Effective Communication in Healthcare Settings, Exams of Nursing

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NURS 3632 Chapter 8 Communication Questions With Complete Solutions

1. • Professional is essential for the professional nurse role.

• Communication is essential in fostering interactions.
• Communication is a issue for the healthcare environment. Miscom- munication is the cause of most medical errors.
• Hospitals are graded on HCAHPS scores- Hospital Consumer Assessment of Healthcare Providers & Systems and Press Ganey scores.: communication; nurse-patient; safety

2. What is AIDET?: Acknowledge, Introduce, Duration, Explanation, Thank you
3. Electronic Communication in Health Care:

• Electronic Health Records--who has and to what
• Social Media Guidelines for RNs i. American Nurses Association i. National Council of State Boards of Nursing
• E-mails, Text Messages, Other Risk of violating patient and : -

access; information; privacy; confidentiality

4. Electronic Communication in Health Care:

• The Internet and a variety of social websites provide new and challenging opportunities for nurses to communicate and collaborate with other health care providers.
• The challenges of using social media include protecting patient and and preventing unintended for the employer or the nurse.
• Protocols for using e-mail, sending text messages, and accessing the social media sites are vital for wise use of these forms of electronic communication. Student nurses also must know these guidelines for use of electronic com- munication venues.
• Increased exposure to these expectations can foster the development of an conscience that begins when one is a student and carries into future practice.: privacy; confidentiality; consequences; ethical

5. American Nurses Association's Principles for Social Networking:

• Nurses must not transmit or place online individually patient infor-

mation.

• Nurses must observe ethically prescribed professional patient-nurse.
• Nurses should understand that patients, colleagues, institutions, and em- ployers may postings.
• Nurses should take advantage of settings and seek to separate and information online.
• Nurses should bring content that could harm a patient's privacy, rights, or welfare to the attention of appropriate.
• Nurses should participate in developing institutional policies governing

online .: identifiable; boundaries; view; privacy; personal; professional; au- thorities; conduct

6. What is ISBARR?: Identify (yourself and the patient), Situation, Background, Assessment, Recommendation, Read back
7. ISBARR:

• One such teaching resource suggests a revised SBAR for use with nursing students to improve and support practice. This adapted form includes the initial identification of "yourself and your patient (I)" and the op- portunity to and to questions, or "readback (R)," at the close of the communication. This reformulated I-SBAR-R supports clear identification of the and the when communicating patient care information or concerns with another.
• This tool also provides evidence-based solutions to improve commu- nication targeted to specific causes of inadequate hand-off at an individual or- ganization: communication; safe; ask; respond; nurse; patient; healthcare provider;

hand-off

8. Identify:

• / title
• he/she is calling from: Name; Position; professional; Where

9. Sitation:

• Patient by and
• or chief
• for the call/ : name; age; Diagnosis; complaint; Reason; problem;

10. Background and Assessment:

• Relevant past history
• Relevant data
• Recent for the patient: medical; assessment; interventions

11. Recommendations:

• Suggests potential for condition or suggests
• Provides / for action

• back all orders; if needed: reason; interventions; timeframe; urgency; repeats; clarifying

12. 7 Crucial Conversations in Healthcare:

• rules
• (M)
• Lack of
• (I)
• Poor

- (D)

• (M): Broken; Mistakes; support; Incompetence; teamwork; Disrespect; Micromanagement

13. Broken rules:

• Nurse did not use product -> Confront your colleague and tell her that you noticed that she failed to wash her hands and that this could be harmful to herself, the patient, or other patients. If the behavior continues, report your concerns to the and work up the chain of command.
• Nurse Tech wore pair of gloves when taking vital signs.
• "Do the hand gels cause skin ?"
• "I'll sit the patient up in while you change your gloves.": hand; Con- front; nurse manager; same; dryness; bed

14. Mistakes:

• Nurse administers medication to the wrong patient and asks you to keep an on the patient for adverse reactions. She does not plan to

the error. -> Tell your colleague that you'll be happy to help watch the patient, but that a full needs to be made. If appropriate, help your colleague identify what to her giving the medication to the wrong patient.: eye; report; report; contributed

15. Lack of support:

• Nurse refuses to a colleague move an obese patient although she has time to do so -> Explain to this nurse that is essential to good outcomes and that her behavior is simply unacceptable. "When we have patients with special needs and need all hands on deck, everyone who's free is obligated to out!". Develop and enforce zero for selfish behavior.: help; teamwork; help; tolerance

16. Incompetence:

• Nurse fails to correctly administer dialysis. She wasn't finished with her to the unit and attempted a procedure before she was to do it solo. -> In addition to the error, help the nurse identify that in their abilities can have deadly results for patients. The will need

to address the incompetence.: orientation; prepared; reporting; overconfidence; nurse manager

17. Poor Teamwork:

• A particularly difficult family is splitting the team by choosing (and reward- ing) among the staff and to them about other workers. The staff is this behavior. -> Someone needs to the team together and the divisive behavior and get everyone working together again. If there

is staff who are problematic, appropriate channels need to be used to address these behaviors.: favorites; complaining; encouraging; call; name;

18. Disrespect:

• When a student nurse asks a physician if she has time to answer a few questions for her patient, the physician at her and tells her that she has more important things to do than her patient and tells the student to someone else to answer the questions. -> The student should calmly tell the physician that her response is and that she is entitled to conversation, then seek the counsel of an experienced. The physician's behavior should be .: screams; babysit; find; inappropriate; respectful; nurse; reported

19. Micromanagement:

• A student asks her clinical preceptor, "Will you walk me through this pro- cedure before I do it, since it's my first time?" The preceptor then , doing the procedure for the student, and starts watching her every move. ->

The student should inform her preceptor that she merely wanted to review the steps of the procedure to make sure that she would perform it correctly and that it is essential for the student to gain experience by new procedures. If the preceptor's behavior does not change, the student should seek the counsel of her .: takes over; trying; instructor

20. CUS:

• I am
• I am
• This is a issue--!
• Such as behaviors that are potentially and/or : concerned; uncomfortable; safety; STOP; unsafe; unprofessional

21. CUS:

• CUS is another communication tool, recommended for use to assist in effective communication related to patient concerns.
• CUS offers a consistent method for health care team members to speak up about patient safety concerns in an manner that is clear, structured,

and easy to use.

• CUS can be used when the nurse feels there is an situation and needs to effectively this concern to other .: safety; assertive; unsafe; communicate; health care providers

22. What are 4 levels of communication?: Intrapersonal, Interpersonal, Small Group, Organizational
23. Intrapersonal communication:

• • -talk; communication within a ; positive

• This communication is crucial because it affects the nurse's and can enhance or detract from positive interactions with the patient and family.
• Imagine two different nursing students preparing for the first experience with a critically ill patient. Both are frightened. One tells herself, "Calm down, you've been in challenging situations before and always survived. You can handle this." The other repeatedly tells himself, "There's no way you can survive this experience. The instructor will be all over you, and you might as well admit defeat before you start." Obviously, the first student's self-talk is more than that of the second student.: Self; person; affirmations; behavior; enhance; detract; positive; helpful

24. Interpersonal communication:

• = Occurs between or more people with a goal to messages
• Most of the nurse's day is spent communicating with , family mem- bers, and of the health care team.
• The ability to communicate effectively at this level influences your sharing,

solving, attainment, building, and effectiveness in crit- ical nursing roles (e.g., caregiver, teacher, counselor, leader, manager, patient advocate).: 2; exchange; patients; members; problem; goal; team

25. Small group:

• = Occurs between or more people.
• To be functional, members of the small group must to achieve their goal.
• Examples of small-group communication include staff , patient care , sessions, and groups.
• The more people involved in the communication process, the more it becomes.: 2; communicate; meetings; conferences; teaching; support; complex

26. Organizational:

• = Occurs in groups when there is a goal
• Nurses on a practice working to review unit policies or nurses working with groups on strategic planning or quality assurance use organizational communication to achieve their aims.: common; council; interdis-

ciplinary

27. Patient care and communication:

• "They (your patients) may not remember your name but they will remember how you made them ." -M. Angelou
• "Is there anything I can do before I leave?": feel; else

28. What are 2 forms of communication?: verbal (language) and non-verbal (body language)

29. Verbal:

• Verbal communication is an exchange of information using , including both the and word.
• Verbal communication depends on , or a prescribed way of using words so that people can share information effectively.
• Language includes a definition of words and a method of arranging the words in a certain.
• A person's use of written and spoken language forms reveals aspects of the person's development, l level, and geographic and cultural origin. Nurses must also consider whether English is a language for the patient. Language helps nurses assess what the patient and . In turn, nurses must develop their own language skills to assist in reciprocal responses in the communication process.: words; spoken; written; language; common; order; intellectual; education; second; knows; feels

30. Non-verbal:

• The transmission of information without the use of is termed nonver- bal communication.
• Nonverbal communication includes expressions, touch, contact, posture, (g), gestures, general appearance, mode of and , sounds, silence, space, (T), boundaries, and movements.
• Nonverbal communication is as important as verbal communication, if not more so. Nonverbal communication often helps to understand and meanings in what the patients or others are saying verbally.
• For example, a nurse asks the patient, "How do you feel today?" The patient responds, "I feel all right." However, the nurse notes that the patient does not maintain eye contact and his facial expression is tense. This should prompt the nurse to investigate further because of the of the patient's verbal and nonverbal communication: words; facial; eye; gait; physical; dressing; grooming; time; body; subtle; hidden; incongruence

31. Touch:

• Touch (a person's tactile sense) is a very personal behavior and means things to people.
• Familial, regional, class, and cultural influences largely shape tactile experi- ences.
• Factors such as and also play a key role in meanings associ- ated with touch.
• Despite its individuality, touch is viewed as one of the most effective non- verbal ways to express feelings of , love, affection, security, ,

frustration, aggression, , and many others.: different; different; age; sex; comfort; anger; excitement

32. Eye Contact:

• Communication often begins with eye contact, looking into the other per- son's eyes. A glance, for example, is often an -getting method to open conversation.
• In many cultures, eye contact suggests and a willingness to and to keep communication open. Its absence often indicates or defenselessness, or of communication.
• Some view eye contact as the nonverbal communication that reveals a person's true nature. However, some Native American and Asian cultures view eye contact as an of a person's privacy or as confrontational. In other cultures, people are taught to avoid eye contact or, out of respect, not to make eye contact with a superior.: attention; respect; listen; anxiety; avoidance; invasion

33. Eye Contact:

• In addition to the messages sent by eye contact, the eyes carry other nonverbal messages. For example, the eyes fix in a during anger, tend to in disgust, and ordinarily open in fear. Some people who experience fear might be unable to speak and only their eyes will send the message of. A blank stare can indicate or inattentiveness.: - stare; narrow; wide; anxiety; daydreaming

34. Facial Expressions:

• The face is the most expressive part of the body. Examples of the various messages facial expressions convey are anger, joy, suspicion, sadness, fear, and contempt.
• Some people have extremely faces, whereas others their feel- ings, making it more difficult to determine what the person is really thinking. Nurses need to learn to their own facial expressions.: expressive; mask; control

35. Posture:

• The way a person holds the body carries nonverbal messages.

• People in good health and with a positive attitude usually hold their bodies in alignment. Depressed or tired people are more likely to.
• Posture also often provides nonverbal clues concerning and physical (for instance, a rigid, stiff appearance might be a good indicator of and ).: good; slouch; pain; limitations; tension; pain

36. Gait:

• A , walk usually carries a message of well-being. A less purposeful, gait often means the person is sad or discouraged.

• Certain gaits are associated with illness. For example, patients recovering from recent abdominal surgery usually walk slightly over and slowly and might need the assistance of or a person.: bouncy; purpose- ful; shuffling; bent; handrails; person

37. Gestures:

• Gestures using various parts of the body can carry numerous messages—for example, thumbs up may mean , kicking an object often expresses , wringing the hands or tapping a foot usually indicates or , and a waving hand serves to beckon someone to come on, or if waved in another way, signifies that someone should.
• Gestures are often used extensively when two people speaking in different attempt to communicate with each other.
• Gestures may have meanings in different cultures, and nurses must consider how culture influences the meaning: victory; anger; anxiety; anger; leave; languages; different

38. General Physical Appearance

• Many illnesses cause at least some alterations in general physical appear- ance. Observing for changes in appearance is an important nursing responsi- bility for detecting illness or evaluating the effectiveness of care and therapy.
• For example, a person with an insufficient intake of fluids has skin that easily, eyes that might be and in appearance, and muscle tone. On the other hand, the person in good health tends to radiate a healthy status through general appearance.: dry; wrinkles; sunken; dull; poor

39. Mode of Dress and Grooming

• A person's clothing and grooming practices carry significant nonverbal messages. For example, healthy people tend to pay attention to details of dress and grooming, whereas people feeling ill often demonstrate little in personal appearance.
• It is often a sign of health when interest in their physical appearance and mode of dress returns.: interest; returning

40. Sounds

• Crying, moaning, gasping, and sighing are oral but nonverbal forms of communication.
• Such sounds can be interpreted in numerous ways. For example, a person might cry because of or. Gasping often indicates , , or surprise. A sigh might be a sign of agreement to do some- thing or of .: sadness; joy; fear; pain; reluctant; relief

41. Silence:

• Periods of silence during a conversation often carry important nonverbal messages. A silence between two people might indicate complete of each other, that both are , or that they are with each other.: un- derstanding; thinking; angry

42. Factors influencing communication:

• level; Gender; differences; Space & territoriality; , mental, & state; ; Environment; & : Developmental; sociocultural; physical; emotional; values; roles; responsibilities

43. Developmental level:

• The rate of language development is directly correlated with the patient's competence and development.
• For instance, a 10-year-old child has limited understanding of what an infec- tion is; therefore, explain things in terms so that the child cooperates with the treatment without being frightened.