Structured intervention in nursing communication and cohesion: an exploratory pilot study in a community care unit
DOI:
https://doi.org/10.29352/mill0231.45879Keywords:
communication; social cohesion; organizational culture; safetyAbstract
Introduction: Interprofessional communication is a cornerstone of patient safety, requiring structured strategies to strengthen healthcare team cohesion.
Objective: To evaluate the feasibility and impact of a structured intervention on the perception of communication competencies and cohesion within a nursing team.
Methods: An exploratory pilot study with a quantitative approach was conducted in a Community Care Unit (n=4). The intervention included three team-building sessions (based on the TeamSTEPPS model) and the implementation of daily briefings (SBAR framework) over seven months. Data were collected using the ICHS scale at two time points (T0 and T1). Analyses focused on effect size (Cohen’s d) and intervention fidelity assessed through a documentary audit.
Results: Positive changes were observed in the total ICHS score, with a substantial effect size (d = 0.73). The “Leadership” dimension showed the greatest impact (d = 0.70), reflecting increased professional agency and care coordination. The “Teamwork” dimension remained stable at high levels (M=3.95), suggesting a ceiling effect in experienced teams. Adherence to the daily briefings was 88.1%, confirming the intervention’s feasibility.
Conclusion: This exploratory pilot study suggests that the intervention may be feasible and clinically relevant, potentially enhancing nurses' professional agency. Given the small sample size, these preliminary findings should be confirmed by future multicenter studies aimed at consolidating structured communication in primary care.
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Aaberg, O. R., Ballangrud, R., Husebø, S. I. E., & Hall-Lord, M. L. (2025). An interprofessional team training intervention with an implementation phase in a surgical ward: A controlled quasi-experimental study. Journal of Interprofessional Care, 39(1), 57–66. https://doi.org/10.1080/13561820.2019.1697216
Alhur, A., Alhur, A. A., Al-Rowais, D., Asiri, S., Muslim, H., Alotaibi, D., Al-Rowais, B., Alotaibi, F., Al-Hussayein, S., Alamri, A., Faya, B., Rashoud, W., Alshahrani, R., Alsumait, N., & Alqhtani, H. (2024). Enhancing Patient Safety Through Effective Interprofessional Communication: A Focus on Medication Error Prevention. Cureus. 16(4). https://doi.org/10.7759/cureus.57991
Ashour, H. M. A. A. A., Abou Hashish, E. A. O., & Awad, N. H. A. (2025). From awareness to action: investigating the impact of bigfive teamwork model awareness on rationing of nursing care and patient-centered care. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-02711-y
Bragadóttir, H., Kalisch, B. J., Flygenring, B. G., & Tryggvadóttir, G. B. (2023). The Relationship of Nursing Teamwork and Job Satisfaction in Hospitals. SAGE Open Nursing, 9. https://doi.org/10.1177/23779608231175027
Brás, C. P. da C., Ferreira, M. M. C., & Figueiredo, M. do C. A. B. de. (2023). Construção e validação da Escala de Comunicação Interprofissional em Saúde. Revista Brasileira de Enfermagem, 76(3). https://doi.org/10.1590/0034-7167-2022-0483pt
Carrapiço, E. I. do N., Correia, A. R. S., & Monteiro, B. R. (2025). Desenvolvimento da Governação Clínica e de Saúde: Cuidados de Saúde Primários na Região de Lisboa e Vale do Tejo. Ciência & Saúde Coletiva, 30(7). https://doi.org/10.1590/141381232025307.21562024
Curșeu, P. L., van Rijswijk, J., & Schruijer, S. G. L. (2025). Collaborative and shared leadership dynamics in healthcare action teams: A systematic literature review. Journal of Healthcare Leadership (Vol. 17, pp. 877–899). https://doi.org/10.2147/JHL.S520534
Dalla Nora, C. R., Schaefer, R., & Neves-Amado, J. (2018). Nurses’ practices in the context of primary healthcare in Portugal. Journal of Research in Nursing, 23(6), 520–532. https://doi.org/10.1177/1744987118788728
Dietl, J. E., Derksen, C., Keller, F. M., & Lippke, S. (2023). Interdisciplinary and interprofessional communication intervention: How psychological safety fosters communication and increases patient safety. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1164288
Fernandes, V., Contente, A. C., Guerreiro, I., Guerreiro, H., Gouveia, M. J., & Melo, M. F. (2021). Liderança e satisfação na equipa de enfermagem: revisão narrativa. Gestão e Desenvolvimento, 29(2021), 465–482. https://doi.org/10.34632/gestaoedesenvolvimento.2021.10226
Friederich, C., Schulte-Unetrop, L., Cenaj, D., Kröger, L. F., Küllmei, J., Zöllner, C., & Moll-Khosrawi, P. (2025). The Creation of Shared Mental Models in Simulation Training Enhances Quality of Resuscitation: A Randomized Controlled Study. Journal of Medical Education and Curricular Development, 12. https://doi.org/10.1177/23821205251316749
Haugstetter, M., Hines, S., Sousane, Z., & Mossburg, S. (2024). Revising TeamSTEPPS: The Evolution of Patient Safety Teamwork Training. https://shre.ink/GSCq
Hills, L. (2025). The Psychologically Safe Healthcare Team. Healthcare Administration Leadership & Management Journal, 3(3), 124–133. https://doi.org/10.55834/halmj.8725686881
Inês, A., & Pacheco, F. (2021). A influência da eficácia da liderança percebida no desempenho da equipa de enfermagem em contextos hospitalares. [Dissertação de Mestrado, Universidade da Beira Interior]. Repositório da Universidade da Beira Interior. https://abrir.link/kCJUI
Kanno, N. de P., Peduzzi, M., Germani, A. C. C. G., Soárez, P. C. De, & Silva, A. T. C. da. (2023). Interprofessional collaboration in primary health care from the perspective of implementation science. Cadernos de Saúde Pública, 39(10). https://doi.org/10.1590/0102-311xen213322
Gleeson, L., O’Brien, G. L., O’Mahony, D., & Byrne, S. (2023). Interprofessional communication in the hospital setting : a systematic review of the qualitative literature. In Journal of Interprofessional Care (Vol. 37, Number 2, pp. 203–213).
Taylor and Francis Ltd. https://doi.org/10.1080/13561820.2022.2028746 Marques, S. F. (2025). Um novo modelo organizacional de proximidade? Unidade Integrada de Cuidados na Comunidade (UICC). JustNews. https://shre.ink/GSCt
Mujuru, C., & Peisah, C. (2024). Beyond error: A qualitative study of human factors in serious adverse events. Journal of Healthcare Risk Management: The Journal of the American Society for Healthcare Risk Management, 44(2), 7–13. https://doi.org/10.1002/jhrm.21583
Neves, M. (2012). O papel dos enfermeiros na equipa multidisciplinar em Cuidados de Saúde Primários – Revisão sistemática da literatura. Revista de Enfermagem Referência, III Série (no 8), 125–134. https://doi.org/10.12707/RIII11124
Pimentel, C. B., Snow, A. L., Carnes, S. L., Shah, N. R., Loup, J. R., Vallejo-Luces, T. M., Madrigal, C., & Hartmann, C. W. (2021). Huddles and their effectiveness at the frontlines of clinical care: a scoping review. Journal of General Internal Medicine, 36(9), 2772–2783. https://doi.org/10.1007/s11606-021-06632-9
Ribeiro, H. C. T. C., Pardini, R. D., da Silva, J., Menezes, A. C., Franco, E. C. D., da Mata, L. R. F., & Campos, C. G. (2021). Patient safety in primary health care: the perceptions of professionals working in family health teams. Revista de Enfermagem Referencia, 5(6). https://doi.org/10.12707/RV20082
Silva, C., Santos, D., Morais, J., Dias, R., Oliveira, S., & Figueiredo, S. (2024). Impacto das estratégias de comunicação do enfermeiro gestor nos ambientes de trabalho em enfermagem. Millenium - Journal of Education, Technologies, and Health, 2(16e), e37492. https://doi.org/10.29352/mill0216e.37492
Souza, M. B., & Sá, A. B. (2013). Trabalho em equipe na atenção primária: a experiência de Portugal. Rev Panam Salud Publica, 33(3), 190–195. https://shre.ink/GSCe
Stychno, E., & Kulczycka, K. (2023). Communication in Medical Teams: a Literature Review. Teka Komisji Prawniczej PAN Oddział w Lublinie, 16(2), 537–548. https://doi.org/10.32084/tkp.6863
Weller, J. M., Mahajan, R., Fahey-Williams, K., & Webster, C. S. (2024). Teamwork matters: team situation awareness to build highperforming healthcare teams, a narrative review. In British Journal of Anaesthesia (Vol. 132, Number 4, pp. 771–778). Elsevier Ltd. https://doi.org/10.1016/j.bja.2023.12.035
World Health Organization. (2023). Global Patient Safety Action Plan 2021-2023. https://shre.ink/GSCM
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