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Improving Patient Safety in Long-Term Care Facilities:
Communicating Change in a Resident’s Condition
Student Version
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A Safe Environment
Effectively communicating change in a resident’s condition is critical to
patient safety.
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Case Study #1
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Ms. Malone
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Creating a Safe Environment
• Reporting changes helps keep resident’s safe.
• Learning and experience are what make safety possible.
• Openly reporting anything that might affect a resident’s well-being is essential for a safe environment.
• Change in a resident’s condition should be reported openly whenever it happens.
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Key Principles of Effective Communication
• Teamwork
• Open reporting
• Reporting unwanted events
• Giving and receiving information
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Teamwork
• Report change across the care team.
• Work together to identify what the change may mean.
• Take action as a team.
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Reporting Unwanted Events
• Learn to communicate promptly and openly when something happens that might affect a resident’s well-being.
• Move beyond blaming anyone to being able to openly share experiences.
• Show you care by speaking up.
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Giving and Receiving Information
• Express information in a way that will be understood by others.
• Hear information as it is being reported.
• Make effective use both of verbal and nonverbal communication skills.
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Barriers to Communication
• Gender
• Age/generation
• Language
• Culture
• Status
• Interpersonal issues
• System barriers
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Case Study #2
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Case Study #2Mrs. Brown
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Case #2Min-Wa and Susan
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Case Study #2Observations
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What Should Be Communicated?
• Physical changes
► Walking
► Urination/bowel patterns
► Skin quality
► Level of weakness
► Falls
► Vital signs
• Nonphysical changes
► Demeanor
► Appetite
► Sleep
► Confusion
► Agitation
► Pain
• Relevant external factors
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How Should Information Be Communicated?
• Reporting and communication tools:►Early Warning Tool►SBAR►CUS
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Stop and Watch Early Warning Tool
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SBAR Tool
SBAR: http://interact2.net/docs/INTERACT%20Version%203.0%20Tools/Communication%20Tools/Communication%20Within%20the%20Nursing%20Home/INTERACT%20SBAR%20Form%20v8%20Jan%2014%202013.pdf
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Case Study #3
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Case Study #3 Mr. Harris
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Case #3 Observations, Day 4
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Case Study #4
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Case Study #4Change-of-Shift Meeting (Min-Wa)
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The CUS Tool
• I am Concerned about my resident’s condition.
• I am Uncomfortable with my resident’s condition.
• I believe the Safety of the resident is at risk.
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Principles in Action CUS: Min-Wa to RN Team Leader
• I'm concerned about Mr. Harris. • I’m uncomfortable that his temperature is up and
that he has developed diarrhea. • I believe that he might be developing an
infection that should be treated.
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Case Study #5
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Case Study #5: Mrs. CarverFebruary 2012 – March 2014
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Case Study #5: Mrs. CarverApril 1, 2014
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Case Study #5: Mrs. CarverApril 2, 2014
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Key Points
• Communicate changes promptly.
• Reports of change can come from many sources.
• Every team member is responsible for reporting changes.
• Everyone faces barriers to communication.
• Tools to break down barriers.