Communication in health Flashcards

Communicate and work effectively in health and community services

1
Q

Benefits of effective communication:

A

Keeps everyone in the loop, feeling informed and like part of the team. Whenever major and minor misunderstandings arise the cause can usually be traced back to poor communication

Ties together team members, management and external agencies.
Welds together the various parts of a service or organisation into an enterprising, efficient and effective business that serves both the economy and the community as a whole

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2
Q

Forms of communication:

A
words
symbols
pictures
graphics
voice
tone
facial expressions
clothing
body language.
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3
Q

“Six C’s of Communication”:

A
Clear 
Complete 
Concise 
Concrete 
Correct 
Courteous
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4
Q

Person centred practice:

A

Healthcare which is tailored to individual needs, preferences and cultural diversity.
Also known as client centred practice or patient centred practice.

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5
Q

Universal needs:

A

The universal needs we all have, such as basic survival needs, must be met.
In these needs we are more similar than different.
We all need a safe place to live and we need food and clean water. We have the need for knowledge, work to support ourselves and our family and we have spiritual aspirations.

The way these needs are met is determined to some extent by the culture in which we live.

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6
Q

Communication types:

one- and two-way

A

Intrapersonal:
The internal use of language or thought.
Often used for clarifying information or analysing a situation. For example, the nurse observes that the patient is shivering and the nurse thinks to themselves ‘perhaps the client is cold, maybe I should check their temperature and get another blanket if necessary’.

The nurse observes the patient’s needs and thinks internally to address the problem

Interpersonal:
Basic to human interaction and essential for healthcare practice.
Communication is a process that requires interpretation, sensitivity, imagination and active participation.
Nurses interact with many persons in the course of their profession and effective communication assists in meeting legal, ethical, and clinical standards of care.
If communication is ineffective, there may be serious difficulty, increased liability and a threat to professional credibility.
Interpersonal communication requires sensitivity

Transpersonal:
Can be thought of as communicating spiritual sensitivity or emotional support.
Transpersonal communication may be demonstrated by the nurse as they enhance therapeutic relationships with the client by conveying acceptance, respect and non-judgemental attitudes and instilling hope in the future for the client and their family.

Transpersonal communication conveys respect and non-judgemental attitudes.

Small group:
This type of communication may be utilised by the nurse in many instances, from handover at the commencement of shift to the nurse who leads and Occupational Health and Safety Committee or to one who is participating in a support group for clients with particular health issues, such as rehabilitation.
Small groups are more effective when they have a suitable environment and all members of the group are aware of the objectives of the group and committed to working towards achieving these objectives.

Small group communication is more effective when all members are committed to a common goal.

Public:
Communication to an audience where the nurse who is presenting at a conference or leading a classroom discussion with peers must plan how to convey their message effectively.
Consideration needs to be given to the verbal information (being relevant and interesting) and the non-verbal gestures, tone and volume of voice being appropriate to the needs of the group. The presenter must consider if they require technology to support their presentation, enabling the audience to have the verbal message enhanced by the use of pictures and the written word. The size of font and the simplicity of the written communication need to be considered if the message being conveyed is to be effective.

Public communication considers verbal and non-verbal cues from the audience for effective delivery.

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7
Q

One-way interaction:

A

The sender is in control.
This form of communication generally sees the receiver give little, or no, response to the sender of the message.

Advantages:
Faster
Orderly
Authoritative

Disadvantages:
No receiver participation
Lack of feedback
Unable to assess understanding

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8
Q

Two-way interaction:

A

The message is sent, received, interpreted and response(s) given. It requires more time and energy and involves questioning, clarification and active listening.

Advantages:
More receiver participation
Open to feedback
Able to check for understanding

Disadvantages:
Slower
Can be a more challenging skill

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9
Q

The essence of effective communication:

A

Responding with meaning.
As the process of this communication is influenced by a number of significant variables, the meaning cannot be merely transferred from one human being to another, it must be mutually negotiated.

If you send communication to a colleague/supervisor and it is returned to you, the flow then becomes two-way. When communications are distributed among a department, such as a report that requires comments from other colleagues, the flow will become a two way flow as soon as the team members return their comments to the original sender.

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10
Q

Listening is:

A

One of the most important skills you can have. How well you listen has a major impact on your effectiveness, and on the quality of your relationships with others.

It is not:
Maintaining polite silence while waiting for a break in the flow of talk so you can jump in.
Mentally rehearsing what you want to say next or waiting for flaws in the information so you can pounce on them.

True listening is about trying to understand how the other person sees things, which can’t be achieved with poor listening habits like interrupting, jumping to conclusions, finishing others’ sentences and changing the subject.

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11
Q

Active listening:

A

Look at the speaker, to observe body language and listen for changes in voice tone and pitch.
Ask questions, summarise frequently and repeat in own words what you’ve understood the conversation to be about.
Don’t rush the speaker. Be poised, calm and emotionally controlled.
Respond with positive non-verbal communication such as smiles and nods.
Let people finish what they are saying before offering an opinion.

How can I be a better listener to gain more information?
PARAPHRASE the speaker’s meaning.
CLARIFY misunderstandings with phrases like ‘You feel…’ ‘You think…’ ‘It seems to you that…’ ‘You sound as though…’
WAIT OUT pauses - allow the speaker silence to gather their thoughts.
Only address the FACTS - don’t get caught up in emotions.
Remain NEUTRAL (don’t make judgements).
Don’t second guess the speaker and start adding or subtracting to their statements

Active listening prevents and minimises misunderstandings because it provides clear feedback from the receiver to the sender about what has been understood. Active listening also helps to build trust and encourages the speaker to provide you with more information.

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12
Q

Non-verbal communication:

A
Use of body language  to support the transmission of a message, such as:
facial expressions;
gestures;
touch;
and appearance

The sender needs to be aware that the message may be confusing to the receiver if the non-verbal communication does not match the verbal communication.
It is important to be aware of the non-verbal messages that are sent by others or to others.

Non-verbal communication ‘speaks’ very loudly and if it is not consistent with what is said verbally, in a given set of circumstances, it can cause confusion and there are times when it may completely override the sender’s intended message.
Example:
you notice a client is agitated, going red in the face and scowling. You ask them if they are upset and they deny that they are feeling upset. This example illustrates a disparity between the feelings that are being communicated non-verbally and the verbal response from the client.

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13
Q

What percentage of a message is taken from body language?

What does body language include?

A

Over 70%

Facial expressions, gestures, eye contact, posture, body orientation and the distance you stand or sit from the person you are talking to communicate meaning. Even the way you dress makes a statement about you and your business.

Tone of voice equates to approximately 23%, with the actual words spoken being only ~7%

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14
Q

You have mastered the art of effective facial communication when:

A

You can maintain a warm, friendly facial expression even when confronted with someone who irritates or challenges you. Refraining from using negative facial expressions like rolling your eyes, scowling, or even worse, yawning, is the hallmark of a professional.

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15
Q

How can I use gestures to help me communicate?

A

Gestures can be used to:
Emphasise a point (pointing to a wrist watch to suggest time is running out);
Illustrate a point (creating a shape with your hands or miming an action);
Communicate a desired action (motioning to a chair inviting someone to sit down).

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16
Q

Is there any such thing as a negative gesture?

A

Yes, gestures can also be used negatively.

Your challenge will be to keep ‘unconscious’ gestures, like tapping your feet, in check.
At all times your facial expressions and gestures should match the meaning of your words.

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17
Q

So, what happens when I send mixed messages while communicating?

A

It risks confusing the recipient
It raises doubts about how genuine you are
It raises questions about your credibility or knowledge.

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18
Q

A professional image:

A

is not only generated from appropriate facial expressions and gestures alone. Hygiene and grooming are also very important.

is imperative and can be aided by projecting your professionalism visually.

To project a professional image you can:
Wear smart casual or corporate attire appropriate for the situation
Invest time into staying well groomed (neat hair, clean nails etc.)
Pay attention to your personal hygiene (keep deodorant at work if you sweat a lot, make sure your breath is fresh before treating clients etc.)

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19
Q

Verbal communication:

A

the spoken part of communication. It can be face to face, over the telephone, or via voice mail.

Advantages:
fast;
easy;
natural. 
Disadvantages:
words “disappear” once spoken;
conversations are often remembered differently by different participants-if at all. 

Word selection impacts not only the message that is sent but also the ability to receive and respond to that message. For example, the use of professional jargon with a client may be confusing since the interpretation of the word may be different from a medical perspective to a layperson’s understanding.

We need to tailor our communication to the person that we are speaking with and need to consider that the way we speak with clients may be different to the way we speak with colleagues, managers, friends and family.

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20
Q

Tips for verbal communication in a healthcare setting, when
Speaking to patient:
Speaking to nurse etc:

A

Speaking to patient:
You should address your patient by name unless they have specified otherwise.
You also need to explain any procedure to a client properly and then obtain consent.
Avoid unnecessary terminology.
Don’t be abrupt, it’s disrespectful.
Explain why, if you are unable to meet any requests.
If you are not able to do something immediately try and let your client know how long you will be.

Speaking to nurse etc:
You should always refer to a client by name rather than room number.
Explain what the problem is to help the nurse prioritise their time.
(eg: Mr Johnston wants to speak with a nurse about his sore arm. Could you take a look at him when you get a chance?)

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21
Q

Positive phrasing:

A
  • tells the listener what can be done
  • suggests alternatives and choices available
  • sounds helpful and encouraging, not bureaucratic
  • stresses positive actions and positive consequences that can be anticipated
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22
Q

Negative phrasing:

A
  • tells the listener what cannot be done
  • can have a subtle tone of blame
  • includes words like can’t, won’t, unable to
  • does not stress positive actions that would be appropriate, or positive consequences
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23
Q

Turning negative phrases into positive phrases:

A

Eliminate negative phrases and replace them with positive ways of conveying the same information.
Examples of positive phrasing.
I will do all that I can to help you
How can we make this a positive experience for you
I understand what you are saying
If you just provide us with (whatever), we can do (whatever)

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24
Q

Clarification:

A

confirms mutual understanding, by offering back to the speaker the essential meaning, as understood by the listener, of what they have just said.

Clarification involves:
Ensuring that the listener’s understanding of what the speaker has said is correct, reducing misunderstanding.
Reassuring the speaker that the listener is genuinely interested in them and is attempting to understand what they are saying.
It can involve asking questions or occasionally summarising what the speaker has said.

A listener can ask for clarification when they cannot make sense of the speaker’s responses. Sometimes, the messages that a speaker is attempting to send can be highly complex, involving many different people, issues, places and/or times. Clarifying helps you to sort these out and also to check the speaker’s priorities.

Through clarification it is possible for the speaker and the listener to make sense of these often confused and complex issues.
Clarifying involves genuineness on the listener’s part and it shows speakers that the listener is interested in them and in what they have to say.

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25
Q

Timely communication:

A

Improves the likelihood of effective communication
Assists decision making
Demonstrates respect
Improves safety

Even if we clearly communicate a message, poor timing can result in that communication being effective.
Example: trying to provide client education when a client is in severe pain would most likely render that communication ineffective.

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26
Q

Confidential communication:

A

Maintaining confidentiality is a sign of professionalism and respect.
Each client has a right to privacy and it is important for each healthcare worker to protect this privacy.
You cannot give out any information about a person without their permission.

In a health care setting, you will deal with a lot of personal and sensitive information including a person’s age, gender, address, and date of birth, as well details of health and family issues. Information of a personal or sensitive nature should only be discussed with the appropriate people when and where others cannot overhear the conversation.

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27
Q

Examples of breaches of confidentiality:

A

Client asks you how the man in the next bed is and if he is getting better. You tell him that the man is not doing well and needs to go for further tests.

Client is sat out in the chair and while you are making the bed with your colleague, you begin discussing one of the other residents.

Client has a severe leg ulcer and while you are assisting the nurse to redress the wound you take a photo and then later post it on social media.

You participate in a bedside handover of patient information and relatives of one of your patient’s overhear.

You go out to dinner after work with some colleagues and friends and openly discuss one of the clients that you have been looking after.

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28
Q

Confidential documents:

A

Documents need to remain private and confidential.

If documents of a sensitive nature are left where members of the general public or other unauthorised people may access them, the information within them could be taken out of context or made public.
There also may be information that the client does not wish their family, friends or others to know.

Records also need to be correctly stored and eventually destroyed by the correct personnel to make sure that information of a sensitive nature does not get into the wrong hands.

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29
Q

Confidentiality is important because:

A

It allows clients a safe place to talk about their health needs and any health problems they may have;
It helps clients trust your service because they know their health information will be kept private;
It lets clients know that they can decide who knows about their health issues and concerns.

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30
Q

Maintaining Confidentiality:

A

Personal or confidential information about a client should only be provided to another person if it is for the purpose of the client’s health and the client has agreed to the information being shared.

You may share certain information about a client with another health professional to help them understand and meet the client’s needs – with your client’s consent.

When you are required to provide information about a client to other people, it is important that you seek permission from the client to do so and only when it is obtained can you share the information with the consented parties.

You must not provide any information about a client in your care to the media, or allow media access to the client records.

Any client notes or records should be kept in a safe place (a lockable filing cabinet only accessible by those requiring it for treatment purposes)

Before sharing information you should always ask yourself, ‘Does this person need to know the information I am about to share and why do they want it?’ If I give this information will I be breaking the rules of confidentiality?

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31
Q

Following instructions:

A

When working in healthcare, it is important to listen to, clarify and agree timeframes for carrying out instructions you are given in the workplace.

An instruction or procedure is a series of steps to follow in a specific order to achieve a certain result. They are used to carry out an action which you may not be familiar with and by being explicit, can save time and prevent accidents and errors.

Following instructions is important for a number of reasons.
Safety of yourself and others
Following organisational policy and procedures
Prevention of errors
For an organised workflow

32
Q

Negotiation re: instructions:

A

When receiving instructions it is important that you know what needs to be done.
If instructions are too complex or unclear, the message may not get through.
As an AHA it is important that you clarify instruction if you are unsure what you have been asked to do. Not doing so can result in the wrong task being performed or a task being performed incorrectly.

When given instructions it is important to agree a timeframe for carrying out the instruction with your supervisor. In order to do this it is necessary that you are able to prioritise your duties. One method of doing this is to create a ‘to do’ list or time management sheet

33
Q

Procrastination:

A

To have a good chance of conquering procrastination, you need to spot straight away that you are doing it! Then, you need to identify why you are procrastinating and take appropriate steps to overcome the block.

Causes:
You don’t understand the difference between urgent tasks and important tasks;
You feel overwhelmed by the task and don’t know where to begin;
You doubt that you have the skills or resources you think are required;
You are waiting for the right mood or the right time to tackle the important task at hand;
You have a fear of failure or success;
You have underdeveloped or uncertain decision making skills;
You have poor organisational skills;
Perfectionism (I don’t have the right skills or resources to do this perfectly now, so I won’t do it at all)

34
Q

Multidisciplinary teams:

A

Within healthcare the delivery system includes:
nurses;
doctors;
allied health professionals;
auxiliary staff.
Multi-disciplinary care is an integrated team approach to health care for patients, where medical, nursing and allied health care professionals consider all aspects of patient care and collaboratively design an individual care plan for each patient.

35
Q

Multidisciplinary team communication:

A
Intra team communication:
    sharing information
    generating ideas
    solving problems
    designing actions
    evaluating the outcomes of actions

This means that team members will be required to clearly put forward their opinions, thoughts and ideas. They will also need to provide feedback that is useful and not personally damaging to a team mate/colleague.

In today’s workplace there are many methods of communication at our disposal. It is an advantage if the team establishes a number of ways in which members can communicate. The more frequent and up to the minute the communication, the better. Whichever forms are used they must be readily accessible to all.

Inter team communication:
This refers to the pathways of communication between the team and the organisation.
There may be both formal and informal methods designed to do this.
The team will need to provide the organisation with regular progress reports and updates and any other data that may be requested of them.

36
Q

Written communication:

A

This is much more permanent (than verbal/non-verbal) and, for many, carries a lot more weight. Written communication can have the advantage of being independent of individual memories or personal biases. If it is badly phrased, however, written communication can still be ambiguous and subject to misinterpretation.

Email, text messaging, and instant messaging are used widely for informal communications, but is often verbal/non-verbal.
In contrast, formal communication contains a greater proportion of written material, often because people need to keep records.
In formal or even informal communication, it is good practice to follow up a verbal exchange with written confirmation of what was said.

37
Q

Examples of each type of communication:
(verbal, non-verbal and written)
(7 examples of each)

A
Verbal:
Team meetings 
Telephone 
Video conferencing 
Presentations 
Conversations 
Training 
One-on-one meetings 
Non-verbal:
Tone of voice 
Active listening 
Drawings/diagrams 
Smiling 
Observation
Gestures
Body language
Written:
Newsletter 
Internet
Specifications
Instructions 
Email 
Faxes
Memos

While all communication contains one or more of the three primary communication forms in different combinations, some are more appropriate to formal communications and others to informal ones, but most can be adapted to suit specific circumstances.

38
Q

Healthcare funding in Australia

A

Consumes about 9% of Australia’s gross domestic product per year.
69% of health funding comes from public sources.

The Australian Health Care System is funded through a complex partnership between the Federal, State and Territory governments and the private sector (though there is debate about removing the state governments from the process, limiting health care budget to federal funding).
Money is raised by a system of taxes, levies and where possible, a ‘user pays’ process.

Public funding is usually politically driven, with working parties and areas of need identified by the government to establish ‘who gets what’.
When health funding is reduced, then some services are restricted or placed on care provision. (Example: cutting bed numbers in tertiary hospitals due to budgetary cuts, staff shortages or changes in the focus of health care)

39
Q

The partnership between public health institutions and private health insurers:

A

means that people have a choice - to be part of the private system or to use the public system.
The implementation and provision of health care is managed through local area health services in the public sector and by the operators of private facilities.

It is important that lines of effective communication are established between organisations in order for high quality healthcare to occur. For example patients may be transferred from one facility to another and in these situations effective communication is required for a seamless transition of care.

40
Q

Medicare:

A

Started in the 1970s under the Whitlam government as ‘Medibank’ and was renamed in 1984.
It is run by the Federal Government.
The Medicare system allows free, universal hospital cover for eligible persons in public hospitals.

The Pharmaceutical Benefits Scheme (PBS) is an extension of Medicare and allows prescription medications to be purchased by Australians at differing rates, depending on their income. There’s a threshold and once this threshold is met, the pharmaceuticals can be purchased at a discounted rate.

41
Q

Private health care:

A

Available in Australia under a ‘user pays’ system, whereby Medicare covers some costs, the private health company covers other costs and the patient pays the remainder or ‘gap payment’.
Private health care insurers and providers receive the majority of their funds from charging their members.

Private hospitals receive minimal to no funding from the government and are funded through the ‘user pay’ system of private health insurance. This is why there is a gap payment with private health.
The private health system also benefits from a private health rebate to all people who purchase private health insurance, which is paid for by the Federal Government. This rebate aims to encourage more participation in the private health system, to take some of the pressure of the public health system.

Private health insurance works alongside Medicare and can be used in both public and private hospitals. Patients have the right to elect to be admitted as a public patient even if they have private health insurance within public hospital facilities.

42
Q

Different methods organisations can use to communicate with each other:

A
Phone calls
    Faxes
    Health records/progress notes
    Electronic health records
    Handover/transfer documentation
43
Q

Healthcare industry’s terminology “language”:

A

Health terminology.

This language is used to communicate facts and ideas specific to medicine and healthcare.
It is used in written and verbal communication with clients, family, carers and colleagues.
These words and symbols relate to body systems, anatomical structures, medical diagnoses and procedures.

For someone new to the healthcare environment this terminology can sound like a completely different language and understanding it can be challenging and confusing at times. However, the construction of most medical terminology is based on word roots, prefixes and suffixes.

44
Q
contra—
post—
pre—
re—
semi—
trans—
uni—
 di—  or bi— 
tri—
quadr(i)—
A
against  (contraindicated)
after (postmortem)
before/in front of (premature)
again/backward  (relapse)
half (semilunar)
through (transgastric)
one (unilateral)
two (diplopia - double vision) 
three (triceps)
four (quadriceps)
45
Q

For unfamiliar words:

A

look up in a Medical Terminology dictionary

or ask a more senior colleague

46
Q
I.C.U.
H.D.U.
C.C.U.
O.T.
E.N.T.
O. & G.
O.P.D.
E.D.
C.S.S.D.
A
Intensive Care Unit
High Dependency Unit (very sick patients)
Coronary Care Unit (cardiac patients special care)
Operating Theatres or Operating Rooms
Ear, Nose, Throat
Obstetrics and Gynaecology
Outpatients Department
Emergency Department
Central Sterile Supply Department
47
Q

Communication protocols:

they may cover:

A

relate to the way in which information exchange occurs within an organisation.
Each organisation has its own set of communication protocols.

Communication protocols can provide clear direction and consistency and enhance accountability. Knowing the correct procedure helps to ensure that the information goes to the correct person and place.

Protocols may cover:
Methods of communication to be used;
Time-frames for responding;
Communication format (presentation guidelines, or signature on email);
Inclusive language (use correct titles; avoid gender based terms - chairman, wardsman etc)

The communication protocol may differ depending on who we communicate with and it is important to tailor communication to the person who we wish to interact with.
Example: a phone call may be an acceptable form of communication with our direct supervisor but an email or letter may be preferred if communicating with a senior manager.

48
Q

4-point communication cycle:

barriers encountered:

A

(intent) -> message -> (understanding) -> confirmation

ENCODING barriers are when the components of a message are not effectively chosen. This can include inappropriate words or terminology, poor communication skills or insufficient information. E.g: You explain to a client about a test they are about to have but speak only using medical terminology.
TRANSMISSION barriers are things that can interfere with the message. These can be physical or can occur when an inappropriate channel or communication medium used. E.g: You are provided with a long set of detailed instructions over the telephone, or Documents sit on person’s desk, because they have been overlooked in the pile or the person is unsure of how to handle the matter.
DECODING barriers occur at the receiving end of the communication cycle. E.g: Your client is emotionally distracted after receiving some bad news and you attempt to provide them with some information on how to take their medication.
RESPONSE barriers can arise when feedback is unsuccessful. E.g: Your supervisor provides you with some instructions but does not give you the opportunity to respond or check for your understanding.

Sender encodes Message, Receiver decodes. Both provide feedback.
Encoding = words, body language/written, tone and pace of voice etc. Take into account receiver’s background, mental clarity, education level etc.
Feedback = verbal and/or nonverbal.

49
Q

Examples of (individual) factors that can affect communication:

A
Language
    Culture
    Religion
    Disability
    Health
    Age
50
Q

Skills for dealing with difficult conversations:

A
Information gathering;
Being assertive;
Being empathic;
Being prepared to negotiate;
Using appropriate verbal and non-verbal language;
Listening;
Staying calm and focused.
51
Q

In face to face communication you can help the communication process by:

A

Asking a person to repeat themselves if you’ve not understood them due to a heavy accent;
Resorting to other communication techniques such as diagrams or pictures if language presents a major barrier to communication;
Remembering that speaking louder does not make your message any clearer when language is the barrier to communication - it can be mistaken as aggression.
Asking questions about a person’s religious practices (in relation to how those practices impact on their daily routines and possibly treatment)

52
Q

Three fundamental sources of conflict:

A

Different attitudes, values and beliefs
Conflicting needs
Ineffective communication

53
Q

Poor listening is often caused by:

A

Perception being distorted by attitudes, values or beliefs;
Threatened needs.
These can also cause aggressive behaviour, which can result in conflict.

54
Q

Conflict is healthy and a normal part of any human and team relationship.
Lack of conflict/disagreement could mean:

A

Staff members are relating at a very superficial level and not being as honest or effective as they could be.
Many people are conditioned to avoid conflict at any cost - that conflict is bad, a failure. Overcoming this tendency to avoid conflict is difficult and conflict resolution training is a good first step.

Dealing with interpersonal relationships is a complex subject that is often given inadequate attention. Each individual has a particular and unique personality style that has been shaped by the lifetime of their experience and this needs to be considered during conflict resolution.

Conflicts and miscommunications occur and are part of life. Not everyone thinks acts or responds in the same way and team members come under stress at different times which creates differences in tolerance and patience. Not everyone has the same level of commitment, honesty, or even integrity.

It is important to define a process that resolves problems and encourages members to talk about the issues under conflict in a controlled and reasonable way, even if those issues are intensely personal.

55
Q

It is important that unresolved conflict is addressed as it can result in:

A

Poor morale
Reduced productivity
Lack of timely communication
Poor decision-making due to poor communication
Inefficient workloads - restructured to accommodate employees in conflict.
Reduced collaboration (leads to patient care mistakes)
Increased absenteeism
Hidden agendas
Lost opportunities.
Litigation and dealing with grievances
Increased turnover - termination costs, recruitment and effective onboarding time – the national average of voluntary resignations due to unresolved conflict is 65%

Increased management activities – Managers spend more than 25% of their time working on reducing conflict.

‘Presenteeism’ – a term that describes a person who “retires on the job.”  They intend on leaving the job, but don’t.  They have lower commitment to their job and reduced moral.  It’s estimated that presenteeism may be as much as three times that of absenteeism (WarrenShepel (online), Health & Wellness Research Database, 2005).
56
Q

Privacy is:

A

the right of an individual to maintain control of information about them

57
Q

Confidentiality is:

A

how those working in healthcare treat information about the individual, such as whether or not they disclose that confidential information about their patients to outside organisations.

This type of disclosure should not be confused with Open Disclosure (OD) – which refers to medical staff telling a patient about errors or incidents that resulted in harm to them while they were receiving health care.

58
Q

Personal and sensitive information guidelines:

A

personal/sensitive information includes a person’s age, gender, address, and date of birth, as well details of health and family issues.
Information of a personal or sensitive nature should only be discussed with the appropriate people when and where others cannot overhear the conversation.

Documents must remain private and confidential.
If documents of a sensitive nature are left where unauthorised people may access them, the information within them could be taken out of context or made public. There also may be information that the client does not wish their family, friends or others to know.

Records also need to be correctly stored and eventually destroyed by the correct personnel to make sure that information of a sensitive nature does not get into the wrong hands.

59
Q

Discrimination:

A

Do not discriminate against any individual due to their health, age, gender, culture, religion, sexual orientation or language they speak.

60
Q

Duty of care:

A

Legal obligation to adhere to a standard of reasonable care.
All those that work within the health care environment have a duty of care to ensure that they communicate effectively with clients, relatives, colleagues and other healthcare professionals.

Example: duty of care to maintain privacy and confidentiality, to avoid discrimination and to ensure that we report any situations beyond our roles and responsibilities.

61
Q

Mandatory reporting:

A

Requirement for those working in healthcare to report suspected instances where harm may have occurred to others.

Required in suspected cases of:
child abuse;
elder abuse;
domestic violence;
    Threats to self-harm;
    Threats to harm others;
    Certain communicable diseases.
62
Q

Child protection legislation:

A

In Queensland the legislation that controls mandatory reporting of child abuse is the Child Protection Act 1999 (Qld) and Public Health Act 2005 (Qld).

“any detrimental effect of a significant nature on the child’s physical, psychological or emotional wellbeing”. Such harm can be caused by “(a) physical, psychological or emotional abuse or neglect; or (b) sexual abuse or exploitation” and the Act states that it is “immaterial how the harm is caused”. (Section 9 of the Child Protection Act 1999)

Mandatory reporters = workers and managers in:
Health care;
Welfare (social workers, youth workers etc);
Education;
Children’s services (childcare, day-care and home-based care);
Residential services (e.g. refuge workers);
Law enforcement (e.g. police)

The Department of Child Safety is responsible for overseeing and upholding child protection in Queensland.

Other relevant Acts for child protection:

Commission for Children and Young People and Child Guardian Act 2000;
Education (General Provisions) Act 2006;
Public Health Act 2005;
Adoption of Children Act 1964;
Family Law Act 1975
63
Q

Informed consent:

A

The patient is informed or aware of:
benefits, risks and side-effects of a procedure.
It is important that this is explained clearly to the patient and that their understanding is confirmed.

No treatment may be administered without the consent of the patient. If consent is not acquired this may leave the nurse open to the offences of:
Negligence
Trespass to the person including Assault and/or Battery or False Imprisonment.

64
Q

Three types of consent:

A

Written - Where consent for invasive procedures, e.g. surgery, is obtained in writing

Verbal - The client verbally agrees to a procedure after having it explained to them by the healthcare professional

Implied - Consent is implied by the actions or posture of the client

65
Q

If you are unable to perform required duties for any reason:

these reasons could include:

A

It is essential that you report this to your supervisor so that they can discuss this with you and allocate duties accordingly.

Reasons that you may be unable to perform duties could include:

Injury or illness
Lack of skills/knowledge
Insufficient time
Lack of experience
66
Q

Adverse events:

A

Any incident which results in harm, loss or damage. Adverse events can include:

    Falls
    Mistaken identity
    Pressure ulcers
    Adverse drug events
    Equipment malfunction
    Infections
    Violent or threatening behaviour
67
Q

(5) Key principles for completing high-quality documentation:

A

Document fact: documentation should be concrete and objective

Accuracy: Use exact measurements where possible

Completeness: all relevant information should be documented

Currency: the documentation should occur as soon as possible to time it occurred. (likely using 24 hour clock)

Integrity: the integrity of the documentation should be maintained even when errors have occurred

68
Q

How to ensure high-quality written documentation:

A
Legible handwriting;
Short and simple sentence construction;
Avoid jargon;
Only approved abbreviations to be used;
Correct spelling, grammar and punctuation;
Accuracy. factual and objective.

Occasional mistakes are inevitable. If clearly identified as mistakes/errors and corrected, the potential for misinterpretation is removed.
Avoid using correction fluid or scribbling out errors - instead use one line to cross out the error, and then initial the error.
Errors should be corrected promptly.

Avoid using generalised statements such as ‘no change’ or ‘had a good night’

Only complete documentation for tasks after you have completed them. Actions should not be recorded before they have been performed.

Avoid leaving lines or spaces as this prevents others writing in this space. A line should be drawn through any blank spaces.

Begin each entry with the date and time and end with your signature, name and title.

Always use black ink not pencil, in order to provide a permanent record.

Adhere to organisational procedures regarding documentation.

69
Q

Electronic records and information support the provision of quality health care by allowing:

A

Sharing of information between health professionals, facilitating a shared understanding of the patient’s state of health: medications, investigations, etc.

Automated checking for prescription errors, drug interactions, allergies, etc.

Avoiding unnecessary/duplicate investigations

Facilitating rapid transmission of information such as reports, results, etc. without information going missing

Aggregation of information, allowing the understanding of epidemiological data and patterns of disease on a population level

Improving access to-and compliance with-best practice clinical guidelines and management algorithms
(http://www.achi.org.au)

70
Q

Digital media in healthcare:

A
Digital media includes:
    Web
    Email
    Social media
    Podcast and video
    Tablets and applications
    Newsletters and broadcasts
    Intranet

It is common for healthcare professionals to have apps on their smart phones for medications, clinical management or clinical updates. Medical officers also use many different applications on smart phones and tablets and may use the intranet or internet for research and information.

71
Q

Communication policies and procedures for using digital media can cover a range of issues including:

A
confidentiality
    harassment
    use of internet
    use of mobile phones/devices
    use of work email addresses

“When using social media, health practitioners should remember that the National Law, their National Board’s code of ethics and professional conduct (the Code of conduct) and the Guidelines for advertising regulated health services (the Advertising guidelines) apply.

Registered health practitioners should only post information that is not in breach of these obligations by:
Complying with professional obligations
Complying with confidentiality and privacy obligations (such as by not discussing patients or posting pictures of procedures, case studies, patients, or sensitive material which may enable patients to be identified without having obtained consent in appropriate situations)
Presenting information in an unbiased, evidence-based context, and
Not making unsubstantiated claims.”

(Australian Health Practitioner Regulation Agency (2014) For registered health practitioners. AHPRA, Melbourne VIC)

72
Q

Kotter’s eight step model to guide successful change.:

A
1     Establish a sense of urgency
2    Create a guiding coalition -managers choose team of individuals capable of carrying out change.
3    Develop a clear shared vision
4    Communicate the vision
5    Empower people to act on the vision - address obstacles (supervisors, subordinates, lack of training/skills, information). think strategically.
6    Create short term wins
7    Consolidate and build on the gains
8    Institutionalise the change
73
Q

AHA Skill development:

A

Once you become a member of the health profession, it is essential that you maintain currency in your professional knowledge and keep up to date with the policies and guidelines from the health industry or professional associations.

Learning about your industry and your obligations as an employee in the industry is just one aspect of your professional development.
You also need to know how to apply this knowledge in your daily work.
Keeping up to date with policies, procedures and guidelines can help you apply this knowledge in your daily work.
Seek feedback from your supervisor or manager regarding your performance level.

74
Q

Strategies for providing feedback:

A

Establish a time and method to give feedback in the agreement document
Acknowledge feelings and give space for reactions
Be hard on the issue, soft on the person
Look for solutions
Balance positives and negatives
Collaborate on a plan of action
Describe the desired skill
Be specific, concrete and sincere
Offer support
Convey respect
Explain why you give feedback

Should aim for 3x more positive feedback than negative, for confidence & motivation

75
Q

Being receptive to feedback:

A
Be calm
Listen
Regard as an opportunity to learn not a personal attack
Ask for clarification, or
Summarise, so you are clear you have understood
Discuss suggestions
Collaborate
Accept responsibility for yourself
Show respect and thank them
76
Q

Training and development:

A

Management responsible for providing access to adequate training/development
Staff responsible for actively participating in training.

If staff become aware they do not have the updated skills required to perform duties competently, discuss with management to ensure the situation is addressed.

Keep your own personal record of training/development. This enables you to provide an up-to-date account of your current level of training.

Prioritise training needs/work goals (most important 1st)
Start by ensuring the organisational requirements for mandatory training are met initially, then progress to seeking opportunities to further develop skills and knowledge base.

Organisations will have a policy on staff development and training. This is a good place to start with accessing opportunities as they become available. Some organisations may provide a common area such as a notice board which will outline up and coming opportunities, a regular e-newsletter, or may discuss your training opportunities during the performance appraisal process.

Staff are also encouraged to seek out their own development opportunities, by reading journals or material associated with their line of work.
Then bring these to supervisor either via verbal discussion or by completing relevant paperwork to apply to participate in a training opportunity.
In some cases, for external courses and development opportunities, the organisation will fund the cost of the employee attending. In other cases, there may be a mutual arrangement made between the employee and employer.