Transcript Communication PPT

Effective Communication
Communication:
exchange of information, thoughts, ideas, and feelings
Verbal
Non-verbal
 Spoken words
 Facial expressions
 Written
 Body language
communication
 touch
3 essential
elements:
•Sender
•Individual who creates a
message to convey
information or ideas to
another person
•Message
•Information, idea or
thought
•Receiver
•Individual who receives
the message from the
sender
Feedback is a method that can be used to determine if
communication was successful.
Occurs when the receiver responds to the message
Allows the original sender to evaluate how the
message was interpreted and to make any necessary
adjustments or clarification.
Feedback can be verbal or non-verbal.
Elements of effective
communication:
• THE MESSAGE MUST BE CLEAR
(USE OF TERMINOLOGY BY BOTH PARTIES; EXPLAINING PROCEDURES IN LAY TERMS)
• THE SENDER MUST DELIVER THE MESSAGE IN A
CONCISE MANNER
(CORRECT PRONUNCIATION AND GOOD GRAMMAR)
• THE RECEIVER MUST BE ABLE TO HEAR AND RECEIVE
THE MESSAGE
(HEAVILY MEDICATED PATIENT WON’T HEAR MESSAGE; HEARING/VISUAL IMPAIRMENTS; FOREIGN LANG.)
• THE RECEIVER MUST BE ABLE TO UNDERSTAND THE
MESSAGE
(ATTITUDES/PREJUDICE; ASK QUESTION TO MAKE SURE MESSAGE IS UNDERSTOOD)
• INTERRUPTIONS OR DISTRACTIONS MUST BE AVOIDED
(TALKING WHILE ANSWERING THE PHONE; LOUD NOISES, UNCOMFORTABLE TEMPERATURE)
Communication process
Listening
Non-verbal
communication
 Paying attention to and
 Involves use of facial
making an effort to
hear what the person is
saying
 Allows you to perceive
the entire message that
a person is trying to
convey
expressions, body
language, gestures, eye
contact and touch
 Health care worker
must be aware of both
their own and patient’s
nonverbal behavior
Barriers to communication
• Something
that gets in the way of clear communication
• Three common barriers:
•Physical disabilities
•Psychological attitudes/prejudice
•Cultural diversity
Barriers (continued)
Physical disabilities
Psychological
 Deafness/hearing loss
 Caused by prejudice,
 Blindness/impaired
vision
 Aphasia/speech
impairments
attitudes and
personality
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Moralizing
Lecturing
Over-reacting
Arguing
Prejudging
Advising
Barriers (continued)
 Cultural Diversity
 Beliefs regarding health care
 Language differences
 Eye contact
 Ways of dealing w/ terminal illness and/or severe disability
 Touch
Recording &
Reporting
Must record and report
all observations while
providing care
Must listen to what
patient is saying, but
observe with other
senses as well
Types of observation
Subjective
Objective
 Cannot be seen or felt
 Can be seen or
 Commonly called
measured
 Commonly called signs
symptoms
 Usually statements or
complaints made by
patient/resident
 Report in exact words
Recording/documentation
 Written observations must be accurate, concise and
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complete as well as neat and legible
Spelling and grammar should be correct
Only objective observations should be noted
Subjective data that the health care worker feels or
thinks should be avoided
Errors should be crossed out neatly with a straight
line, have “error” recorded by them, and initials of
the person making the error
Telephone communication
 Do not give info about
staff or residents over the
phone
 Place caller on hold if
you need to get someone
to take the call
 Follow facility policy on
personal phone calls
 Be cheerful when
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greeting a caller
Identify your facility
Identify yourself and
your position
Listen closely to caller’s
request
Get telephone number
Say “thank you” and
“good-bye”
Guidelines for good communication
Hearing
impairment
 Make sure hearing aids working well
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(batteries)
Reduce noise in room
Get resident’s attention before speaking
Speak slow, clear and in good lighting
Directly face person
Do not shout
Lower pitch of your voice
Do not chew gum
Keep hands away from face
Repeat using different words
Use picture cards or notepad if needed
Don’t get frustrated
Vision
impairment
• Make sure glasses are clean
• Identify yourself and explain what your
doing
• Provide good lighting
• Orient person to time and place if
needed
• Use the face of imaginary clock as a
guide to explain the position of objects in
front of the resident
• Do not move personal items or furniture
without the resident’s knowledge
• Offer large-print newspapers/magazine
• Use large clocks in room
• Get books on audiotape
Stroke & communication
occurs when a clot or a ruptured blood vessel suddenly cuts off blood supply to the brain
 Depends on severity of stroke
 Keep questions and directions simple
 Phrase questions so they can be answered with “yes” or “no”
 Agree on signals such as shaking or nodding head
 Use pencil and paper if resident able to write
 Never call weaker side “bad side”
 Use picture, gestures or pointing (communication boards or
special cards to aid communication work well)
 Keep call signal within reach and let them know you will come
when they need you
Combative resident
can result from disease process affecting the brain, frustration, or part of personality
 Block physical blow or step out of way
 Stay at a safe distance
 Stay calm
 Be flexible and patient
 Be neutral
 Do not respond to verbal attacks (don’t argue)
 Do not use gestures that could frighten/startle
resident
 Be reassuring and supportive
 Leave resident alone if you can safely do so
Angry behavior
Disease process, fears, pain and loneliness
 Stay calm
 Do not respond to verbal attacks – don’t argue
 Empathize with the resident
 Try to find cause of anger
 Treat resident with dignity and respect
 Answer call light promptly
 Stay at a safe distance if resident becomes combative
Inappropriate Behavior
 Includes sexual advances and comments; residents
removing clothes or touching themselves (Illness,
dementia, confusion and medication)
• Don’t over-react
• Try to distract resident
• Notify the nurse
• Problems may mimic inappropriate behavior:
clothes too tight, rash, too tight, etc.
Documentation
OBSERVATION, REPORTING & DOCUMENTING
Nursing Process
 The RN is responsible for achieving “patient focused
care” (you learned this in Role of NA)
 He/she coordinates and delegates to other caregivers
 Consists of 5 steps:
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Assessment
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Collect data about patient/resident (interviews, records, family &
physical examination)
 Patient has surgical incision due to hip replacement
Problem identification
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“nursing diagnosis” – statement of patient problem; provides
foundation for nursing care
 Rick for infection related to surgical incision
Nursing Process continued
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Planning
Care of the patient - “care plan” – identifies possible solutions to the
identified problem within scope of practice
 Establishes goals for the patient
 May be kept in a file or “kardex”
 Assess for s/s of infection q4h
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Implementation
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Carrying out the approaches listed on the care plan to help patient
reach the goal
 Documentation q4h of assessment for infection in kardex
Evaluation
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Ongoing; determines whether patient is reaching goals; can be
extended if need and goals can be changed when condition changes
 no fever noted on vital signs sheet, no drainage from surgical site,
etc.
Types of forms
used in
documentation
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Admission
History/physical exam
Care plans
Doctor’s orders
Doctor’s progress notes
Nursing assessment (MDS)
Nurse’s notes
Flow sheets
Graphic record
Intake/output record
Consent forms
Lab/test results
Surgery reports
Advance directives
 Check for right patient, room,
Charting
Guidelines
“If it’s not charted, it’s
not done”
Purpose is to record
patient care and prove
accountability for care
given
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form, & chart
Fill out completely
Correct color of ink
Correct sequence of events
Correct spelling
Correct entries (brief/accurate)
facts/not opinions
DO NOT
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Use “ditto” marks
Use term patient
Use white-out for corrections
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Single line through error with initials
Military Time
clock
Facilities use 24-hour
clock to reduce
confusion in am/pm
hours.
To change hours simply
add 12 to the original
hour: 3 + 12 = 15
3:00 pm = 1500 hours
Hours from 12:00am –
12:00pm are written as
00:01-1200
 Accident or unexpected event that
Incident
reports
happens during care given
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Feeding a resident from the wrong tray
Fall or injury to the resident
Accusation against a staff member by a
family
 State & Federal guidelines to fill out
incident report documenting facts
about what happened
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State what happened, time, place, condition
of resident
State facts, not opinions
Do not write in medical record
Describe action taken
Include suggestions for change