Development of the Medical Intensive Care Unit Shift Report Communication Scale as a measure of nurses' perception of communication

David James,¹ Angela Jukkala,² Andres Azuero,² Pamela Autrey,³ Lynne Vining,⁴ Rebecca Miltner<sup>2

1</sup>Center for Nursing Excellence, University of Alabama at Birmingham Hospital, ²School of Nursing, University of Alabama at Birmingham, ³Nursing Administration, University of Alabama at Birmingham Hospital, ⁴Medical Intensive Care Unit, University of Alabama at Birmingham Hospital, Birmingham, Alabama, USA

Objective: Evidence documenting the negative impact of poor communication on patient safety during intra-hospital transfer is prevalent and attributed to 80% of serious medical errors. An event particularly vulnerable to communication error is the patient "handoff." One of the more common handoffs occurring in health care settings is the report provided between nurses at the change of shift. The objective of this article is to report the process used to develop and examine the reliability and validity of a Medical Intensive Care Unit (MICU) Shift Report Communication Scale to measure nurses' perception of the quality and quantity of communication during shift report.
Design and participants: This was a scale development and descriptive study undertaken at the Medical Intensive Care Unit within an Academic Health Center. Forty-three medical intensive care nurses took part.
Results: An exploratory factor analysis revealed three domains: communication openness, quality of information, and shift report. Medical Intensive Care Unit Shift Report Communication Scale scores ranged from 12 to 27 (mean = 18.78; standard deviation = 3.28). Perception of communication did not vary between nurses based on years of nursing experience or age. Scale reliability was good (Cronbach's alpha = 0.079). Nurses were likely to have had a positive perception of the openness of communication on the unit. However, they had a less favorable perception of peer ability to fully understand information shared during shift report and identified as a common problem the frequent need to review the chart to verify reported information.
Conclusion: The MICU Shift Report Communication Scale may be used to provide useful information to support health care organizations and nurse leaders in the evaluation of nurse communication during shift report. Initial testing indicates that the MICU Shift Report Communication Scale is easy to use; however, additional testing with larger groups of nurses is needed.

Keywords: medical error, patient handoff, patient safety