Improving Patient Safety in Long-Term Care Facilities
Appendix 2-A. Suggested Slides for Module 2
Participants will understand:
- Why communicating changes in a resident's condition is an important safety issue.
- Why communication lapses are a major risk factor for resident safety.
- Key principles of effective communication.
Knowledge Objectives (continued)
Participants will understand:
- Typical obstacles to effective communication and how to overcome them.
- What should be communicated about changes in a resident's condition.
- How to communicate a resident's change in condition using the SBAR and CUS tools.
Participants will be able to:
- Demonstrate good communication techniques.
- Practice good communication skills.
- Effectively communicate a change in a resident's condition.
- Use some simple tools to improve communication.
Case Study: Mrs. C
- What needs to be communicated?
- By and to whom?
- How do you know when the communication has worked?
Reporting Changes in a Resident's Condition
- Detecting and reporting changes: essential to patient care.
- Reporting changes is necessary for quality resident care.
- Reporting involves the following skills:
- Communicating what you have noticed to the care team.
- Working together to identify what the change might mean.
- Working with the team to take action to make sure the resident is safe.
A Safe Environment
- Reporting changes helps keep residents safe.
- Learning and experience are what make safety possible.
- Openly reporting anything that might affect a resident's wellbeing is essential for a safe environment.
- Change in a resident's condition should be reported openly, whenever it happens.
Communicating About Unwanted Events
- Learn to communicate openly when something happens that might affect a resident's well-being.
- Move beyond blaming anyone to being able to openly share experiences.
- Show you care by speaking up.
- Express yourself in a way that you will be "heard."
- "Hear" how other people answer you.
- Two types of communication: verbal and non-verbal.
We all are responsible for communicating about change in a resident's condition.
Stages of Communication
- Get ready.
- Give your information.
- Check to see if it was received.
Stages of Receiving Communication
- Following up.
Barriers to Communication
- Differences in:
- Interpersonal issues.
- Environmental or system barriers.
- Workload issues.
We may face several communication barriers at the same time.
Session 1 Summary
For good communication:
- Have ideas about how to work around barriers.
- Give clear messages.
- Focus your attention by actively listening.
- Be aware of nonverbal signals, both given and received.
- Give and ask for feedback.
- Identify yourself.
- Identify the resident.
- State the problem.
- Give a physical assessment report.
- Be brief and concise.
- Brief medical history.
- Health care already provided.
- Medications list.
- Vital signs.
- Lab results.
- Advance directive or code status.
- What should happen next?
- What do you need?
Benefits of SBAR
- Critical thinking skills.
- Patient safety.
Using the SBAR Tool
- Speak clearly.
- Review the chart.
- Complete the SBAR.
- Document the SBAR in progress notes.
Example: Nursing Assistant to Nurse
- Ms C fell asleep in her clothes this evening and cursed at me.
- She is the 85-year-old from room C6; she is usually pretty friendly and does her own ADLs.
- She seems okay physically, but I am worried.
- I'd feel better if you would take a look at her and make an assessment.
- I am Concerned.
- I am Uncomfortable.
- The Safety of the resident is at risk.
Information to Be Communicated
- Top physical and non-physical changes to watch for in residents.
- Nursing assistant communication tasks.
- Licensed nurse communication tasks.
Session 2 Summary
- Noticing changes in a resident's condition is important, but it is not enough to ensure resident safety and well-being.
- Changes must be detected early and communicated promptly.
- A safe environment depends on good communication.
- Everyone is responsible for speaking up.
- Communication skills can be learned.
- We all face barriers to communication.
- Caring means communicating.
- Communication happens in many directions, among many disciplines.
- Communicating effectively = speaking up and listening for feedback.
- Effective communication involves speaking and listening.
- Often, there are barriers to communication, and frequently several barriers at the same time.
- Communication tools like SBAR and CUS help us structure our communications.
- Assuming that someone in a higher position knows what is happening is often incorrect.
- Saying something does not mean you have been heard.
- Assuming that someone from a different culture who speaks your language understands you is often incorrect.
- Forgetting to listen can be as much of a problem as not speaking up.