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201 patient services > w9 healthcare communication > Flashcards

w9 healthcare communication Flashcards

1
Q

what is primary objective of any healthcare professionals code of ethics?

A

**patients welfare

  • all info confidential
  • primum non nicer comes from hippocratic oath- first, do no harm
  • proxemics- patients zone of comfort
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2
Q

four zones of proxemics

A
  1. intimate space- direct contact up to 45cm (18 inches) * phlebotomists enter this space - patients can feel anxious or threatened
  2. personal space 45cm to 1.3 meters ( 18 inches to 4 feet)- interactions amongst friends
  3. social space- 1.3 meters to 4 meters (4-12feet) interactions in day to day life
  4. public space- more than 4m or 12 feet lectures speeches
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3
Q

kinesics

A

study of non-verbal communication- body language

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4
Q

positive kinesics

A

-smiling, eye contact confident body language, good grooming

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5
Q

negatie kinesics

A

frowning, sighing, nervous behaviours, crossed arms, yawning, clock watching, hurrying

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6
Q

what to do if door closed

A

knock, check of isolations procedures. even if the curtains or drawn knock to maintain patients privacy. – always identify yourself to patient as well ( hi im Melanie im from the lab etc)

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7
Q

what to do if patient is asleep

A
  • touch the bed to wake them up, use a soft tone of voice, do not turn on bright light, turn on once their eyes have adjusted.
  • never collect from a sleeping patient (could injure patient or phlebotomist)
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8
Q

what to do if patient unconscious

A

request a nurse or other phlebotomist assist with collection

  • speak to them, identify yourself to patient ( unconscious patients often hear what is going on around them)
  • may respond to painful stimuli- hold arm down
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9
Q

what to do if patients doctor or clergy present

A

-collect at a different time unless stat

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10
Q

safe talk with patient

A
  • weather
  • hospital food
  • coffee or tea
  • ask about pictures of family
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11
Q

unsafe subjects with patient

A
  • no medicine
  • politics
  • religion
  • tests being performed
    • How are you
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12
Q

how will patient judge you

A

based on your professional experience and personal appearance

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13
Q

what is the most critical step in phlebotomy

A

patient identification

  • two identifiers: name and PHN
  • you can’t just use name and birthday
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14
Q

patient name

A

say
“state your first and last name”
never ask “are you___”- patients who are hard of hearing, senile or heavily medicated may say yes to anything
-if any doubt check with nursing staff
- in outpatient make sure you have right patient- some people could have the same first and last name check id especially in drug testing, or DNA paternity testing

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15
Q

patient ID band

A

in-patients wear id band

  • check this info against req or labels that you have THIS INFORMATION MUST MATCH EXACTLY
  • any mistake on ID band vs req or labels should be brought to attention of nursing staff. specimen will not be collected until patient has been directly identified with ne ID band
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16
Q

what to do if there is no ID band on wrist

A
  • check ankle if there is IV on wrist

- may be on bed rail, which is not proper identification, get nurse to move it onto patients wrist.

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17
Q

instances where patients have identical or similar names

A
  • after car accident several family members may be present in hospital
  • multiple-birth babies
  • relaties invloed in tissue transplant procedures
  • unrelated patients with common or similar names
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18
Q

review bottom 4 paragraphs of page 5

A

do it

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19
Q

patients consent

A
  • before treatment or procedure there must be informed consent unless valid exception (emergency)
  • express- documentation
  • implied-presumed patient presents voluntarily- putting out arm for phlebotomy
20
Q

how is implied consent given to phlebotomists

A

extending their arm- usually for ambulatory patients at collection sites

21
Q

how is expressed consent given

A

documents signed by patient or relative. -done when patient admitted into hospital or prior to procedure. - some verbal most is formal consent form

22
Q

if patient doesn’t understand procedure

A
  • may not extend their arm, dont know what to do. - may not understand english or may be mentally confused.
  • patient must understand procedure– get a family member, nurse, relative or interpreter to assist or write them down
23
Q

patients right to refuse

A
  • patient object to having blood drawn
  • usually “test was ordered by your doctor” will work
  • PHLEBOTOMIST MUST NOT INSIST OR RESTRAIN PATIENT
  • if patient still refuses document on req
24
Q

patient-directed collections

A
  • patient collect their own specimen

- MLA inform patient how to collect, storage, transport -verbal and written

25
Q

good verbal communication skills

A
  • clear voice
  • awareness of tone and volume
  • choice of vocal
  • introducing self and stating why you are there helps build rapport with patient - always assume patient does not have experience with routine lab procedures
26
Q

what to do if patient has language barrier

A
  • try to communicate using body or sign language, use translator or family member,
  • always make sure patient understands
27
Q

sensory disability

A

hearing or sight impaired. recognize immediately and adapt your communication to make patient feel safe and secure.
blind: narrate procedure so patient understands whats going on- speak clearly and let them know when you are going to touch them

hearing impaired: slow and clear communication when you are facing patient. - read lips

28
Q

age of children: what type of collection

A

children younger than two have blood drawn from arm or back of hand with a 23 gauge butterfly needle and a small syringe. (heel poke for under 1)
children over age 4 can be successfully collected with a vacutainer and a butterfly

29
Q

what determines phlebotomists approach for collecting on child

A

age and temperament of child. phlebotomist must also deal with parent- calm will be helpful an apprehensive parent can often make child scared

30
Q

what to do if parent apprehensive

A

ask them to leave the room.q

31
Q

what can a calm confident parent help with

A

PSC- parent can allow child to sit on their lap and restrain and reassure child. the childs arm can be raised to correct height for collection.
hospital: parent can hold opposite hand and distract child

32
Q

how are paediatric collections best done?

A

in pairs with trained lab professional or ward staff to immobilize childs arm that is to be used to venipuncture -parents usually can’t hold childs arm down forcefully enough

33
Q

how to treat child

A
  • never lie to them and say procedure will not hurt- say it will not last long and be small
  • if will feel like a little pinch
  • if you stay really still it will hurt only a little
  • if you want to you can say a great big ouch
  • play games
  • show them the tourniquet and say it will feel tight but not hurt and that you will be feeling for their vein on their arm it might feel funny but it won’t hurt.
  • let them know the alcohol may feel cold
  • call the cotton ball a bunny tail
  • once blood is drawn praise child
  • child can look at the blood but not touch
  • make sure pressure is applied
  • make sure you say “ oh good the hole is all closed up”
34
Q

how to deal with apprehensive patients

A
  • afraid of needles or blood
  • talk naturally about whether and distract patient while quietly doing venipuncture.
  • dont ask how they are
  • “you can look away”
  • “take a deep breath”
  • once needle is in “you can breath now”
35
Q

topical anesthetic

A
  • eutectic mixture of local anesthetic EMLA cream for children and apprehensive patients
  • at drug store- apply one hour before sampling
  • initially causes vasoconstriction so dont do right away
36
Q

what to say if patient makes a comment about amount of blood being drawn

A

5ml is one teaspoon
if you are donating blood its about 50-70 tubes
the patients total blood volume is over 500 tubes

37
Q

types of special needs 11

A
  • cerebral palsy, multiple sclerosis, parkisons
  • arthritis
  • casts or braces
  • unconscious/ not responding
  • intravenous drug abusers
  • renal dialysis or chemotherapy
  • mentally handicapped
  • psychiatric units
  • obese
  • elderly
  • miltiple intravenous lines
38
Q

how to help patients with special needs

A
  • different arm positions
  • help them with making a fist
  • extra palpation to find a useful vein
  • help with applying direct pressure after
  • alternate sites
  • assistance from nurse
  • restrain or stabilize patient
39
Q

reasons why not every collection is routine

A
  • irrational fear of needles or blood

- in-patients already in physical or motional stress by illness or isolation from hospital environment

40
Q

how to determine if patient stressed

A

ask “have you ever had blood drawn before, did yo encounter any problems?”–gather info and you can adapt to anxious patient or someone who faints -once needle is in vein, ask patient how they are doing.

41
Q

indications that patient is going to faint

A

skin colour change-pale
nausea
excessive sweating
eye rolling
talk with patient to determine if collection will continue
never let a patient leave if feeling faint or unwell

42
Q

empathy in healthcare setting

A 
-understand and share another individuals feelings and emotions -joy, sorrow, sympathy, excitement, grief, and more 
develop stronger relationships 
improve communication 
deeper trust
patient satisfaction and compliance
43
Q

written policy for reporting critical values

A
  • patients full name
  • hospital number
  • time of collection
  • test result
  • date and time
  • initials or name of the person phoning and the name of the person receiving the results
44
Q

telephone add-ons

A 
MLA can order add on test to already existing accessioned specimen upon request of physician. 
information:
patients full name
PHN or hospital number
DOB
date and time of collection
45
Q

LIS information for add-ons

A
  • test being added on
  • the person requesting the add-on test
  • date and tie
  • your initials or name

201 patient services (27 decks)

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