Principle E

Principle E letterNurses and nursing staff are at the heart of the communication process: they assess, record and report on treatment and care, handle information sensitively and confidentially, deal with complaints effectively, and are conscientious in reporting the things they are concerned about. 


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Principle E focuses on communication, handling feedback, record keeping, reporting and monitoring.

You may find the following commentary article about Principle E a useful starting point for exploring this Principle. It was published by the Nursing Standard as part of an introductory series on the Principles of Nursing Practice:
Casey A, Wallis A (2011) Effective communication: Principle of Nursing Practice E. Nursing Standard 25(32) 13 April pp.35-37 (PDF 563KB) [see how to access PDF files].

Other useful resources are:

A selection of RCN resources which are particularly relevant to Principle E 

The following resources and services produced by the RCN provide guidance and support to people wishing to use the Principles for quality improvement purposes or their own continuing professional development. 

To access any Learning Zone content you will be asked to enter your RCN membership number. If you require assistance with entering the Learning Zone, or would like further information on becoming a member of the RCN please contact RCN Direct on 0345 772 6100.

Clinical governance: information focus: one of the themes in the clinical governance online resource, this signposts key policies, agencies, guidance and tools, including resources on confidentiality, data protection and information governance.

Clinical governance: patient focus: one of the themes in the clinical governance online resource, this signposts key policies, agencies, guidance and tools, including resources on complaints and the informed patient.

Communication tools: this learning area will help nurses to develop communication skills such as: assertiveness, avoiding interruptions; phone management; delegation and learning to say no. 

Telehealth explained: this learning area provides a deeper understanding of what telehealth is all about and the major influence it will have on health care provision in the future. 

Confidentiality: related resources

Information disclosure: this learning area provides information and guidance on confidentiality, consent and sharing patient information. 

The patient record: related resources

Abbreviations and other short forms in patient/client records (2010) (PDF 579KB): this publication is aimed at nursing staff that come into contact with patient/client records. It reflects the RCN position on the use of abbreviations and other short forms in patient/client records, and includes specific guidance on electronic records. 

Consent to create, amend, access and share eHealth records (2010) (PDF 290KB): this publication sets out basic principles, and offers guidance to frontline practitioners involved in making decisions about their own use of electronic patient records, and who have responsibility for explaining the position to patients and helping them to make their decisions. 

eHealth and nursing practice: abbreviations and other short forms in patient/client records (2009): this Policy Unit briefing reflects the RCN position on the use of abbreviations and other short forms in patient/client records, including specific guidance on electronic records.

eHealth Forum community: this is a forum for nurses who are working or interested in the use (collecting, recording, storing, retrieving and sharing) of clinical data and information for the advancement of patient care and nursing. It aims to promote, develop and integrate an awareness of eHealth and health informatics into every area of professional nursing practice, research and education.

Nursing content of eHealth records (2010) (PDF 155KB): this publication discusses the importance of record keeping as an essential element of nursing practice. Six standards are highlighted as being essential for ensuring that electronic records truly reflect nursing care. 

Putting information at the heart of nursing care (2010) (PDF 198KB): this eHealth publication provides an introduction to eHealth for nursing staff. It describes key concepts associated with eHealth, including the electronic patient record. It also explains the importance of eHealth to nursing and why it is vital for nursing staff to get involved. 

Technology and multimedia

eHealth position statement (2012) (PDF 966KB)
The RCN's eHealth position statement covers electronic means of record keeping, giving examples of the benefits of working in this way and using examples of eHealth from throughout the UK. Health and IT systems are now an integral part of professional nursing practice and are used by many nursing staff for managing the large amounts of information generated when caring for patients.

Using technology to complement nursing practice (2012) (PDF 1.1MB): this guidance which introduces a range of guides on using technology to complement nursing practice, provides an overview, covering the broad principles and key issues to consider for safe and effective eHealth services.

Using telephone advice for patients with long-term conditions (2012) (PDF 1.4MB): this guide provides health care practitioners with an initial framework for building or redesigning a telephone advice service.

Using text messaging services (2012) (PDF 723.6KB): this guide raises awareness about the complex issues around using text messaging on mobile phones such as using text to mail software system to ensure a documentation trail and provides guidance for writing a policy.

Developing and using websites (2012) (PDF 941.1KB): this publication provides guidance on what needs to be considered in developing and using websites or providing a web service, including tips for creating a good website.

Using telehealth to monitor patients remotely (2012) (PDF 2.9MB): this guide looks at using technology to complement nursing practice, including information about different types of information being transmitted and on designing a remote monitoring service. 

Raising concerns: related resources

Whistle blowing hotline: This is an additional service for RCN members who have urgent concerns over clinical and staff safety in the workplace. It is important that health care professionals raise concerns directly with their employer. Registered nurses have a duty under the NMC to report concerns where patient care may be affected.

Raising concerns, raising standards: Safe, compassionate care is everyone's business. Raising and responding to concerns is something that we should all be comfortably able to do. But we know that being able to speak out is not always as easy as it sounds. These pages build on previous guidance issued by the RCN, providing information to help you raise concerns wherever you work - in the NHS or independent sector.

For further RCN publications see Publications and research

RCN library and heritage services e-library: provides a range of resources that RCN members can access for further information. These include full text journals, databases, e-books and Fast searches which are up-to-date searches on frequently asked selected topics.