Communication Competency and Self-efficacy of Nurses in Emergency Departments: A multicenter study

The emergency department is one of the most important departments of the hospital, the performance of which can have a great impact on the activities of other hospital departments. In the emergency room, emergency services are provided to patients at all hours of the day and night, and there is a large number of patients in this ward, which shows the importance of good performance and effective communication between nurses to maintain patient safety and quality of patient care. Nursing is one of the professions that effective communication is one of its pillars and having communication skills is a professional necessity that is necessary for all nurses especially nurses who work in the emergency wards and it is a prerequisite for nursing competency. Nurses’ competent performances in the emergency wards are also affected by their self-efficacies. Thus, in this study, nurses’ competencies and communication self-efficacies were examined.

This cross-sectional study with descriptive design was carried out on the emergency wards of hospitals affiliated to Iran University of Medical Sciences in 2020. In this study, 234 nurses were recruited through census method and they filled questionnaires. Data collection was conducted by using communicative competence scale and self-efficacy questionnaire. Data was analysed via SPSS Software Version 18 by utilizing independent t-test, one way analysis of variance, Pearson correlation coefficient and linear regression.

234 nurses working in emergency departments participated in this study. The response rate of the participants was 100%. According to the results, the mean score of nurses’ communication competency was 141.03 ± 15.09 which was higher than the meidan of the scale (108). The highest average communication competencies related to "let others know that you understand them", "listen to what people say" and "support others" are 0.70, respectively. ± 4.15, 4.15 57 0.57 and 4.15. 0.68. The lowest mean was for the phrase "you do not pay attention to meeting and talking with strangers" (2.32 ± 1.28). The mean score of emergency nurses’ communication self-efficacy was 86.24±22.00 that was slightly higher than the median of the questionnaire (66). What is the highest average communication self-efficacy related to "Have appropriate nonverbal behaviors (such as eye contact, facial expressions, gestures, and gestures) during conversation?" Was. Lowest average for "Make a pre-prepared plan to talk to the patient?" Was. Based upon the regression model, 11% of communication competency among emergency nurses were explained by working hours per week (P=0.001), hospital type (P<0.001) and educational level (P=0.023) and working hours per week with the standard coefficient -0.249 had the most effect on nurses’ communication competencies. Also only 12 percent of nurses’ communication self-efficacy had been explained influenced by working hours per week (P<0.001).

Although the levels of communication competencies and communication self-efficacies of the emergency wards nurses in this study are approximately high, Due to the activity and role of emergency nurses in the front line of the organization, higher levels of communication competency and self-efficacy are expected. Effective communication by health workers, especially nurses, is essential in improving the quality of care and maintaining patient safety. Due to their role, nurses should have extensive communication with patients and other health workers, so communication competence is an important principle in providing nursing care. Owing to the structure of the emergency department and the clients of this department, it is useful and necessary to find the cause and determine the appropriate solutions to bring the communication competency and self-efficacy of emergency nurses to the highest possible level and thus improve quality and safe care. According to the results of the present study, communication competence decreases with increasing working hours. This can be due to fatigue and high work pressure after spending long hours in a stressful emergency environment. The presence of patients in need of immediate and acute care has increased fatigue, which leads to low efficiency of nursing services and endangers the safety of patients. It is necessary to plan for the use of experienced nurses as well as higher and specialized education in the emergency department. However, this does not diminish the importance of increasing the workforce in the emergency departments and reducing the workload of nurses in order to improve the quality of services and improve patient safety. Communication self-efficacy of nurses working in the emergency department was relatively high. The highest communication self-efficacy of the studied nurses was related to having appropriate non-verbal behaviors during the conversation and the lowest communication self-efficacy of the nurses was related to pre-planning for talking to the patient. Self-efficacy is considered as an important indicator of a personchr('39')s confidence in performance, including job performance. A strong sense of self-efficacy increases nurseschr('39') confidence in their performance and knowledge. Nurses who are confident in their abilities in all areas, including effective communication, define their goals and commit to maintaining them.