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DiversityNursing Blog

Effective Communication Tips For Nurses

Posted by Erica Bettencourt

Fri, Jun 17, 2022 @ 09:02 AM

GettyImages-1043174932On an average day, Nurses interact with many patients, their families and friends, and exchange information with numerous healthcare staff. It is critical to be a good communicator because medical errors will occur if providers aren't all on the same page about patients' diagnoses, treatment plans, etc.

Some effective communication skills every Nurse should possess:

VERBAL

Verbal communication is one of the most important skills in Nursing. The goal is to always speak clearly, in a professional tone, and with honesty. Be aware of your patient's level of health literacy and avoid complex medical jargon. Vocally make sure everyone on the medical staff is on the same page about any vital patient information. 

NON-VERBAL

Patient's pick up on body language and nonverbal cues just as much as verbal language. According to Indeed, some examples of nonverbal communication skills include:

  • Maintaining eye contact when speaking or listening to someone
  • Having a relaxed facial expression
  • Smiling
  • Nodding
  • Keeping arms uncrossed
  • Crouching when interacting with a bedridden patient
  • Respecting the patient's personal space

CULTURAL AWARENESS 

Nurses care for patients from all different backgrounds and cultures. It is important to be sensitive to the needs of each individual. For example, when working with a deaf patient or someone who speaks a language you aren't fluent in, bring in a translator if necessary. Or if someone has a preferred name or pronoun, you should respect them and refer to them by what they prefer. 

WRITTEN

We understand how incredibly busy you are every minute of your shift. Transitioning patient information to the next caregiver is critical and you must be as clear and concise as possible. This includes creating and updating your patient’s medical record and whiteboard.

Try to jot down notes as soon after meeting with your patient as possible so you don't forget anything and write clearly so others don't get confused. Notebooks and charting books are great tools for every shift. You can write down any concerns or important information about patients and discuss them later on with other team members.

ACTIVE LISTENING

Active listening means you are listening to understand the other person’s experience and empathize with their situation. This requires your ultimate attention and engagement. Some active listening techniques include:

  • Nodding your head, but never interrupting. 
  • Leaning forward and maintaining eye contact to let the patient know you’re engaged.
  • Include minimal verbal encouragement, such as “I understand,” and “go on.”
  • Repeating back to them their main point or concern

COMPASSION

Compassionate communication is the ability to exchange your thoughts and ideas with someone, while being empathetic to their suffering and anxiety. Put yourself in their shoes and create a judgment free space for them.

You can demonstrate compassion by using the parroting response which is repeating back what the patient said, but be careful not to overuse this technique because it will inhibit the patient from saying more. It's also important to validate the patient's feelings with a response of understanding or sympathy. 

As you know, Nursing is challenging, but incredibly rewarding as well. Effective communication skills improves your patient’s well-being and puts you and your healthcare team on the same page

Topics: communication, communication in nursing, effective communication skills, nurse communication

Effective Communication in Nursing: Theory and Best Practices

Posted by Brian Neese

Mon, Sep 19, 2016 @ 11:44 AM

thumbnail_795x250-NursingCommHeader-SEU-1.jpgTo be a successful nurse, excellent communication skills are required. The ability to communicate and connect with patients and health care professionals can help build relationships, prevent mistakes and provide a higher level of care.

According to a 2013 study published in the Journal of Patient Safety, as many as 440,000 people die each year from preventable medical errors, representing the third leading cause of death in the U.S. on the list from the Centers for Disease Control and Prevention (CDC). Of deaths due to medical errors, The Joint Commission estimates that 80 percent involve miscommunication. The Joint Commission’s analysis of 2012, 2013 and first-quarter 2014 data revealed that in all three time frames, communication was one of the top three leading causes of sentinel events, a patient safety event unrelated to the patient’s illness or condition that results in death, permanent harm or another qualifying negative outcome.

Increases in nursing communication can lessen medical errors and make a difference in positive patient outcomes. In a 2014 study published by the New England Journal of Medicine, medical error rates in nine children’s hospitals decreased by 23 percent after a handoff program was instituted to enhance and standardize communication. According to Ros Wright, the body of literature in nursing communication points to “increased recovery rates, a sense of safety and protection, improved levels of patient satisfaction and greater adherence to treatment options” as well-documented results of effective communication.

Communication Theories in Nursing

Multiple communication theories are used in nursing to help explain and guide interactions made between nurses and patients, as well as nurses and other health care professionals.

Peplau’s Interpersonal Relations Theory

This theory focuses on the nurse-client relationship and the therapeutic process that takes place. Communication that occurs in this context involves complex factors such as environment, in addition to attitudes, practices and beliefs in the dominant culture. Peplau’s interpersonal relations theory defines four stages of the relationship that achieve a common goal:

  • Orientation Phase: The nurse engages the patient in treatment, and the patient is able to ask questions and receive explanations and information. This stage helps the patient develop trust and is where first impressions about the nurse and health care system begin to evolve.
  • Identification Phase: The patient and nurse begin to work together. These interactions provide the basis for understanding, trust and acceptance as the patient becomes an active participant in treatment.
  • Exploitation Phase: The patient takes advantage of all services offered, exploiting the nurse-patient relationship to address treatment goals.
  • Resolution Phase: As a result of effective communication, the patient’s needs are met, and he or she moves toward full independence. The patient no longer needs help, and the relationship ends.

Dyadic Interpersonal Communication Model

The dyadic interpersonal communication model describes the dynamic interactive process that takes place between two people. Based on a sender and recipient — the encoder and decoder — and outside influences such as perception, attitude, content and the emotional and physical elements, the model points to the many factors that can alter the message or the message’s delivery.

As the sender or encoder provides a message, the recipient, or decoder, must process the information. The dyadic interpersonal communication model highlights the importance of clarity and awareness for the many factors that can affect verbal and nonverbal communication.

Other Theories

A number of other theories in communication and specifically in nursing communication have been used in health care. For instance, Jean Ann Seago notes that “Habermas’ critical theory has been used to identify successful nurse-physician collaborative strategies, including a willingness to move beyond basic information exchange and to challenge distortions and assumptions in the relationships.” Also, Seago mentions theories deriving from Foucault, feminism and the aviation industry to understand and enhance communication. In addition to these types of theories, several others could be named, such as those in experiential communication.

Best Practices in Nursing Communication

In order to help patients and work alongside peers, nurses must consider the skills and tools that are involved in effective communication. From being aware of potential barriers blocking effective communication to utilizing integral communication skills, nurses can take steps toward providing better care.

Barriers to Effective Communication

Nurses who are aware of the common barriers to effective communication will be able to anticipate and properly react to any roadblocks. With this focus, nurses can help ensure optimal communication and patient care.

In "Effective Communication Skills in Nursing Practice," Elain Bramhall highlights common barriers to effective communication for the patient and health care providers. Patient barriers include environmental items such as noise, lack of privacy and lack of control over who is present; fear and anxiety related to being judged, becoming emotional or being weak; and other barriers such as an inability in explaining feelings and attempting to appear strong for someone else’s benefit. Health care professional barriers include environmental items such as lack of time or support, staff conflict and high workload; fear and anxiety related to causing the patient to be distressed by talking or responding to questions; and other barriers such as a lack of skills or strategies for coping with difficult emotions, reactions or questions.

Effective Communication Skills

In the Journal of the Academy of Medical Sciences of Bosnia and Herzegovina, Lambrini Kourkouta and Ioanna Papathanasiou highlight three foundational skills in communication:

  • Nonverbal Communication: An “ongoing process … characterized by facial expressions, gestures, posture and physical barriers such as distance from the interlocutor,” nonverbal communication must agree with verbal communication. In stressful moments, Kourkouta and Papathanasiou note, changes in these two communication types can be difficult to assess.
  • Listening: An important part of communication, listening is a “responsible nursing practice and requires concentration of attention and mobilization of all the senses for the perception of verbal and nonverbal messages emitted by the patient.” By listening, nurses can be attentive to the patient and integrate care according to the patient’s evolving needs.
  • Personal Relationships: Marked by kindness, compassion and care, nurses can develop good personal relationships with the ability to “ask questions with kindness and provide information that does not scare, that demonstrates interest, creates feelings of acceptance, trust and a harmonious relationship, especially in modern multicultural society.” This relationship is connected to not only the transmission of information but also the mental and emotional dynamics found in communication.

Further skills can promote effective communication practices in nurses. Bramhall points out that asking open questions, clarification and screening questions can help keep the focus on the patient. For information giving, providing small amounts of information at a time, checking what information the person knows already and pausing before continuing can help. And for listening, summarizing, paraphrasing, empathizing and making educated guesses can demonstrate that the nurse is listening and able to communicate effectively to patients and other health care professionals.

Developing Crucial Communication Skills

It is no secret that communication skills for nurses are essential and difficult to master — and they require proper attention. “Promoting effective communication in health care is demanding, complex and challenging because of the nature of the work environment, which is often stressful and pressurized, providing little time for communication,” Bramhall writes. “If nurses are to meet these challenges in the future, they need to be supported by high-quality, evidence-based training.”

Through education and employment-sponsored training, nurses can advance communication skills that are crucial to improving as effective health care professionals. At Southeastern University, current nursing professionals can enhance their communication skills with an online RN to BSN degree. The program expands on knowledge and skills nurses need to advance into leadership positions.

For nurses, communication comes into play in virtually any context. As nurses cultivate these skills to develop professional relationships with fellow health care professionals, connect to patients and become more well-rounded and effective individuals, education and on-the-job training can maximize the impact improved communication skills will have in the workplace.
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Topics: communication

Pre-babbling Babies Prefer Baby Sounds To Adult Sounds

Posted by Erica Bettencourt

Fri, May 15, 2015 @ 12:02 PM

Written by Catharine Paddock PhD

www.medicalnewstoday.com 

four infants on a rug resized 600A new study that offers insights into early language development suggests babies prefer listening to other babies rather than adults as they get ready to produce their own speech sounds.

The study, led by McGill University in Canada and published in the journal Developmental Science, observed the reactions of infants aged from 4-6 months who were not yet attempting speech, as they listened to baby-like and adult-like sounds produced by a voice synthesizer.

They found when the vowel sounds the babies listened to sounded more baby-like (for instance, higher pitch), the infants paid attention longer than when the sounds had more adult-like vocal properties.

Previous studies have shown that children at this age are more attracted to vocal sounds with a higher voice pitch, the authors note in their paper.

The team says the finding is important because being attracted to infant speech sounds may be a key step in babies being able to find their own voice - it may help to kick-start the process of learning how to talk.

They say the discovery increases our understanding of the complex link between speech perception and speech production in young infants.

It may also lead to new ways to help hearing-impaired children who may be struggling to develop language skills, they note.

Baby-like sounds held infants' attention nearly 42% longer

For the study, the team used a voice synthesizer to create a set of vowel sounds that mimicked either the voice of a baby or the voice of a woman.

They then ran a series of experiments where they played the vowel sounds one at a time to the babies as they sat on their mother's lap and listened. They measured the length of time each vowel sound held the infants' attention.

The results showed that, on average, baby-like sounds held the infants' attention nearly 42% longer than the adult-like sounds.

The researchers note that this finding is unlikely to be a result of the babies having a particular preference for a familiar sound because they were not yet producing those sounds themselves - they were not yet part of their everyday experience.

Some of the infants showed their interest in other ways. For example, when they listened to the adult sounds, their faces remained fairly passive and neutral. In contrast, when they heard the baby-like sounds, they became more animated, moved their mouths and smiled.

The following video shows how one of the infants - baby Camille, who is not yet babbling herself - reacts to the various sounds. Every time she looks away, the sound is replaced by another. Her reactions show which sounds she seems to like the most.

Babies need to 'find their own voice'

The researchers say maybe the babies recognized that the baby-like sounds were more like sounds they could make themselves - despite not having heard them before.

The findings may also explain the instinct some people have when they automatically speak to infants in baby-like, high-pitched tones, says senior author Linda Polka, a professor in McGill's School of Communication Disorders, who adds:

"As adults, we use language to communicate. But when a young infant starts to make speech sounds, it often has more to do with exploring than with communicating."

Prof. Polka says babies often try speaking when they are on their own, without eye contact or interaction with others. She explains:

"That's because to learn how to speak babies need to spend lots of time moving their mouths and vocal cords to understand the kind of sounds they can make themselves. They need, quite literally, to 'find their own voice.'"

Funds for the study came from the Natural Sciences Engineering and Research Council.

Meanwhile, parents and schools looking for ways to encourage children to eat more healthily may be interested in a study carried out among kindergarten through sixth-grade students at an inner-city school in Cincinnati, OH. There, researchers discovered that children found healthy food more appealing when linked to smiley faces and other small incentives. The low-cost intervention led to a 62% rise in vegetable purchases and a 20% rise in fruit purchases.

Topics: learning, studies, infants, health, healthcare, research, medical, communication, newborns, babies, sounds, speech

Medical Schools Reboot For 21st Century

Posted by Erica Bettencourt

Mon, Apr 13, 2015 @ 11:19 AM

JULIE ROVNER

www.npr.org

med school custom 57453485b46ead4aaba7e89dfbfaacf142867290 s800 c85 resized 600

Medicine has changed a lot in the past 100 years. But medical training hasn't — until now. Spurred by the need to train a different type of doctor, some top medical schools around the U.S. are tearing up the textbooks and starting from scratch.

Most medical schools still operate under a model pioneered in the early 1900s by an educator named Abraham Flexner.

"Flexner did a lot of great things," says Dr. Raj Mangrulkar, associate dean for medical student education at the University of Michigan Medical School. "But we've learned a lot and now we're absolutely ready for a new model."

Michigan is one of many med schools in the midst of a major overhaul of their curricula.

For example, in a windowless classroom, a small group of second-year students is hard at work. The students are not studying anatomy or biochemistry or any of the traditional sciences. They're polishing their communication skills.

In the first exercise, students paired off and negotiated the price of a used BMW. Now they're trying to settle on who should get credit for an imaginary medical journal article.

"I was thinking, kind of given our background and approach, that I would be senior author. How does that sound to you?" asks Jesse Burk-Rafel, a second-year student from Washington state.

His partner, also a second-year student, objects; he also wants to be senior author. Eventually they agree to share credit, rotating whose name comes first on subsequent papers related to the imaginary research project.

It may seem an odd way for medical students to be spending their class time. But Dr. Erin McKean, the surgeon teaching the class, says it's a serious topic for students who will have to communicate life and death matters during their careers.

"I was not taught this in medical school myself," says McKean. "We haven't taught people how to be specific about working in teams, how to communicate with peers and colleagues and how to communicate to the general public about what's going on in health care and medicine."

It's just one of many such changes, and it's dramatically different from the traditional way medicine has been taught. Flexner's model is known as "two plus two." Students spend their first two years in the classroom memorizing facts. In their last two years, med students shadow doctors in hospitals and clinics. Mangrulkar says Flexner's approach represented a huge change from the way doctors were taught in the 19th century.

"Literacy was optional, and you didn't always learn in the clinical setting," he says. Shortly after Flexner published his landmark review of the state of medical education, dozens of the nation's medical schools closed or merged.

But today, says Mangrulkar, the two-plus-two model doesn't work. For one thing, there's too much medical science for anyone to learn in two years. And the practice of medicine is constantly in flux.

What Michigan and many other schools are trying to do now is prepare future doctors for the inevitable changes they'll face throughout a long career.

"We shouldn't even try to predict what that system's going to be like," he says. "Which means we need to give students the tools to be adaptable, to be resilient, to problem-solve — push through some things, accept some things, but change other things."

One big shift at many schools is a focus on how the entire health system works — rather than just training doctors how to treat patients.

Dr. Susan Skochelak, a vice president with the American Medical Association, is in charge of an AMA project that is funding changes at 11 schools around the country. She says the new teaching focus on the health care system has had an added benefit: Faculty members are learning right along with the students about some of the absurdities.

For example, she says, only because they have to guide students through the system do they discover things like the fact that some hospitals schedule patients for MRI and other tests around the clock.

"And one of my patients had to come and get their MRI at 3 a.m.," Skochelak says. " 'How do they do that?' " she says a faculty member asked her. " 'Do they have kids?' "

Physicians aren't always the best teachers about how the system works.

Doctors tend to focus on patient care, since that's what they know. However, Skochelak says, "If you hook [students] up with a clinic manager when you want them to learn about the system and what the system does, then the clinic manager focuses on the system."

Another major change to medical education aims at helping future doctors work as team players, rather than as the unquestioned leaders.

In a classroom at the University of California, San Francisco, several groups of students practice teamwork by working together to solve a genetics problem.

Joe Derisi, who heads the biochemistry and biophysics department at UCSF, is guiding more than teaching when he gently suggests a student's tactic is veering off course. "I would argue that it may not be as useful as you think," he tells the student. "But I'm obliging."

Onur Yenigun, one of the students in the class, says that working with his peers is good preparation for being part of a team when he's a doctor.

"When I'm in a small group I realize that I can't know everything," Yenigun says. "I won't know everything. And to be able to rely on my classmates to fill in the blanks is really important."

The medical schools that are part of the AMA project are already sharing what they've learned with each other. Plans are in the works, as well, to begin sharing some of the more successful changes with other medical schools around the country.

Topics: nurses, doctors, medicine, communication, career, clinics, medical schools, medical student, medical science, medical training

Pets May Help Improve Social Skills Of Children With Autism

Posted by Erica Bettencourt

Wed, Jan 07, 2015 @ 01:26 PM

By Carolyn Gregoire

n LITTLE GIRL DOG large570 resized 600

Having a family pet can be beneficial for child development in a number of ways, including keeping kids active and promoting empathy, self-esteem and a sense of responsibility. But dogs may be particularly beneficial for kids with autism, acting as a "social lubricant" that helps them build assertiveness and confidence in their interactions with others, according to new research from the University of Missouri. 

The researchers surveyed 70 families with autistic children between the ages of eight and 18, all of whom were patients at the MU Thompson Center for Autism and Neurodevelopmental Disorders. Nearly 70 percent of the participating families had dogs, half had cats, and some owned other pets including fish, rodents, rabbits, reptiles and birds. 

The study's lead author Gretchen Carlisle, a research fellow at the University of Missouri, observed that autistic children are were likely to engage socially in social situations where pets were present. While previous research has focused specially on the ways that dogs benefit the development of autistic children, Carlisle found that pets of any type were beneficial for the childrens' social skills.

"When I compared the social skills of children with autism who lived with dogs to those who did not, the children with dogs appeared to have greater social skills," Carlisle said in a statement. "More significantly, however, the data revealed that children with any kind of pet in the home reported being more likely to engage in behaviors such as introducing themselves, asking for information or responding to other people's questions. These kinds of social skills typically are difficult for kids with autism, but this study showed children's assertiveness was greater if they lived with a pet."

Carlisle observed the strongest attachments between the children and small dogs, although parents also reported strong attachments between their children and other pets, such as cats and rabbits. 

“Dogs are good for some kids with autism but might not be the best option for every child,” Carlisle said. “Kids with autism are highly individual and unique, so some other animals may provide just as much benefit as dogs. Though parents may assume having dogs are best to help their children, my data show greater social skills for children with autism who live in homes with any type of pet.”

Carlisle's research joins a body of work demonstrating the benefits of animal interaction among autistic children. A 2013 review of studies found that specially trained dogs, horses and other animals can facilitate increased social interaction and improved communication among autistic children, as well as decreased stress and problem behavior. 

Source: www.huffingtonpost.com


Topics: learning, study, animals, health, healthcare, research, children, medical, communication, autism, dogs, skills

NAHN Launches Medical Spanish Certification Course

Posted by Erica Bettencourt

Mon, Dec 22, 2014 @ 12:55 PM

canopy resized 600

NAHN is pleased to present the NAHN National Certification for Bilingual Healthcare Providers Medical Spanish Course & Exam in partnership with Canopy Apps, a health tech company that is improving access to information across language barriers to improve healthcare.

In line with NAHN’s dedication to the professionalism and advancement of Hispanic nurses, the NAHN Medical Spanish Certification offers access to improved provider competencies in Hispanic culture and language. Healthcare providers- both on the individual and organizational level - benefit from increased proficiency in medical Spanish, resulting in the ability to reach individuals who are unable or afraid to get assistance because of linguistic barriers. The acceptance of this credentialing in the provider community on a wide-spread basis has broad-reaching potential, including reduced risk of medication and treatment non-adherence in a growing Hispanic American population with increasing medical needs. 

The NAHN Medical Spanish Course is a comprehensive, self-paced online course covering the essentials of patient-provider communication in Spanish. The medical Spanish knowledge provided in the three-level program results in a provider who can communicate with and provide appropriate care to Hispanic patients. Following the program, the NAHN Medical Spanish Certification exam assesses the ability for an individual to communicate directly with Hispanic patients in a clinical setting without the use of an interpreter. The program offers 18 Continuing Nurse Education (CNE) hours for completion of the course. 

NAHN members receive a discount on both the course and the exam. When registering for the course and/or the exam, please login using the email address from which you received this email to receive your discount. 

Source: http://www.nahnnet.org

Topics: NAHN, Spanish, course, exam, Spanish course, program, hispanic, healthcare, nurses, medical, communication

Three Tips for Better Nurse–Physician Communication In The Digital Age

Posted by Erica Bettencourt

Mon, Nov 17, 2014 @ 12:58 PM

By Melissa Wirkus

Milisa Manojlovich resized 600

“HIT has been shown to help some patients, but it has also been shown to perhaps provide some complications in care, or less than adequate care, when messages are not received, when messages are interrupted or when messages are routed to the inappropriate person,” explained Milisa Manojlovich, PhD, RN, CCRN, associate professor at the University of Michigan School of Nursing (UMSN) and member of U-M’s Institute for Healthcare Policy and Innovation.

Manojlovich will serve as the primary investigator on a new $1.6 million grant from the federal Agency for Healthcare Research and Quality (AHRQ) that will focus on health IT’s effects on nurse–physician communication. Manojlovich and her co-investigators will look at how communication technologies make it easier or harder for doctors and nurses to communicate with each other. They hope their research will identify the optimal way to support effective communication while fostering improved and positive interdisciplinary team-based care.

Until the research is completed, Manojlovich offers some simple procedures clinicians can begin to adopt right now to help alleviate common problems with digital communication:

1.   Use multiple forms of technology  

Just like there is more than one way to treat a cold, there is more than one way to communicate electronically. Utilizing multiple forms of technology to communicate important information, or sometimes even reverting back to the “old-fashioned” ways of making a phone call or talking in person, can help ensure the receipt of a message in an environment that is often inundated.

“One of the things we are going to investigate is this idea of matching the message to the medium,” Manojlovich said. “So depending on the message that you want to send, you will identify what is the best medium to send that message.”

Using the current Ebola situation in Texas as an example, Manojlovich explained that using multiple forms of technology as a back-up to solely documenting the information in the EHR system could have mitigated the breakdown in communication that occurred. “Although the clinician did her job by entering the information into the EHR, she maybe should have texted or emailed the physician with the information or found someone to talk to in person about the situation. What we are trying to do with this study is see if there is another way that messages like this could have been transmitted better.”

2.   Include the whole message 

Reducing fragmented messages and increasing the aggregation of key data and information in communications may be one of the most critical pieces to improving communication between nurses and physicians. Manojlovich has been passionate about nurse–physician communication throughout her career and has conducted several previous studies on communication technologies.

“What we’ve noticed, for example, is that nurses will sometimes use the same form of communication over and over again. In one of the studies we actually watched a nurse page the same physician three times with the same question within an hour period.”

The physician did not answer any of the messages, and Manojlovich concluded it was because the pages were missing critical components of information related to the patient’s care plan. Increasing the frequency of communications can be beneficial, but only if the entire message and all important facets of information are relayed.

“If you do what you’ve always done, you’re going to get what you’ve always gotten. If you don’t alter or change the communication technology you are using, you are going to get the same results,” she added.

3.   Incorporate a team-based approach 

“At a really high level the problem is that a lot of these computer and electronic health record technologies are built with individuals in mind,” Manojlovich said. “When you talk about care process and team processes, that requires more interaction than the technologies are currently able to give us. The computer technologies are designed for individual use, but health care is based on the interaction of many different disciplines.”

Infusing this collaborative mindset into the “siloed” technology realm will undoubtedly help to improve the communication problems between providers and clinicians at all levels and all practice settings--which is especially important in today’s environment of co-morbidities and coordinating care.

Nurses play a critical role in improving communication as frontline care providers. “Nurses are the 24-hour surveillance system for hospitalized patients. It is our job to do that monitoring and surveillance and to let physicians know when something comes up.”

“I believe that for quality patient care, a patient needs input from all disciplines; from doctors, nurses, pharmacists, nutritionists--everyone,” Manojlovich said. “We are being trained separately and each discipline has a different knowledge base, and these differences make it difficult for us to understand each other. Developing mutual understanding is really important because when we have that mutual understanding I think outcomes are better and it can be argued that the quality of care is better when you have everyone providing input.”

Source: www.nursezone.com

Topics: physician, digital, technology, health, healthcare, nurses, patients, hospital, communication

Simulation lab, war room help prevent medical errors, improve doc-nurse communication

Posted by Erica Bettencourt

Wed, Jun 04, 2014 @ 01:47 PM

By Ilene MacDonald

RoomOfErrorsBedside

Despite new technology and evidence-based guidelines, medical mistakes happen too frequently and may lead to as many as 400,000 preventable deaths each year.

But two new programs, launched at the University of Virginia Medical Center, offer a new approach to patient safety that may prevent medical errors, WVTF Public Radio reports.

This year the organization introduced a simulation lab in the pediatric intensive care unit. The "Room of Errors" features high-tech infant mannequins attached to monitors. When doctors and nurses enter the lab, they have seven minutes to determine what is wrong.

As part of a recent exercise, a doctor-nurse team worked together to spot 54 problems with the scenario, including the fact the ventilator wasn't plugged into the correct outlet, the heat wasn't turned on and the potassium chloride was programmed at the wrong concentration.

The interpersonal, team-based learning approach helps doctors and nurses improve their ability to make decisions together and communicate with one another, Valentina Brashers, M.D., co-director of the Center for Interprofessional Research and Education, an effort headquartered at UVa's Schools of Nursing and Medicine, told WVTF.

"Knowing that there are others that you can work to think with you and share with you their concerns as you work through difficult problems makes care provision a much more enjoyable and rewarding activity. It reduces staff turnover. It creates an environment where we feel like we're all in it together with the patient," she said.

The pilot proved so successful that the medical center intends to roll it out to the entire hospital.

In its quest to eliminate medical mistakes at the organization, UVa also launched a second patient safety initiative that calls for hospital administrators to meet each morning to talk about any problems that occurred in the previous 24 hours, according to a second WVFT article.

The "Situation Room" features white boards and monitors, where administrators review every new infection and unexpected death and then visit the places where the problems took place.

Sometimes the solutions are easy fixes, such as a receptionist who removed a mat that caused patients to trip at the entrance of an outpatient building. Others, caused by communication problems, are more complicated, Richard  Shannon, M.D., executive vice president for health affairs, told the publication. To address it, Shannon wants to shake up the medical hierarchy where the physician sits at the top.

"The physician may spend 20 minutes at the bedside a day. The nurse is there 24/7 and has about 13 times more direct contact with the patient than does the physician," he told WVFT. "You can't have someone at the head of the pyramid who is absent a lot of the time."

Finally, to encourage better communication among caregivers, patients and families, Shannon now encourages healthcare professionals to make rounds in the afternoon, when visitors are on premises.


Source: fiercehealthcare.com

Topics: error, nursing, technology, healthcare, practice, communication

Heart association offers tips for good teamwork in OR

Posted by Alycia Sullivan

Fri, Aug 23, 2013 @ 01:55 PM

Improving communication and strengthening teamwork among cardiac surgery teams are among recommendations for reducing preventable mistakes in the cardiac OR, according to a statement from the American Heart Association.

The statement provides recommendations for improving patient safety after the association reviewed evidence-based research focused on communication within and between teams, the physical workspace and the organizational culture of the cardiac OR.

"In multiple studies, self-assessment of communication and teamwork skills by surgeons and anesthesiologists is disturbingly discordant with the opinions of their associated nursing and perfusion staff," the statement authors wrote. "Surgeons rated the teamwork of other surgeons as high/very high 85% of the time, but nurses rated their collaboration with surgeons as high/very high only 48% of the time."

The authors also noted that in the OR, "conflicts are often poorly managed through avoidance, yielding or competition, when collaboration and compromise would yield a better outcome. Collaboration and compromise are particularly difficult when there is status asymmetry, whereby one member has greater power or seniority, such as physicians with nurses or an attending physician with residents."

Highlights of the statement, published Aug. 5 on the website of the journal Circulation, include: 

• Using checklists and/or briefings before every cardiac surgery, followed by postoperative briefings;

• Developing institutional policies to define disruptive behaviors by medical professionals in all hospital settings, with transparent, formal procedures for addressing unacceptable behaviors; 

• Establishing an institutional culture of safety by implementing a robust quality improvement system that encourages input from all team members to continuously identify and correct safety hazards. 

"From the data available," the authors wrote, "it appears that teams should be trained as teams, not as individuals; that use of simulated scenarios is effective; that both executive leadership and nurse managers are critical to effective implementation; and that repetition, continued coaching or both are required to strengthen and maintain benefits."

The authors noted the critical elements of teamwork can be summarized by the Six Cs: communication, cooperation, coordination, cognition, conflict resolution and coaching.

The statement is available as a PDF:http://circ.ahajournals.org/content/early/2013/08/05/CIR.0b013e3182a38efa.full.pdf

Source: Nurse.com 

Topics: improve, communication, teamwork, cardiac, cardiac OR, AHA

Interprofessional education: The answer to better healthcare communication

Posted by Alycia Sullivan

Fri, Jul 12, 2013 @ 12:57 PM

by Courtney H. Lyder

In a recent editorial in The New York Times, Theresa Brown wrote about how clinical hierarchies and the impact of conflict between nurses and physicians can be deadly for a patient. She said "when doctors and nurses don't get along, it's the patient who suffers."

A lot of studies show that poor communication is linked to adverse patient outcomes. For example, of the 1,243 sentinel events reported to the Joint Commission in 2011, communication problems were identified in 60 percent.

By its very nature, healthcare is complicated; it is a rapidly changing environment and unpredictable. Professionals from a variety of disciplines can care for a patient during a 24-hour period, which can limit the opportunities for face-to-face communication.

Physicians and nurses are expected to work together, not only practicing side by side, but interacting to achieve a common goal: the health and well-being of the patient. But there are several factors that can make effective communication between nurses and physicians particularly difficult to achieve, including historic tension; conflicting viewpoints based on education, training, communication style; and terminology and existing communication processes that are inefficient at best.

With the focus of healthcare moving increasingly to the team approach, it becomes even more critical for physicians and nurses to work in collaboration. Higher education institutions including UCLA and the University of Virginia, for example, are working to improve how nurses and physicians work together before they enter the clinical environment.

The University of Virginia now requires interprofessional education for its nursing and medical school curriculums. Courses, training modulus and even faculty members are shared across both disciplines. Medical and nursing students are taught to respect each other's areas of expertise.

In the Fall of 2008, the UCLA School of Nursing and the David Geffen School of Medicine at UCLA, introduced a pilot program to integrate nursing students (in this case advanced practice students) and third-year medical students. The result was an innovative program that focused on content, such as communication with patients, ethics, behavioral medicine and other psychosocial issues. The idea was to get the two groups working together sooner rather than later so students from both schools could develop team-building skills, increase their awareness of each other's roles and get used to working together in making decisions to improve patient outcomes.

Our initial results indicated the students found the experience to be of great value. In addition to assisting students with their clinical decision-making skills, the discussions that took place during the course provided an excellent forum in which the nursing and medical students gained a better mutual understanding.

I believe collaborations like this represent the future of medical and nursing education. No two groups of health professionals are more interrelated in practice, and by starting here, we allow them to understand each other and to grow up together as students.

We are now taking the next step by creating assessment tools to evaluate interprofessional competencies not only in the classroom but in clinical practice settings as well. Tools such as an iPad app will allow instruction leaders to assess actual collaborative practices through observations and walk-throughs in clinical settings. Our ultimate goal is to disseminate the tools with a wider community.

Patient safety needs to be our top priority. Successful delivery of healthcare needs to be interdependent and respect shown for the education and knowledge of each team member. Interprofessional education is an excellent start.

Courtney H. Lyder is dean and professor of the UCLA School of Nursing, professor of Medicine and Public Health as well as Executive Director of the UCLA Health System Patient Safety Institute and Assistant Director of the UCLA Health System.

Source: Hospital Impact

Topics: interprofessional education, healthcare, nurses, doctors, communication

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