Transcript How to Prevent Harmful Events and Promote Patient Safety

Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Chapter 11
Patient-Safe Communication and
Patient Education
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Health Literacy Programs
 Teach patients what to ask for their own
safety:
 What is my main problem?
 What do I need to do?
 Why is it important for me to do this?
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
What All Patients Need to Know:
METHOD Daily Teaching Plan
M
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T
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Medications
Environment
Treatments
Health knowledge
Outpatient/inpatient
Diet
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Medications
 Name and actions
 Hospital drugs: 1 sentence each
 This is an antibiotic for your infection
 This is a blood thinner to prevent clots
 Home drugs: Add how to take to avoid
complications: 1 sentence each
 Take antibiotic 3X a day, morning, noon, night. Take
entire prescription. Take with food to avoid upset
stomach.
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Environment
 Hospital environment
 Safety/falls modifications: Furniture arrangement
 Activity orders
 WBAT
 BRP
 Home environment
 Safety/falls modifications: Phone, stairs, rugs
 Activity/exercise : Walking, lifting, driving
 Financial considerations: Drugs, dressings
 Family- social support: Supplies, food
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Treatments
 Hospital
 Purpose—why
 Home
 Procedures—correct techniques
 Supplies—obtaining
 Simple directions
 Care of wound
 Injections
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Health Knowledge of Disease
 Signs and symptoms of problems pertaining to
specific health state
 Wound—S/S infection
 Heart Problem—S/S of heart failure
 Contact physician
 How
 When—if s/s occur
 Web site
 www.diabetes.org
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Outpatient or Inpatient Services
 Hospital
 Diagnostic tests: 1 sentence
 Laboratory
 Procedures
 Home
 Office appointments
 Physician
 Home health services
 Hospice
 Community-based support services
 American Diabetes Association
 American Cancer Society
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Diet
 Food pyramid
 Serving sizes
 Healthy eating guidelines
 Promote wound healing Protein, vitamin C
 Promote elimination—bladder & bowel
 Fiber, water
 Specific menus
 Obtain samples from dietary department
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Summary METHOD Teaching Plans
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Medications—name, action, side effects
Environment—home, finances, family
Treatments—purpose and techniques
Health teaching—effects of disease, s/s
Outpatient/inpatient referrals—office
appointments, support groups, diagnostic tests
 Diet—appropriate diet, food restrictions, menus
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Adult Learning Principles
 Be realistic; stick to the basics
 Take advantage of the teachable moment by
incorporating teaching into your ongoing
patient care
 Reinforce all learning
 Solicit feedback
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Adult Learning Principles
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Build on previous experiences
Focus on immediate concerns first
Adapt teaching to the patient’s lifestyle
Make the patient an active participant
Determine learning readiness
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Psycho-Social-Cultural Patient
Assessment Tool
 Emotional state (mood, body language, eye contact,
facial expressions)
 Patient’s life experience (previous experiences with
health care)
 Family (mood of family members; are family members
supportive)
 Patient age (how health problem has interfered with
growth and development)
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Psycho-Social-Cultural Patient
Assessment Tool
 Relations with health-care providers (what is the
patient/family level of understanding of the health problem;
are they satisfied with the care given)
 Self-esteem and body image (changes in physical appearance;
changes in activity)
 Cultural (religious preference and practices; favorite foods;
years lived in the region; travel outside the region)
 Gender (patient’s speech behaviors; patient-safe
communication strategies used with this patient)
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Assessment
 Learning style—prefer to watch movie,
listen to audiotape, read, computer, talk
one on one
 Reading level—does patient like to read
(illiterate—1 of 5 adults reads at 5th-grade
level or lower)
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Assessment
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Learning readiness and motivation
Age, developmental tasks, and cognitive level
Current understanding of health problem
Culture/gender issues—women as caretakers; food
preferences
 Economics—drugs, dressings, supplies
 Support systems/family—emotional support and support of
treatment plan
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Assessment Factors Inhibiting
Learning
 Negative emotions—anxiety, depression, grief; may not
be able to learn
 Defense mechanisms—denial, rationalizing
 Physiological problems—blind, deaf, cognitive
impairment, pain, hunger, nausea
 Cultural barriers—Amish & electricity, Jehovah's
witnesses and blood, differing values and beliefs
between health-care providers and patients
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Teaching Plans
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Learner/family assessment
Teaching goals and objectives/content
Planning teaching strategies
Implementation of teaching
Evaluation of teaching
Documentation of learning and teaching
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Patient Goals and Objectives
Goals: General statement—administer insulin
independently
Objectives: Cognitive, affective, psychomotor
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Cognitive objectives—the patient will:
 Describe the purpose of insulin
 Describe the adverse effects of too much or
too little insulin
 State what to do if side effects occur
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Affective objectives—the patient will:
 Listen to instructions on how to give insulin
 Appear relaxed without signs of anxiety during
instruction
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Psychomotor objectives—the patient will:
 Assemble supplies needed to self-administer
insulin
 Draw correct dosage into syringe without
contamination
 Inject insulin without contamination of needle
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Teaching Methods Must Coincide
With Type of Knowledge
Cognitive (Facts)
 Explanations, descriptions, books, pamphlets, films,
programmed instruction, computer programs
Affective (Feelings and Beliefs)
 One-on-one discussion, group discussions, role playing,
discovery to guide the patient to problem-solve situations
and to express feelings
Psychomotor (Skill)
 Use demonstrations accompanied by explanations
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Implementation
Warning: Do Not Lecture Patients
 No interaction
 Puts teacher in charge
 Learner is passive and dependent
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
Evaluation of Teaching: Did the
Patient Learn?
 Cognitive knowledge
 Oral or written questions, diary or records for self-monitoring
 Affective knowledge
 Inferred from how patient responds and speaks, verbal
expression of feelings and values
 Psychomotor knowledge
 Return demonstrations
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
When a patient decides not to change
a behavior
The patient does not want to stop smoking
 You have done everything to convince a patient to change
and become healthier
 Do not get in an argument; agree to disagree; patients have
the right to their own opinions and decisions
 Document, and wait for a teachable moment, when the
patient is motivated to change
Communication for Nurses: How to Prevent Harmful Events
and Promote Patient Safety
References
References for this content can be found in the text.
Chapter 6: P. 91
Chapter 7: Pp. 103 and 104
Chapter 8: Pp. 116 and 117
Chapter 9: Pp. 128-130
Chapter 10: P. 142
Chapter 11: Pp. 155 and 156