Sarah E Shannon

Sarah E Shannon
University of Washington Seattle | UW · Department of Biobehavioral Nursing and Health Systems

PhD, RN

About

74
Publications
300,434
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
32,891
Citations
Citations since 2016
5 Research Items
24240 Citations
201620172018201920202021202201,0002,0003,0004,000
201620172018201920202021202201,0002,0003,0004,000
201620172018201920202021202201,0002,0003,0004,000
201620172018201920202021202201,0002,0003,0004,000
Additional affiliations
January 2010 - present
January 1997 - present
University of Washington Seattle

Publications

Publications (74)
Article
Background: Unresolved conflicts in health care threaten both clinician morale and quality of patient care. We piloted a training model that targeted clinicians' conflict resolution skills. Methods: Sixty clinicians from local hospitals were randomized into an intervention group (n = 30), completing a 3-hour conflict resolution training session,...
Data
A. Interprofessional Error Disclosure Module folder B. Error Disclosure Faculty Facilitators Guide.docx C. Profession-Specific Cases.docx D. Error Disclosure Pocket Cards.pdf E. Error Disclosure Slides.pptx
Article
Full-text available
National guidelines call for health care organizations to provide around-the-clock coaching for medical error disclosure. However, frontline clinicians may not always seek risk managers for coaching. As part of a demonstration project designed to improve patient safety and reduce malpractice liability, we trained multidisciplinary disclosure coache...
Article
We examined health care conflicts through interviews with health care leaders, providers, and patients. Ninety-two medical providers, nurses, technologists, hospital leaders, and patients/families shared 156 conflict stories. We identified individual, interpersonal, and organizational factors contributing to interprofessional conflicts. Individual...
Article
Background: We conducted a randomized trial of a simulation-based multisession workshop to improve palliative care communication skills (Codetalk). Standardized patient assessments demonstrated improved communication skills for trainees receiving the intervention; however, patient and family assessments failed to demonstrate improvement. This arti...
Article
Background: Communication among doctors, nurses, and families contributes to high-quality end-of-life care, but is difficult to improve. Objective: Our objective was to identify aspects of communication appropriate for interventions to improve quality of dying in the intensive care unit (ICU). Methods: This observational study used data from a...
Article
Rationale: Communication with family of critically-ill patients is often poor and associated with family distress. Objectives: To determine if an ICU communication facilitator reduces family distress and intensity of end-of-life care. Methods: We conducted a randomized trial at two hospitals. Eligible patients had a predicted mortality >30% an...
Article
Examined as an isolated situation, and through the lens of a rare and feared disease, Mr. Duncan's case seems ripe for second-guessing the physicians and nurses who cared for him. But viewed from the perspective of what we know about errors and team communication, his case is all too common. Nearly 440,000 patient deaths in the U.S. each year may b...
Article
Full-text available
Guidelines call for healthcare organizations to provide emotional support for clinicians involved in adverse events, but little is known about how these organizations seek to meet this need. We surveyed US members of the American Society for Healthcare Risk Management (ASHRM) about the presence, features, and perceived efficacy of their organizatio...
Article
Communication about end-of-life care is a core clinical skill. Simulation-based training improves skill acquisition, but effects on patient-reported outcomes are unknown. To assess the effects of a communication skills intervention for internal medicine and nurse practitioner trainees on patient- and family-reported outcomes. Randomized trial condu...
Article
Full-text available
Background: Communication with patients and families is an essential component of high-quality care in serious illness. Small-group skills training can result in new communication behaviors, but past studies have used facilitators with extensive experience, raising concerns this is not scalable. Objective: The objective was to investigate the ef...
Article
Objectives: Although studies have shown regional and interhospital variability in the intensity of end-of-life care, few data are available assessing variability in specific aspects of palliative care in the ICU across hospitals or interhospital variability in family and nurse ratings of this care. Recently, relatively high family satisfaction wit...
Article
The intensive care unit (ICU), where death is common and even survivors of an ICU stay face the risk of long-term morbidity and re-admissions to the ICU, represents an important setting for improving communication about palliative and end-of-life care. Communication about the goals of care in this setting should be a high priority since studies sug...
Article
Background: One in fi ve deaths in the United States occurs in the ICU, and many of these deaths are experienced as less than optimal by families of dying people. The current study investigated the relationship between family satisfaction with ICU care and overall ratings of the quality of dying as a means of identifying targets for improving end-...
Chapter
Practitioners face many barriers to disclosing errors to patients, including embarrassment, fear of litigation, and minimal training in how to discuss them. Efforts at teaching error disclosure skills often focus on a one-on-one doctor–patient interaction and neglect the inter-professional context. This chapter describes research conducted at the U...
Article
This article provides findings on the role of the nurse in simulated team-based error disclosures. Triangulation of 3 qualitative data sets revealed that a tension exists for nurses in the error disclosure process as they attempt to balance professional boundaries. Study findings point to multilevel strategies including cultural, structural, and ed...
Article
Full-text available
Communication skills are the key for quality end-of-life care including in the critical care setting. While learning general, transferable communication skills, such as therapeutic listening, has been common in nursing education, learning specific communication tools, such as breaking bad news, has been the norm for medical education. Critical care...
Conference Paper
Purpose: The purpose of this study was to describe and explore organizational factors that support nurses’ supervision of nursing assistants, from the perspectives of nursing home management, staff nurses, and nursing assistants. The presentation will highlight the challenges confronted and the strategies applied to protect human subjects in the re...
Article
Full-text available
Because of high mortality, end-of-life care is an important component of intensive care. We evaluated the effectiveness of a quality-improvement intervention to improve intensive care unit (ICU) end-of-life care. We conducted a cluster-randomized trial randomizing 12 hospitals. The intervention targeted clinicians with five components: clinician ed...
Article
Multiple-choice exams are not well suited for assessing communication skills. Standardized patient assessments are costly and patient and peer assessments are often biased. Web-based assessment using video content offers the possibility of reliable, valid, and cost-efficient means for measuring complex communication skills, including interprofessio...
Article
Despite the call for open and team-based approaches to error disclosure, the participation beyond physicians and managers is not a common practice in health care settings. Moreover, within the growing literature base on error disclosure, team-based error disclosure is an emerging concept. To address this knowledge gap, a study was undertaken to exp...
Article
The aim of this paper was to increase international collaboration on end of life care (EoLC) in critical care. Objectives included highlighting key challenges for critical care nurses in EoLC through a transcribed interview between a clinician, an educationalist and a researcher who all hold an EoLC focus. EoLC continues to hold high profile within...
Article
Clinicians often feel challenged by the need to deliver difficult prognostic information to patients with a life-limiting illness while, at the same time, support their hopes. Few studies have examined nurses' perspectives on their roles in meeting these patient and family needs. Our objectives were to 1) describe nurses' perspectives on meeting pa...
Article
Full-text available
This study was designed to identify nurses' perspectives on nursing skills that are important yet under-utilized in end-of-life care. A 45-item survey was administered to nurses (n = 717) in four U.S. states with a response rate of 79%. We identified skills that were endorsed by more than 60% of nurses as extremely important and also endorsed as no...
Article
Full-text available
After-death surveys are an important source of information about the quality of end-of-life care, but response rates generally are low. Our goal was to understand the potential for nonresponse bias in survey studies of family members after a patient's death in the hospital ICU by identifying differences in patient demographics and delivery of palli...
Article
Disclosure of medical errors has been conceptualized as occurring primarily in the physician-patient dyad. Yet, health care is delivered by interprofessional teams, in which nurses share in the culpability for errors, and hence, in responsibility for disclosure. This study explored nurses' perspectives on disclosure of errors to patients and the or...
Article
Nursing supervision of the routine daily care (e.g., grooming, feeding, and toileting) that is delegated to unlicensed assistive personnel (UAP) is critical to nursing home service delivery. The conditions under which the supervisory role is organized and operationalized at the work-unit level, taking into account workloads, registered nurse/licens...
Article
Classic trajectories of illness at end of life (EOL) suggest different care needs for patients with cancer versus chronic obstructive pulmonary disease (COPD) and may lead to different experiences of transitions over the course of a life-limiting illness. Patients may experience transitions in different ways than clinicians. No prior studies have e...
Article
Full-text available
Palliative care in the intensive care unit (ICU) is an important focus for quality improvement. To evaluate the effectiveness of a multi-faceted quality improvement intervention to improve palliative care in the ICU. We performed a single-hospital, before-after study of a quality-improvement intervention to improve palliative care in the ICU. The i...
Article
RD, a seventy-year old man, fell in his home several weeks ago and did not receive assistance for four days, causing pressure sores to develop on his body. He also has multiple chronic illnesses, including diabetes, hypertension, obstructive pulmonary disease, and dementia. After judging him too weak to care for himself, RD's doctors tried placing...
Article
Full-text available
The aim of this study was to identify inherent tensions that arose during family conferences in the intensive care unit, and the communication strategies clinicians used in response. We identified 51 clinician-family conferences in the intensive care unit from 4 hospitals in which the attending physician believed discussion of withdrawing life-sust...
Article
Full-text available
Competent patients' refusals of nursing care do not yet have the legal or ethical standing of refusals of life-sustaining medical therapies such as mechanical ventilation or blood products. The case of a woman who refused turning and incontinence management owing to pain prompted us to examine these situations. We noted several special features: la...
Article
A large proportion of deaths in the United States occur in the intensive care unit (ICU) or after a stay in the ICU, and there is evidence of problems in the quality of care these patients and their families receive. In an effort to respond to this problem, we developed a multifaceted, nurse-focused, quality improvement intervention that is based o...
Article
Attempts to improve end-of-life care increasingly focus on family-centered care, but few validated assessment tools exist. To evaluate 3 new short questionnaires measuring nurses' perspectives on family-centered end-of-life care in the intensive care unit and to show the usefulness of the questionnaires. Principal components analysis of data from 1...
Article
14 HASTINGS CENTER REPORT March-April 2006 M s. Winnow is a fifty-year-old morbidly obese Hawaiian woman with a history of diabetes, hypotension, and chronic atrial fibrillation. She was recently hospitalized with acute kidney failure as a side effect of being treated with the antibiotic gentamicin, and has developed large skin ulcerations resultin...
Article
Full-text available
Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The majo...
Article
Full-text available
Improved communication with family members of critically ill patients can decrease the prolongation of dying in the intensive care unit (ICU), but few data exist to guide the conduct of this communication. Our objective was to identify missed opportunities for physicians to provide support for or information to family during family conferences. We...
Article
Family members of critically ill patients report dissatisfaction with family-clinician communication about withdrawing life support, yet limited data exist to guide clinicians in this communication. The hypothesis of this analysis was that increased proportion of family speech during ICU family conferences would be associated with increased family...
Article
Nurse educators have identified lack of end-of-life content as a serious deficit in undergraduate nursing education. TNEEL, a new software program with tools for teaching end-of-life topics, was created to help educators overcome this problem. The authors implemented an experiential workshop to help educators learn how to use TNEEL's wide variety o...
Article
This study addressed the emotional and personal needs of dying patients and the ways physicians help or hinder these needs. Twenty focus groups were held with 137 individuals, including patients with chronic and terminal illnesses, family members, health care workers, and physicians. Content analyses were performed based on grounded theory. Emotion...
Article
This study addressed the emotional and personal needs of dying patients and the ways physicians help or hinder these needs. Twenty focus groups were held with 137 individuals, including patients with chronic and terminal illnesses, family members, health care workers, and physicians. Content analyses were performed based on grounded theory. Emotion...
Article
This study investigated the specific physician skills required to interact with health care systems in order to provide high quality care at the end of life. We used focus groups of patients with terminal diseases, family members, nurses and social workers from hospice or acute care settings, and physicians. We performed content analysis based on g...
Article
From an online survey of current technological capabilities of US undergraduate nursing programs, we found almost universal use of Microsoft Windows-based computers and Microsoft Office Suite software. Netscape and Microsoft Internet Explorer were the most popular browsers for Internet access. The survey also assessed faculty preferences for end-of...
Article
From an online survey of current technological capabilities of US undergraduate nursing programs, we found almost universal use of Microsoft Windows-based computers and Microsoft Office Suite software. Netscape and Microsoft Internet Explorer were the most popular browsers for Internet access. The survey also assessed faculty preferences for end-of...
Article
Family-clinician communication in the intensive care unit (ICU) about withholding and withdrawing life support occurs frequently, yet few data exist to guide clinicians in its conduct. The purpose of this study was to develop an understanding of the way this communication is currently conducted. We identified family conferences in the ICUs of 4 Sea...
Article
Patients' views of physician skill in providing end-of-life care may vary across different diseases, and understanding these differences will help physicians improve the quality of care they provide for patients at the end of life. The objective of this study was to examine the perspectives of patients with COPD, cancer, or AIDS regarding important...
Article
To overcome insufficient attention to end-of-life (EOL) care in nursing education, the authors are developing the "Toolkit for Nursing Excellence at End-of-Life Transition" (TNEEL). An evidence-based design process was used to create a computerized (CD-ROM) multimedia toolkit of instructional aides. An online survey of all U.S. undergraduate nursin...
Article
To compare patient, nurse, and physician assessments of quality of care and patient satisfaction in selected critical care units. As part of a study of patient outcomes from critical care, data were collected between December 1991 and March 1993 from 489 patients, 518 nurses, and 515 physicians in 25 critical care units located in 14 hospitals in t...
Article
In replyWe appreciate Dr Reinharth's thoughtful comments concerning why physicians might find communicating with dying patients difficult. Dr Reinharth comments that physicians' fear of patient and/or family anger directed at them may be an additional reason that physicians find communicating with dying patients difficult. One of the investigators...
Article
Full-text available
Efforts to improve communication between physicians and dying patients have been unsuccessful, and guidelines for improving patient-physician communication about end-of-life care are based primarily on expert opinion. This study assessed which aspects of communication between patients and physicians are important in end-of-life care. Twenty focus g...
Article
The intensive care unit (ICU) represents a hospital setting in which death and discussion about end-of-life care are common, yet these conversations are often difficult. Such difficulties arise, in part, because a family may be facing an unexpected poor prognosis associated with an acute illness or exacerbation and, in part, because the ICU orienta...
Article
A framework for understanding and evaluating physicians' skills at providing end of life care from the perspectives of patients, families, and health care workers will promote better quality of care at the end of life. To develop a comprehensive understanding of the factors contributing to the quality of physicians' care for dying patients. Qualita...
Article
BACKGROUND: A framework for understanding and evaluating physicians’ skills at providing end-of-life care from the perspectives of patients, families, and health care workers will promote better quality of care at the end of life. OBJECTIVE: To develop a comprehensive understanding of the factors contributing to the quality of physicians’ care for...
Article
Public demand and professional standards dictate that primary care providers must be prepared to offer guidance and advance care planning for end-of-life decision-making to their patients. The purpose of this study was to describe the relationship between nurse practitioners' (NPs) knowledge of legal guidelines for end-of-life decision-making, thei...
Article
Patient perceptions are increasingly used to measure quality of care in a diversity of health-care delivery settings. The goals of this article are to review the current use of patient perceptions and to review what is known about the sensitivity of patient perceptions for discerning variations in care across delivery systems. This article first pr...
Article
Caring in Crisis: An Oral History of Critical Care Nursing. ZalumasJacqueline [Studies in Health, Illness, and Caregiving Series. LynaughJoan E., Gen. Ed.] Philadelphia, PA: University of Pennsylvania Press, 1995. 212 pp. - Volume 5 Issue 1 - Sarah E. Shannon
Article
Organizational structure and process are thought to affect patient care outcomes beyond the effects of expert clinical care. To test the hypothesis that a discretionary pattern of organizational structure and process factors is predictive of critical care unit performance, ie, desirable patient and organizational outcomes. Quality-of-care patient a...
Article
Thesis (Ph. D.)--University of Washington, 1992 Decisions to withhold or withdraw therapy precede about half of all patient deaths in critical care. The purpose of this study was threefold: (a) to describe the lived experience of caring for critically-ill patients receiving life-sustaining therapy, (b) to examine the normative literature regarding...

Network

Cited By