Transcript Chapter 2 - TeacherWeb

Chapter 2
Communication in the Work
Environment
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Communication
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Lack of consistent process for communication
increases the number of medical errors
Communication requires interactions, understanding
and responses which is different than just giving
information
Direct communication (person to person, or in writing)
is best as there is less chance of the message being
distorted as it passes through senders
Communication should elicit feedback to assess and
confirm understanding
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Basic Principles of E-mail Etiquette
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Do not send e-mails regarding non-professional and personal
concerns
Proofread, spell-check and re-read for appropriateness and
confidentiality
Quote original messages properly
Avoid irony, sarcasm and emotionality
Avoid fancy formatting and cutesy pictures. These are for
personal, not professional communication
Never use all caps – it means you are shouting. It is also difficult
to read
Ask before sending large attachments – many times firewalls
will not allow them
Avoid use of smileys, emoticons, instant message (IM) language
and Internet slang
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Communication with Patients and
Staff
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Honesty and respect
Find a balance between too simple, which may be
perceived as condescending, and too complex, which
may not be understood
Provide a neutral, private place for communicating
with angry or upset people
Use a professional interpreter service for non-English
speakers; avoid the use of family members
Culturally competent responses enhance
communication
Follow HIPAA guidelines
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Transcription of Orders
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Accuracy of transcription is essential whether
computerized physician order entry (CPOE) or
manual physician orders are used
Communication of the orders (exactly as it was
written) is the responsibility of the nurse
Communication may be the nursing care plan, MAR,
nursing flow sheet and change of shift report
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Patient Changes in Conditions
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Use of SBAR to report
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Situation
Background
Assessment
Recommendation
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Are you ready to report a change of
condition?
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Did you see or assess the patient yourself?
Do you need to discuss it with the nursing
supervisor?
Do you need to review the chart?
Are you calling the correct physician?
Do you know the admitting diagnosis and
date of admission?
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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What do you need available when
you call?
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Patient’s chart
List of current medications, allergies, IV fluids
and labs
Most recent vital signs
Code status
If reporting lab results, provide date and time
and results of previous tests for comparison
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Use the SBAR process to report:
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Situation
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Identify yourself, patient, unit and room number
State the problem, when it happened or started
and the severity
Background
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Admitting diagnosis and date of admission
Current medication, allergies, IV fluids and labs
Other relevant clinical information
Code status
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Use the SBAR process to report:
(Cont’d)
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Assessment
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What is the nurse’s assessment of the situation?
Recommendation
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What is the nurse’s recommendation? What does
the nurse want?
• Notification of information only?
• Does the patient need to be seen now?
• Order change needed?
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Change of Shift Report
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Communication between outgoing nurses
and incoming nurses during the overlapping
time between shifts
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Face to face
Tape recorded reports
Walking reports
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Report vital information:
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Allergies, code status, diagnosis, critical lab
values, family or medical team information
Current status and therapeutics of the patient
Discuss upcoming plans
Review discharge plans
Other pertinent information
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Conflict Resolution Among Patients,
Families & Staff
Utilize principles of negotiation & collaboration:
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Identify the source of the conflict
Identify interests and clarify issues
Build mutual trust
Separate the individuals from the conflict
 Stay in the present do not dwell on the past
 Avoid placing blame
 Remain focused on the identified issues
 Discover options, develop outcomes
 Come to a consensus
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Organization-wide Communication
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Formal communication
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Newsletters, intranet communication, formal
education
Announcements, surveys, customer complaints,
budget requests
Utilize the chain of command
Informal communication
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Informal discussions during breaks
“Grapevine”
Lacks defined lines of communication
May not reach all parties
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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Essentials of Effective
Communication
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Timely
Efficient
Correct
Respectful
Delivered to those who need the information
Understood by those who receive the
information
Copyright © 2011 by Mosby, Inc., an affiliate of Elsevier Inc.
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