Communication in Healthcare

Presented by Samantha Nziengui

Introduction

What is communication

Importance of communication in healthcare

Significance

Improved communication during shift report can help catch potential medical errors ( IOM, 2009).

SBAR

Clinical Proposal

Tool :KardexTarget population:

Healthcare providersHealthcare setting

Description of the ToolKardex divided into 4

sections

1st section patient history:

patient name, age, gestational age, gravity/parity, gestational age, due date, primary physician, home medications, allergies.

History

Exams

Labs

Procedure/Plan of care

2nd section Exams: current findings vitals signs, vaginal exams,

any bleeding, physical assessment.

3rd section Labs: Patient’s current lab results: blood type,

group beta strep status, RPR, HIV, HepBsag, Rubella, CBC,

Description of the Tool

ToolHistory (Present Status)

Exams (Pertinent Findings)

Labs Plan of Care

Mrs.--------------------is a ------y.o. G……P…….Patient of Drs.----------------/---------------□ GA---------EDD---------□ Elective□ Indicated---------□ Forceps □Vacuum—□ VBACx----□ BTL yes----no□ Language---------

Home medications□ PNV----------------------□ Iron-------------------------□ Insulin------------------------□ BP---------------------------□ Antibiotics------------------------□ Others-----------------------------

T--------P-------R--------BP-----/-----Vag exam□ NKDA□ Allergies (item/reaction)---------------/-----------------------------/---------------

Blood HbsAg--------Rubella--------HIV--------RPR------GBS---------□ treated x -----Admission Labs□ T&S□ RPR□ CBC□ Walk in labs□ Rapid HIV

Delivered □Vaginal □ C-sectionThe-----------at---------Meds Given in L&D□ Toradol 1st dose time---------□ Ancef-------------------------□ Motrin---------------□ Tylenol---------------------□ Percocet------------------□ Bebadryl----------------□ Others----------------------------

ExamsAble to void x ------FoleyEpisiotomyLaceration-----------deg-------Dressing Dry and IntactLochia WNLDiet------------------

Mother/Baby Plan of care Skin to Skin yes noBreastfeeding time-----Left breast:------------Right breast:----------Stool: yes noVoid: yes no

Baby□ Male□ Female Weight-----□ Twins (Time/Weight)A--------/--------M/FB--------/--------M/F□Breast □Bottle□ Circumcision □ HepB Vac□Vitamin K□ Erythromycin

 

 

Prenatal Records □Yes □ No□SROM □ AROM □PROM Time:Complications □Yes □ No□GDM □ PIH □Anemia □PPH□PTL □Seizure □Meconium□Febrile □ Other---------------

 

Room Name Age OB Ped

HELP Report/Postpartum Care Kardex

long term goals Enhance nurses autonomy while providing

patients care Decrease patient safety risks due to errors, short terms goals Empower nurses on patients’ advocacy Provide effective patient care by reducing

errors related to miscommunication

After the implementation of the tool, nurses on the unit will be able to:

Identified the importance of effective communication during shift report

Describe the importance of quality exchange information when handing over patient care

Cite the benefits of using the new communication tool during shift report.

EvaluationMonthly staff

meeting1. Survey

questionnaire: rate the effectiveness of the tool from 1 to 10

2. How helpful is the

3. tool related to your work? Please rate the quality of the tool.

Chapman, K. (2009). Improving Communication Among Nurses, and Physicians. AJN retrieved April 29th, 2013 from http://www.nursingcenter.com/pdf.asp?AID=940556.

 Curtis, K., Tzannes, A., & Rudge, T. (2011). How to talk

to doctors - a guide for effective communication. International Nursing Review, 58(1), 13-20.

  Evans, D., Grunawait, J., McClish, D., Wood, W., &

Friese, C. R. (2012). Bedside Shift-to-Shift Nursing Report: Implementation and Outcomes. MEDSURG Nursing, 21(5), 281-292.

REFERENCES

Christian, K., Haight, T. (2009). Improving communication using a cancer treatment schedule tool. Oncology Nursing Forum, 36(3), 15. 

Jefferies, D.(2012). Communicate with clarity. Nursing Standard, 26(40), 62-63.

Middaugh, D. J. (2013). Signal-to-Noise Ratio: Filtering Out Ineffective Communication. Medsurg Nursing, 22(4), 262-264.

REFERENCES

Institute of Medicine (2009) To Err Is Human: Building a Safer Health System, retrieved 10/30/13 from http://www.justice.org/cps/rde/justice/hs.xsl/8677.htm

The Joint Commission (2007) Sentinel Event statistic retrieved 10/30/13 from http://www.jointcommission.org/assets/1/18/General_Information_1995-2Q2013.pdf

References