1010 WEEK 4 COMU

clinical decisions

- Apply the nursing process - Know your patient - Use clinical decision making practices - Accurate clinical decision-making keeps you focused on the proper course of action

Levels of Communication

- intrapersonal - talk to yourself - interpersonal- you and another - small-group- 2 or more equally active - public - engaged in a public sphere ex public speaking Electronic- email, text

communication and interpersonal relationships

-Communication establishes caring, healing relationships -The ability to relate to others is important for interpersonal communication. -Communication, including posture, expressions, gestures, words, attitudes, has the power to hurt or heal.

Magnet Recognition

Based on five model components Transformational leadership Structural empowerment Exemplary professional practice New knowledge, innovation, and improvements Empirical quality results

clinical care coordination

Clinical Decisions Priority Setting Organizational Skills Use of Resources Time Management Evaluation

nursing process planning

Determine goals and expected outcomes that guide the choice of teaching strategies and approaches with a patient: Set priorities. Select timing to teach. Organize the teaching materials. Use teamwork and collaboration.

Nursing Process: Implementation

Determine patient readiness and involve patient(s) in health care process Review planned interventions with interdisciplinary health care team members to facilitate collaborative effort Utilize principles of delegation, being mindful of supervision and evaluation Counsel person and significant others Refer for continuing care Document care provided

organizational skills

Do the right things. Do things right. Inform and prepare patient. Clean and organize work area. Keep patient's needs at the center of attention.

professional nursing relationships

Nurse-patient helping relationships Nurse-family relationships Nurse-health team relationships Nurse-community relationships

Adapting Communication Techniques

Patients who cannot speak clearly - give pt computer Cognitive impairment -never argue Hearing impairment - hearing aids Visual impairment - glasses Unresponsive - still can hear you Patients who do not speak English (or your language)

Priority setting

Process of establishing a preferential sequence for addressing nursing diagnoses and interventions high priority , intermediate , low

circular transactional model

Referent Sender and receiver Message Channels Feedback Interpersonal variables Environment

total patient care

Registered nurse works directly with patient, family, and health care team members. RN is responsible for patients during shift of care, although care can be delegated. Approach may not be cost-effective owing to high number of registered nurses needed. Patient satisfaction is high.

knowledge building

Remain competent. Pursue lifelong learning. Share the knowledge. To become a leader, actively pursue learning opportunities, both formal and informal, and learn to share knowledge with the professional colleagues you encounter.

time management

Remain goal oriented. Identify priorities. Establish personal goals.

patient and family centered care

Respect and dignity Information sharing Participation Collaboration

Delegation Five rights

Right task Right circumstances Right person Right communication Right supervision

SBAR

Situation - what is happening ? Background- what is the clinical background ? Assessment - what do I think the problem is ? Recommendation- what would i recommend? ISBARR - I identify , R read back

A nurse considers that communication links people with their surroundings. What should the nurse identify as the most important communication link?

Social Without some form of communication, there can be no socialization. People interact with other social beings, not with inanimate objects. Physical, materialistic, and environmental surroundings are all inanimate and cannot interact.

Nursing Process: Assessment

Through the patient's eyes Gather information, synthesize, apply critical thinking Physical and emotional factors Developmental factors Sociocultural factors Gender

Building a Nursing Team

a strong nursing team works together to achieve the best outcomes for patients; effective team development requires team building and training, trust, communication, and facilitates collaboration; transformation leadership- inspires to strive more; time and empowerment

Elements of Professional Communication

appearance, demeanor, behavior, courtesy, use of names, trustworthiness, autonomy and responsibility, assertiveness

nontheraputic communication techniques

asking personal questions; giving personal opinions ;changing the subject; automatic responses; false reassurance ; sympathy; asking for explanations; approval or disapproval; defensive responses

nursing patient relationship

caring relationships are the foundation of clinical nursing practice therapeutic relationships promote a psychological climate that facilitates positive change and growth.

motivational interviewing

client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence to change usually open ended questions

leadership skills for nursing students

clinical care coordination, team communication, delegation, knowledge building

Developing Communication Skills

critical thinking- ability to formulate a good reasoning perseverance and creativity- personal satisfaction ; self-confidence- humility- being humble, important to value others integrity- beyond being honest, doing things the right way

decision making

decentralized management means that decision making occurs at the level of the staff encompasses - responsibility - duties and activities an individual is employed to perform autonomy - independent decisions about patient care authority- legitimate power to give commands and make final decisions specific to a given position Accountability - answerable for the actions

case management

development of patient care plans to coordinate and provide care for complicated cases in a cost-effective manner. collaborative process of assessing and planning and facilitating, advocating

evaluate

evaluate process, patient response, therapy efficacy, patient and expected outcomes

patient safety and health care quality

in the US health care system, an estimated 98,000 medical erros occur each year that lead to patient injury and death

collaboration

is a development of partnerships to achieve the best possible outcomes that reflect the particular needs of the patient, family , or community , requiring an understanding of what others have to offer

three primary categories

linguistic communication; spoken words or written paralinguistic communication - nonverbal messages ( gestures) Metacommunication - context of message ; nonverbal ; person upset but sends a smiley,

decision making

nursing manager supports staff through, establishing nursing practice through problem solving committees or professional shared governance councils ; staff communication ; staff education ; rounding

nursing patient relationship phases

preinteraction phase - occurs before meeting orientation phase- when the nurse & the patient meet & get to know working phase- when the nurse and the pt work together solve problems and accomplish goal Termination phase - occurs at the end of a relationship

delegation

the transfer of responsibility for the performance of an activity to another individual while retaining accountability for the outcome requires knowing which skills are transferable

implementation continued

therapeutic communication techniques; sharing observations ; clarifying ;focusing;paraphrasing sharing empathy sharing hope sharing humor sharing feelings using touch ; using silence

Developing Communication Skills cont

thinking is influenced by perception ; five sense culture; education; perceptual bias; emotional intelligence; thinking plus perception - opinion perceptual bias- can be perceiving in a negative way emotional intelligence- can relate w/ pt when you do not have this; when you can control your emotions you have emotional intelligence

Evaluation

through the pts eyes; patient outcomes; nurses and pts need to determine whether the plan of care has been successful ; nursing interventions are evaluated to determine which strategies or interventions were effective ;if expected outcomes are not met, the plan of care needs to be modified

Nursing Care Delivery Models

traditional - team nursing , primary nursing today's models - pt centered care ; total pt care; case management

Patient Safety

• The Institute of Medicine (IOM) identifies effectively working together as an important professional competency. • The Joint Commission has cited the breakdown in communication among team members as the primary factor in sentinel events. senttinel event- any issue to pt that results pt to death; ex pt falls and they die

communication and nursing practice

•A lifelong learning process for nurses •Therapeutic communication promotes personal growth and attainment of patients' health-related goals •Key to nurse-patient relationships •Patient safety requires effective communication •Improves patient outcomes and increases patient satisfaction

Forms of Communication

•Verbal (language) •Nonverbal (body language) -Facial expressions, touch, eye contact -Posture, gait, gestures -General physical appearance -Mode of dress and grooming -Sounds, silence -Electronic communication Pacing - talk slowly quick or slow Intonation - high pitch or low Clarity - use fewer words timing and relevance - pt gert