Midterm #2: NUSC 1P03

Safe Communication

• Effective communication in healthcare reduces errors and improves patient satisfaction.
• Safe communication includes:
  • Sufficiency: Sharing enough information for shared understanding.
  • Accuracy: Ensuring information is correct.
  • Clarity: Expressing messages clearly to avoid misunderstandings.
  • Contextualization: Considering factors like hierarchy and time pressure affecting understanding.
  • Interpersonal Adaptation: Adjusting to each other's needs (verbal and nonverbal) to improve communication.
• Creating a team culture of collaboration and cooperation also contributes to safe communication.
• Barriers to safe communication include:
  • Fragmentation.
  • Underreporting.
  • Fatigue.

Strategies for Safe Communication

• Standardized communication tools help avoid incomplete or misleading messages.
• Standardized communication tools include:
  • Checklists: Structured lists of evidence-based actions for specific clinical settings.
  • Verbal communication tools: Structured formats for communication, such as SBAR (Situation, Background, Assessment, Recommendation) and IPASS (Introduction, Patient, Assessment, Situation, Safety Concerns).

SBAR

• SBAR is a standardized tool for efficiently communicating patient information to other healthcare team members.
• It is particularly useful in acute situations, like a patient's declining status or during hand-offs.

Factors Influencing Safety

• Environmental factors include:
  • Lighting.
  • Noise.
  • Physical space.
  • Layout.
• Organizational factors include:
  • Leadership characteristics.
  • Culture.
  • Policies.
  • Hierarchy.
  • Span of control.

Swiss Cheese Model

• Explains how errors can occur when holes in different layers of safety align.
• Active failures are the holes at the end of the system that directly impact the patient.

Common Safety Risks

• Nurses must be aware of:
  • Regulatory and organizational safety initiatives.
  • Individual patient risk factors, including developmental level, mobility, sensory and cognitive statuses, and lifestyle choices.

Risks in Health Care Settings

• Staff safety concerns:
  • Environmental risk: Exposure to chemicals used in healthcare settings.
  • Infection control: Maintaining safety for patients, staff, and visitors through infection control protocols.
  • Violence: Potential for violence from patients or their families.
• Patient safety concerns:
  • Falls: Common incidents in hospitals, leading to serious injuries like hip fractures.
  • Procedure-related accidents: Medication errors and improper performance of procedures.

Nursing's Fundamental Patterns of Knowing

• Empirics: Science of nursing.
• Aesthetics: Art of nursing.
• Personal knowledge: Self-awareness and self-reflection.
• Ethics: Moral knowledge in nursing.
• Emancipatory Knowing: Understanding social problems and taking action for social change.
• Praxis: Integration of all five patterns to support social justice.

Evidence-Informed Decision Making (EIDM)

• EIDM incorporates evidence from research, clinical expertise, patient preferences, and other resources to guide nursing decisions.
• Steps of EIDM:
  • Ask a clinical question.
  • Search for evidence.
  • Appraise the evidence.
  • Integrate the evidence into the context.
  • Evaluate and disseminate the findings.

Asking Questions and Searching for Evidence

• Clear clinical questions are formulated using PICO (Patient, Intervention, Comparison, Outcome) or similar frameworks.
• Keywords, Boolean operators (AND, OR, NOT), and filters assist in systematic evidence searching.

Appraising the Evidence

• Evaluating the quality of research studies is crucial for EIDM.
• Tools for appraising evidence:
  • Evidence pyramid: Hierarchy ranking evidence strength, with systematic reviews at the top.
  • Critical Appraisal Skills Programme (CASP): Checklists tailored to specific study designs.
  • Reading scientific papers systematically: Preview for understanding, analyze for critical evaluation, and reflect on the findings.

Applying the Evidence

• James is at risk for foot ulcers due to his diabetes.
• This requires nurses to consider evidence-based practices for diabetes management and foot care to prevent ulcers during his discharge.

This quiz focuses on the principles of effective communication in healthcare settings, emphasizing the importance of sufficiency, accuracy, clarity, and contextualization. It explores the strategies for overcoming barriers and fostering a team culture that enhances patient safety and satisfaction.