Implementation of a bad news communication protocol in nursing: Impact on communication skills

To assess the impact of implementing a Bad News Communication Protocol (BNCP) on nurses' communication skills, patients'/families' perceived communication quality, and the frequency of communication-related hospital conflicts.

Quasi-experimental pretest-posttest study with 247 nurses at a secondary-level hospital. Communication skills were measured using a 5-point Likert questionnaire (α = 0.89). Patients'/families' perception was assessed with 356 structured 5-point Likert surveys (pre = 178; post = 178). Communication-related conflicts were extracted from institutional complaint and internal-report records six months before and after implementation. Paired t-tests, Chi-square tests, and ANOVA were used.

Communication-skills scores increased from 2.8 ± 0.9 to 4.2 ± 0.7 (t = 15.87; p < 0.001). In patients'/families' perception, "poor" decreased from 18.5% to 5.6%, "fair" from 28.7% to 6.7%, "good" rose from 34.3% to 44.9%, and "excellent" from 18.5% to 42.7% (χ² = 36.21; p < 0.001). Communication-related conflicts dropped from 78 to 29 (-62.8%; p < 0.001).

BNCP implementation improved nurses' communication skills, enhanced patients'/families' perception, and reduced conflicts. Embedding structured communication protocols in nursing continuing education may enhance care quality.