What Is Communication Pdf Notes

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Worksthat cannot be retrieved by readers are cited in the text as personal communications. Personal communications include emails, personal interviews, phone conversations, text messages, online chats, live speeches, class lecture notes, letters, etc.

You do not include personal communications in your reference list; instead, parenthetically cite the communicator's name, the phrase "personal communication," and the date of the communication in your main text only.

Sometimes you may find interviews with people in journals, magazines, newspapers, websites etc. In those cases, don't use the "Personal Communications" category. Instead cite them according to how you found the information. For example, an interview in a magazine would be cited like a magazine article. That way anyone reading your assignment could easily track down the interview for themselves by finding the same magazine article.

The Teamwork and Communication module will discuss how safety teams in nursing homes can understand and practice successful teamwork and effective communication to improve the resident safety culture in their facility.

Positive, two-way communication promotes teamwork and improves resident safety culture. According to an article in the Journal of Sociological Research, quote, "The more who feel they are asked for their input in doing their jobs and are told what they need to know to successfully do their jobs, the more likely staff members will be inclined to help others in doing their jobs as well as receive help from others. When these qualities of work are realized, stress is felt as less excessive. The more satisfied the long-term care workforce, the higher quality of care that is delivered to the patients."

Because improved teamwork and communication is proven to increase resident safety, investing in teamwork training for nursing home staff is important. The most critical teamwork competency is effective communication. Team members must be taught to value teamwork and the trusting relationship on which it is based. They must know and be able to use effective strategies to enhance communication.

When critical information is being exchanged, for example during a transition in resident care, the importance of communication becomes apparent. When a patient is being transferred from the hospital to a nursing home or during a change of shift report, vital pieces of information can be omitted, placing the resident at risk for an error in their care. In 2002, a Joint Commission report on medical errors stated that 70 percent of these errors resulted from breakdowns in communication.

Why is effective communication among staff important? When critically important information is not effectively communicated, the results can lead to mistakes and potential resident harm. An example is if a staff member caring for a resident noticed some subtle changes in their health status but did not document this information or share it verbally with their team or the oncoming staff at shift change. These subtle changes may represent the beginning signs of an infection, like a catheter-associated urinary tract infection, or CAUTI. Effective communication could have helped identify a diagnosis and treatment earlier and decreased harm to the resident.

When staff, residents, and family members have mastered effective communication, everyone on the team feels they are contributing to the care of the resident. Compare this with the scenario of ineffective communication that could result in a medication error or other mistake that can cause real harm to the resident. In this scenario, the resident and family suffer and may lose trust in their caregivers, and staff may experience stress as a result of the impact of ineffective communication.

Have you heard of the TeamSTEPPS program? It's an education program that teaches communication skills for teams. The program was first used in the military and was then used successfully in many health care environments. The following table from the TeamSTEPPS Long-Term Care program highlights barriers to communication and the communication tools and strategies that teams can use to improve outcomes. We will review a number of these tools and strategies in detail in the coming slides.

Say:

Examples that have been shared by other long-term care facilities include: institutional barriers to communication, understaffing, a culture in which speaking up is not supported, staff turnover, inadequate (teamwork and communication) training, verbal abuse, fatigue, heavy workloads, and ambiguous instructions. Other barriers to effective communication may involve a lack of a resident safety culture in the facility. Facilities that promote a culture committed to resident safety encourage staff to speak up if they become aware of a safety concern and create an environment in which staff feel comfortable and safe to communicate resident safety concerns. A culture of safety fosters trust that team members will respectfully listen and respond appropriately to the information they share.

The Brief is a short meeting during which all staff caring for a resident can discuss concerns, issues or expectations of the day and then make specific plans to address the concerns, issues, and expectations. A Brief usually occurs at the beginning of the shift and is designed to help all team members develop a shared understanding about the resident's plan of care for the day. This shared understanding creates a sense of teamwork and collaboration and provides an opportunity for team members to speak up if they have concerns. For example, they might discuss the resident's decreasing mobility and the risk for falls. The team could then make a plan to keep the resident from falling by providing a walker and teaching the resident to use the walker safely or explaining to the resident when to contact the staff for help with getting out of bed. The Brief ensures everyone understands the resident's needs and expectations, helps the team avoid surprises that could affect the resident's care, provides an opportunity for every team member to participate, and sets the tone for the day.

AFTER the viewing, ASK:

Does your staff work in teams? If so, do these teams conduct Briefs to review any safety or care concerns? What does it look like? Where is it done, who attends, how long does it take, and are there tools to document the conversation?

Huddles are short, ad hoc meetings between two or more team members designed to ensure everyone who needs to know is aware of the current situation and is part of a shared response to the situation. A Huddle is used in cases where the conditions for the resident, staff, or facility have changed since the last time the team met. A Huddle allows a team to assess the impact of the change on the team's ability to perform duties and to adjust plans as needed to be sure all duties can be performed.

Let's say a resident becomes acutely ill and needs one-on-one care in preparation for transfer to a hospital. Staff members caring for that resident should be assigned fewer residents, which means another team member must care for those residents. A Huddle allows the team to quickly meet to discuss the situation, its effect on workload, and the necessary reassignments. It allows information to be shared with everyone involved, explains why assignments are being changed, and alerts staff to the safety needs of the unstable resident.

Another example of the use of a Huddle is the morning Safety Huddle, where a leader, such as a charge nurse, calls the team together to discuss the safety needs the staff have identified for their assigned residents. This can include a review of residents with an indwelling urinary catheter, the approved indication for the catheter, and the continued need for it.

A Debrief is an informal but structured discussion of an event after it occurs. The Debrief meeting is ideally conducted with all team members that were involved in the event. The discussion is focused only on teamwork issues and is designed to improve performance and effectiveness. A Debrief is a good time to reinforce positive behaviors demonstrated by the team.

The SBAR technique provides a standardized way for team members to concisely communicate about a resident's condition. Standards of communication are essential for developing teamwork and a culture of resident safety. SBAR is an easy-to-remember way to frame any conversation, especially a critical one that requires immediate attention and action. It provides team members with an easy and focused way to set expectations for what will be communicated and how. In phrasing a conversation with another member of the team, consider the following:

Let's review how to properly use SBAR. In this video, the resident's condition has worsened, resulting in a telephone call to the attending physician. Watch the video to see the transfer of information using SBAR.

Ask:

Think of a situation involving your work in a nursing home. Remember a time when you needed to communicate to another team member about a resident situation. Following the SBAR format, practice communicating the necessary information as efficiently or succinctly as you can.

Handoffs occur during a change in assignment for the responsibility of caring for a resident. A handoff may occur when a resident is first welcomed to the nursing home from the hospital or during a shift change. When a resident's care is turned over to another staff member, even for a short timespan such as a lunch break, a structured communication should occur to provide the oncoming staff member essential information about the resident. This important communication process increases resident safety by preventing the omission of important details about the resident's needs. Sometimes staff use a handoff form to effectively and efficiently convey the needed information.

Remember, a handoff can also be used in nonclinical settings and departments.

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