constant translation of medical information, inadequate documentation of medical information and significant professional and cultural pressures. Each of these issues increases the likelihood that healthcare communication will be difficult, incomplete or incorrect. This research provides empirical evidence for, and justifies the development of, an effective framework to enable clinicians to overcome communication challenges. Relevance to clinical practice The findings of this study may shed light on the unique conditions faced by clinicians, particularly in relation to communication, in the complex trilingual healthcare context of an emergency department similar to those in Hong Kong, and provide potential policy solutions for barriers to improve communication in such settings. [ABSTRACT FROM AUTHOR]

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. The interviews were audio-recorded, transcribed, translated into English and coded using the Nvivo software. The researchers examined issues in both clinician-patient and clinician-clinician communication. Through thematic analyses, they identified the factors that impede communication most significantly, as well as the relationship between these factors. This research highlights the significant communication issues and patterns in Hong Kong EDs. Results: The clinician interviews revealed that communication in EDs is complex, nuanced and fragile. The data revealed three types of communication issues: (1) the experiential parameter (i.e. processes and procedures), (2) the interpersonal parameter (i.e. clinicians' engagements with patients and other clinicians) and (3) contextual factors (i.e. time pressures, etc.). Within each of these areas, the specific problems were the following: compromises in knowledge transfer at key points of transition (e.g. triage, handover), inconsistencies in medical record keeping, serious pressures on clinicians (e.g. poor clinician-patient ratio and long working hours for clinicians) and a lack of focus on interpersonal skills. Conclusions: These communication problems (experiential, interpersonal and contextual) are intertwined, creating a complex yet weak communication structure that compromises patient safety, as well as patient and clinician satisfaction. The researchers argue that hospitals should develop and implement best-practice policies and educational programmes for clinicians that focus on the following: (1) understanding the primary causes of communication problems in EDs, (2) accepting the tenets and practices of patient-centred care, (3) establishing clear and consistent knowledge transfer procedures and (4) lowering the patient-to-clinician ratio in order to create the conditions that foster successful communication. The research provides a model for future research on the relationship between communication and the quality and safety of the patient safety. [ABSTRACT FROM AUTHOR]