Leadership & Management Module 19

Nonverbal communication is thought to make up what percentage of the communication process? 1. Over 90% 2. 50%-70% 3. 35%-50% 4. <35%

2. 50%-70% Researchers believe that body language (including facial expressions, body movements, and gestures) account for between 50% and 70% of all communication.

When you explain what the nurse believes the issue is, which stage of SBAR would the nurse be demonstrating? 1. Situation 2. Background 3. Assessment 4. Recommendations

3. Assessment Explaining what the nurse thinks is the issue is part of the assessment tool of SBAR. The other components are associated with description of the problem, background information, and suggestions related to treatment.

Rapidly advancing communication technology has great potential for increasing the productivity and effectiveness of an organization. What is the threat or challenge that exists with new methods that include intranet and electronic information systems? 1. Pose a threat to patient confidentiality. 2. Ineffective communication tool. 3. Will replace nonverbal communication. 4. Replace active listening.

1. Pose a threat to patient confidentiality New forms of communication technology pose a threat to patient confidentiality because the platforms can be breached by unauthorized users. Any breaches in confidentiality should be handled immediately by the nurse leader. Health care facilities have developed policies and procedures to protect the confidentiality and privacy of personal and patient information; however, the threat continues to exist.

Using the SBAR model, when the nurse is providing the background of a patient to teammates, what information should the nurse include? Select all that apply. 1. Patient's name and room number 2. Admitting diagnosis 3. Past medical history 4. current medications 5. Issues identified for discussion

1, 2, 3, & 4 Background information includes admission information, medical history, and current treatments. Issues identified to be discussed would be provided under the situation component of the SBAR tool

Which factor does The Joint Commission consider to be the biggest challenge to successful interprofessional teams? 1. Personality clashes 2. Lack of shared vision 3. Inefficient communication 4. Not having the right people on the team.

3. Inefficient communication

T or F: Channels of communication include upward communication, downward communication, horizontal communication, diagonal communication, and grapevine.

TRUE Channels of communication used by nurse leaders and managers include upward (subordinate to superior), downward (superior to subordinate), horizontal (peer to peer), diagonal (between various team members and managers at all levels), and grapevine (informal, haphazard, and considered random).

T or F: SBAR and ISBAR provide the nurse leader with tools to effectively communicate between team members.

TRUE SBAR and ISBAR have the potential to decrease ineffective communication; it has removed the need for long narrative descriptions and replaced it with a clear and concise alternative communication tool. The SBAR and ISBAR use are essential for ensuring patient safety outcomes.

Which of the following is a form of communication that allows people to express themselves in direct, honest, and appropriate ways reducing tension in the workplace? 1. Assertive communication 2. Aggressive communication 3. Passive-aggressive communication 4. Passive Communication

1. Assertive Communication Many people confuse assertive communication with aggressive communication, and therefore, the assertive communication technique can be associated with negativism.

How much of what we communicate is conveyed through body posture, facial expressions, and tone of voice? 1. Less than 10 percent 2. About 25 percent 3. Between 50 & 70 percent 4. Between 80 & 95 percent

4. Between 80 & 95

A nurse manager is using face-to-face communication when discussing a staff member's performance evaluation. What does the manager determine are the benefits of this method of communication in this situation? (Select all that apply.) 1. The staff member will agree with all aspects of the evaluation. 2. It will strengthen the connection between the manager and staff member 3. The manager can determine if the staff member understands the evaluation 4 It will combine verbal and non-verbal communication to convey messages 5. It will prevent any misunderstandings from occurring.

2, 3, & 4 Misunderstandings can definitely happen in-person; however, by aligning verbal and nonverbal cues and checking understanding in the moment, you can minimize misunderstanding. Face-to-face communication will strengthen the connection between the two and give each the opportunity to ask and answer questions. The manager can ask questions and seek clarification that the staff member understands the performance evaluation. The manager and the staff member can observe verbal and nonverbal cues to understand more than just the spoken word. Face-to-face communication does not ensure that the staff member will agree with the performance evaluation but will present an opportunity to refute any potential disagreement.

A charge nurse informs a staff nurse that they will be admitting the next patient that arrives on the unit. The staff nurse states acceptance and then proceeds to tell the other nurses that the charge nurse is unfair. What type of communication is the staff nurse displaying? 1. Passive communication 2. Aggressive Communication 3. Passive-Aggressive communication 4. Assertive Communication

3. Passive-Aggressive Communication Passive-aggressive communication occurs when a person sends an aggressive message in a passive way. It involves limited verbal exchange by a person who feels strongly about a situation. They feign withdrawal in an effort to manipulate the situation. They may say yes when they want to say no and then complain about others behind their back. Passive communication occurs when a person suffers in silence although they may feel strongly about the issue. Aggressive communication is direct, threatening, and condescending.

T or F: The SBAR tool was first used in the hospital to facilitate safe patient handoffs.

FALSE SBAR was first used in the navy to provide efficient communication between the nuclear submarines. It was further developed by Kaiser Permanente.

A nurse leader is introducing a new glucometer protocol to members of the staff. What method of communication would best be used to make all staff aware of this change? 1. Written Communication 2. Verbal Communication 3. Nonverbal Communication 4. Telephone Communication

1. Written Communication Written messages and texting allow for documentation. Verbal communication is rapid but may result in fewer people receiving the information than necessary. A telephone call is rapid and allows the receiver to clarify the message at the time it is given but does not ensure receipt of the message. Nonverbal communication does not relay a message and is open for interpretation. It would not clearly communicate the new protocol.

A nurse manager is relaying information about staffing changes to the staff on the night shift. What form of communication is the nurse manager using to deliver the changes? 1. Grapevine 2. Diagonal 3. Horizontal 4. Downward

4. Downward In downward communication, the manager relays information to subordinates. In diagonal communication, the manager interacts with personnel and managers of other departments and groups such as providers, who are not on the same level of the organizational hierarchy. In horizontal communication, managers interact with others on the same hierarchical level as themselves who are managing different segments of the organization.

T or F: The American Nurses Association and the National Council of State Boards of Nursing have established principles for social networking.

TRUE In 2011, the Principles for Social Networking and the Nurse was published by the American Nurses Association, in conjunction with National Council of State Boards of Nursing. It has established the six principles for social networking to protect patients' right to privacy.

In the SBAR model, when giving recommendations, what kinds of things should be communicated? (Select all that apply.) 1. Any new treatments or changes ordered 2. Opinions for further action 3. The background or context of the situation 4. The patient's condition and state what you think the problem is. 5. A concise evaluation of the situation in a couple of sentences.

1 & 2 When giving recommendations, it's important to identify any new treatments or changes that have been ordered, and to provide opinions or recommendations for further action. Communicating the context of the situation occurs during the background stage of the SBAR model, and evaluating the patient's condition is part of the assessment stage.

T or F: Some facilities have included an 'Introduction step' to SBAR now called ISBAR in efforts to include an introduction for clinicians during a patient handoff.

TRUE Some health care facilities feel that the 'Introduction step' which includes an introduction to the person who is handing off the patient will clarify and identify the role the person played in the patient's care.

T or F: Effective leadership requires the nurse manager or leader to develop verbal communication skills in order to decrease tension in relationships, decrease anxiety, and prevent depression

TRUE The most important skill required to function well as a nurse leader/manager may be the ability to effectively communicate. Effective communication transmits information in a clear, precise manner assisting with good interpersonal skills including sensitivity and respect for others.

A nurse manager is assessing the internal climate of communication with a group of staff members prior to a meeting. What would the manager consider to be a part of the internal climate of communication? (Select all that apply.) 1. Values 2. Feelings 3. Status 4. Stress 5. Power

1, 2, & 4 The internal climate of communication includes values, feelings, temperament, and stress levels of the sender and the receiver. External climate includes status, power, and authority, as well as weather conditions, temperature, timing, and the organizational climate.

In the SBAR model, what should be conveyed when explaining the situation? (Select all that apply.) 1. Events currently happening 2. Objective statement of the problem 3. Assessment data collected 4. Recommendations for treatment changes 5. Information in a narrative or story form.

1, 2, 3, & 4 Components of the SBAR tool include describing the situation and the problem in an objective, not subjective manner; providing relevant background information; collecting and summarizing assessment data; and finally identifying any possible new orders or changes to existing orders. This format avoids the presentation of information in a narrative format.

Which aspects of creating a successful interprofessional team are addressed by SBAR? (Select all that apply.) 1. Maintaining a shared vision 2. communicating effectively and efficiently 3. Ensuring role clarity 4. Offering a recommended plan of action or next steps 5. Determining leadership of the team

1, 2, 3, & 4 SBAR addresses the aspect of sharing communication effectively and efficiently across the team. While many of the examples in the lesson address using SBAR to relay patient information, the goals of maintaining a shared vision and ensuring that roles are clear require effective and efficient communication as well. They could also be achieved through use of SBAR tool. Determining leadership of the team is determined by the definition and structure of the team but by its form of written communication.

A nurse manager wants to increase the effectiveness of communication with a staff member since the staff member did not respond positively to the same message previously. What action by the manager would improve the communication? (Select all that apply.) 1. Make the message clear & concise 2. Use common terminology 3. Stay positive when sending the message 4. Have the staff member state understanding of the message. 5. Use the previous technique with the staff member.

1, 2, 3, & 4 The message should be clear and concise so that the receiver can understand what the manager is stating. It is beneficial to have the staff member clarify by stating their understanding of the message. Whenever delivering communication, it is proper to stay positive, or at least neutral. Use a common terminology so that the receiver understands what is being said. If the same technique is used, it is likely that the receiver of the message will not understand.

A nurse manager is conducting a meeting with staff. What factors may significantly influence how communication is received and perceived during the meeting? (Select all that apply.) 1. The level of the manager 2. The unit mission 3. Stress levels 4. Gender differences 5. The age of the manager

1, 3, & 4 Levels of authority and gender are external environmental factors that may impact how a message is received. How a person processes stress is an internal environmental factor that may also affect how the person perceives or receives a message. The mission of the unit impacts process and actions by the staff, but is unlikely to play a role in how communication is received or perceived. The age of the manager does not play a role in how the communication is received and perceived.

A health care provider is attempting to improve their connection with the nursing staff. What communication strategy would be appropriate for the health care provider to use to make this change? 1. Maintain eye contact and nod or vocalize to show interest in conversation. 2. Use touch as a nonverbal cue of acceptance. 3. Interrupt nurses going off on tangents in order to model keeping them focused. 4. Hesitate prior to responding.

1. Not everyone likes to be touched, so using the nonverbal cue of touch with everyone would not be effective or authentic. In general, modeling is a great teaching tool; however, modeling interruption instead of honoring the flow of a conversation would not create the connection this doctor seeks. Hesitation often diminishes the effect of the statement and is not an effective means of nonverbal communication.

A new nurse leader asks for strategies to improve communication skills since there has been a large turnover of nursing staff. What suggestion from the director would be beneficial for the nurse leader? 1. Be congruent in your verbal and nonverbal communication. 2. Use aggressive communications to show the staff you are in charge. 3. Allow them to think you are listening to their complaints 4. Restate messages using passive language

1. The nurse leaders should always be congruent in what is being said as well as body language and gestures during communication. The receiver then knows the message is being heard. Assertive technique and not aggression should be used in communication. Insincere listening will not improve communication skills and will destroy any trust in the relationship between the staff and nurse leader. Messages should be restated using assertive, not passive, language.

A nurse working in a large, diverse university hospital informs the charge nurse, 'I never know how far apart to stand from someone since we have patients from many cultures.' What is the best response by the charge nurse? 1. It really doesn't matter, people should just accept it. 2. For personal interactions, you should stand at least 5 feet away. 3. The degree of space is going to vary with cultural norms. 4. About 14 inches is appropriate for a social interaction.

3. The degree of personal space required depends on who is talking and the situation. It also varies according to cultural norms. Some cultures require greater space between the sender and the receiver than others. In the United States, between 0 and 18 inches of space is typically considered appropriate only for intimate relationships; between 18 inches and 4 feet is appropriate for personal interactions; between 4 and 12 feet is common for social exchanges; and more than 12 feet is a public distance. Most Americans claim a territorial personal space of about 4 feet.