Foundations of Nursing Theory Communication, Inclusion, Equity, Diversity, Teaching and Learning, Person-Centered Care PDF

Foundations of Nursing Theory Communication, Inclusion, Equity, Diversity, Teaching and Learning, Person- Centered Care Objectives Apply principles of patient-centered care Examine methods of effective therapeutic communication Analyze concepts of inclusion, equity, and div...

Foundations of Nursing Theory Communication, Inclusion, Equity, Diversity, Teaching and Learning, Person- Centered Care Objectives Apply principles of patient-centered care Examine methods of effective therapeutic communication Analyze concepts of inclusion, equity, and diversity Identify best practice for patient teaching Poll: The nurse is assessing the patient. What question asked by the nurse is best? A. “What brought you to the hospital?” B. “Do you want to talk about your concerns?” C. “Would you like to tell me why you are here?” D. “Would it help to discuss your feelings?” Therapeutic Communication: Open- ended Questions Open-ended questions invite the client to share descriptive answers, open up about their experience, and answer in a way that is most relevant or comfortable from their perspective Examples: Tell me about the challenges you are having with your medications? Poll: A parent is dealing with the loss of a child and is having difficulty coping. What is the nurse’s best response? A. “Now she is out of pain and in heaven.” B. “Everyone will remember her, she was so beautiful.” C. “It must be hard to deal with such a difficult loss.” D. “She is in a better place now.” Communication Strategy: Empathy and Validation Empathy is the action of understanding another person’s emotions and experiences while suspending your own viewpoint. Being empathetic helps the client feel understood and cultivates a trusting and therapeutic relationship. Demonstrate interest by responding to what the client is saying (e.g., “Tell me more. How do you feel about it?”). When a client is talking about a difficult experience, you may say something such as, “That must be very difficult.” Validation lets the client know that the nurse is interested in them and respectful of them and their thoughts It also allows the client to recognize that the nurse is open, honest and without any bias or judgements (Lapum et al., 2020)  Video Reconnaissance + Think Pair Share: SBAR https://rutgers.mediaspace.kaltura.com/media/How+to+give+an+SBAR+ Report+%7C+What+is+it+and+how+SBAR+used+%7C+Lecturio+Nursi ng+%7C+Fundamentals+Theory/1_vxjq2jmg 3 Critical Points Think Pair Share Instructions: This is a timed activity. You will have 1 minute to record your answer. For this activity, record the 3 most critical/important things, or 3 things that you have a difficult time remembering (not the 3 easiest things) about the provided topic. What are the 3 most important things (most critical) you know about SBAR? Be prepared to share your answer with your neighbor and the class SBAR SBAR is a communication process that involves then accurate presentation and acceptance of patient-related information from one caregiver or team to another caregiver or team. SBAR can be used during hand-off communication, which is when information is reported from one health care team member to another healthcare team member. S = Situation (a concise statement of the problem) B = Background (pertinent and brief information related to the situation) A = Assessment (analysis and considerations of options — what you found/think) R = Recommendation (action requested/recommended — what you want) SBAR SBAR is an easy-to-remember, concrete mechanism useful for framing any conversation, especially critical ones, requiring a clinician’s immediate attention and action. It allows for an easy and focused way to set expectations for what will be communicated and how between members of the team, which is essential for developing teamwork and fostering a culture of patient safety. Poll: The nurse is caring for an unconscious patient. What is the nurse’s best action? A. Do not speak so the patient is not disturbed B. Explain all actions to the patient in a normal tone C. Turn on the television to provide environmental stimulation Communicating with Clients who have Special Needs: The Unconscious Client Be careful of what is said in the client's presence, hearing is believed to be the last sense lost Assume the patient can hear you Talk in a normal tone of voice Speak with the patient before touching Keep environmental noises at as low a level as possible Evidence in Action: CLAS Standards Read the article and answer the questions below (article available in Canvas). Share your answers with a partner. Share your answers with the class. Summarize CLAS Standards in 1 sentence. Why are CLAS Standards important? What is a potential patient outcome if a nurse follows CLAS Standards when communicating? What is a potential outcome if a nurse does not follow CLAS Standards? Clarify the Misconception The nurse should not allow the patient control over their care. Patient-Centered Care Patient-centered care is recognizing the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs. Person-centered care is holistic and includes family, significant others, context, prevention, promotion, and preferences. Poll: The nurse is designing a teaching plan on the dangers of vaping for teens, what should the nurse do first? A. Set goals B. Develop content C. Evaluate learning  Review of a Sample Teaching Plan Target Audience: Older Adults Topic: Daily Exercise General Objective: Teaching Content Time Teaching-Learning Resources/ Methods of Goals Allotme Strategies Supplies Evaluation nt 1. Teach Content from 1. 1. Visual/Auditory: CDC Video 1. Answering older adults CDC Active Benefits Video CDC Poster questions about the People, 10 2.Read/Write: Poster Prizes with prizes benefits of Healthy People minutes 3. Kinesthetic: 2. Return daily 1. Benefits 2. Exercise demonstratio exercise 2. Examples of Examples n 2. Provide exercise 10 examples of 3. Strategies to minutes exercises improve 3. 3. Discuss exercise Strategie strategies to s 10 get started minutes with exercise 4. Evaluate Teaching 10 minutes 5. Question s5 minutes Clarify the Misconception: Cultural Competence means learning as many characteristics as possible about every culture. Cultural Competence Cultural competence involves developing awareness, acquiring knowledge, and practicing skills. Learn as much as possible about the belief system and practices of people in your community and of clients in the area in which you work. It is a life-long process that is reapplied in every interaction. Practice techniques of observation and listening to acquire knowledge of the beliefs and values of clients for whom you provide care. Remember, each client must be considered a unique person. It is important that nurses explore their own cultural beliefs and traditions and open their minds to the beliefs of others. In-Class Activity Divide and Apply The nurse in a clinic is caring for a 32 week pregnant patient. The patient is 24 years old and has 3 children at home. This is the patient's first prenatal visit. Physical assessment findings are within normal limits except for high blood pressure. The nurse is concerned. In-Class Activity:The Tree of Inquiry Model (See Canvas for Instructions) Nursing Problem List Nursing Problem List Use the problem list to identify prioritized problems!  The Tree of Inquiry Model Follow-up Make next Connect the patient to appointment resources Assist pt to Assess for overcome barriers to health Pt attends barriers to Educate management next appointment attend next , takes appt Ineffective health meds, BP management Risk for unstable BP WNL Pt misses BP next appt, elevated 3 children at does not start home meds, unknown BP First prenatal 32 weeks visit Health Disparities Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations (CDC, 2020). If a health outcome is seen to a greater or lesser extent between populations, there is disparity. Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual’s ability to achieve good health. It is important to recognize the impact that social determinants have on health outcomes of specific populations (Healthy People 2020, 2021).  ( Artiga, 202 0 ) Health Disparities High Blood Pressure during Pregnancy: Health Disparities Researchers found Black and American Indian/Alaska Native birthing people are more likely to experience hypertension leading to preeclampsia. Preeclampsia is one of the most common and severe disorders that occurs during pregnancy and the postpartum period, affecting at least 5-8% of all pregnancies. The preeclampsia rate is 60 percent higher in bla ck women than in white women, and black women are more likely to develop severe preeclampsia. SBAR Think Pair Share The nurse in a clinic is caring for a 32 week pregnant patient. The patient is 24 years old and has 3 children at home. This is the patient's first prenatal visit. Physical assessment findings are within normal limits except for high blood pressure. The nurse is concerned. S: B: A: R: SBAR Think Pair Share The nurse in a clinic is caring for a 32 week pregnant patient. The patient is 24 years old and has 3 children at home. This is the patient's first prenatal visit. Physical assessment findings are within normal limits except for high blood pressure. The nurse is concerned. S: Patient has high blood pressure B: 24 years old and 32 weeks pregnant; 3 children at home A: Physical assessment findings are otherwise normal R: Social Services referral to connect patient to transportation and childcare so that they can continue with prenatal care Clarify the Misconception: A nurse can post a picture of their patient on Instagram. Video Reconnaissance: Social Media Guidelines for Nurses https://rutgers.mediaspace.kaltura.com/media/Social+Me dia+Guidelines+for+Nurses/1_uswcja4l Social Media Guidelines (NCSBN) Any patient information that a nurse has access to during the course of treatment must be safeguarded. Improper use of social media by nurses may violate state and federal laws including the health insurance portability and accountability act or HIPAA. Inappropriate uses of electronic and social media maybe reported to the Board of Nursing resulting in possible disciplinary action for unprofessional or unethical conduct, breach of confidentiality, or other infractions. Nurses have an ethical and legal obligation to maintain patient privacy at all times. This means that you should never take photos or videos of patients using your cellphones or other personal devices. QUESTIONS?