Practical nursing clinical (online help)
Jack Fowler
PNC121StudentPPT-Week32221.ppt.pptxCommunication in Clinical Practice
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Patient and Family Centred Care
It is important to acknowledge that patient- and family-centred care focuses on the whole person as a unique individual and not just on their illness or disease.
In viewing the individual through this lens, health-care providers come to know and understand the person’s life story, experience of health, the role of family in the person’s life, and the role they may play in supporting the person to achieve health.
Potter & Perry, 2019
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Data Collection
First step in nursing process is assessment
Nurses collect pertinent data about the client’s health or situation.
This includes information from the nursing health history and physical assessment
Potter & Perry, 2019
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Sources of Data
Primary
Secondary
Tertiary
Potter & Perry, 2019
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Nursing Interview - Purpose
Obtain a nursing health history, identify health problems and risk factors
Reason for seeking care
Patient’s perception of the illness
Provides subjective data
Why is this important?
Potter & Perry, 2019
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Phases of an Interview
Orientation – introduction and purpose of interview
Working - gather information, observe verbal and non-verbal behaviour
Termination – end interview
Potter & Perry, 2019
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Questioning Techniques – Open-ended Questions
Explore broader issues
Invite longer answers
Encourage patients to discuss and elaborate
Identify patient’s priorities
Potter & Perry, 2019
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Questioning Techniques – Closed-ended Questions
Can be answered with a yes or no
Do not invite discussion
No additional information is required
Potter & Perry, 2019
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Nursing and Cultural Diversity
What are the challenges in cross cultural communication?
What strategies can we use to overcome them?
Potter & Perry, 2019
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Nurse-Client Interviews with Patients with Special Needs
Our duty to elicit the information
Must adapt communication so that the patient can understand it and we can understand the answers
Think of some examples and how we can ensure the message is received and understood, and we receive and understand the answer
Potter & Perry, 2019
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Components of a Health History Interview
Nursing Health History – subjective data
Family History
Documentation of findings
Physical Examination – objective data
Potter & Perry, 2019
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How to Observe during the Interview
Use your senses
Notice general appearance
Observe body language
Notice interaction patterns
Think holistically (physical, psychosocial, emotional, spiritual, etc.)
Be present, be fully there!
Potter & Perry, 2019
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Professional Communication among Health Care Workers
Communication problems among healthcare personnel have been implicated as a cause of most client errors
Poor communication between nurses and physicians was the most importance factor causing dissatisfaction with working relationships
Ontario’s Bill 168, OHSA prevents disruptive behaviours in workplaces, supported by CAN and CFNU
Potter & Perry, 2019
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Disruptive Behaviour
Includes, incivility, lateral violence & bullying
Let’s discuss some clinical examples
Potter & Perry, 2019
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Assertive Communication
What does it mean?
Why is it important for nurses?
What would be an example of non-assertive communication?
Potter & Perry, 2019
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Professional Communication Styles among Health Care Workers
Nurses tend to be descriptive
Physicians tend to be brief, to the point and problem-focused
SBAR communication helps facilitate
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SBAR
S – situation – introduction and brief reason for call
B – background – history of illness, all relevant past data
A – assessment – current assessment of situation
R – recommendations – what next?
Potter & Perry, 2019
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SBAR Report
Let’s look at some SBAR reports
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Rounds
Nursing perspective for the multidisciplinary team
Short and concise outlining reason for admission, progress to date and barriers to discharge
Potter & Perry, 2019
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Telephone and Verbal Orders
Know who can give and accept telephone orders
Ask prescriber to spell out unfamiliar medications
Read back the order to the prescriber
Use words and not abbreviations
Write on the physician order sheet, record date and time, indicate it was a telephone order, sign name with credentials
Transcribe the order if necessary
Potter & Perry, 2019
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Professional Communication – Nursing Reports
When should nurses report to each other?
What are the important elements of a patient report?
Potter & Perry, 2019
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Change-of-Shift Reports
Can be done in person at the nursing station
At the bedside – consider confidentiality
Can be recorded
Can be written
Potter & Perry, 2019
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Transfer Reports
Usually telephone reports
May be given in person
Concise, may include the following:
past history,
diagnoses etc.,
summary of progress to date
goals for discharge
social supports
Potter & Perry, 2019
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Electronic Communication
We will cover this next week
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