Improving Patient Safety in Long-Term Care Facilities: Communicating Change in a Resident

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Improving Patient Safety in Long-Term Care
FacilitiesCommunicating Change in a Residents
Condition

• Student Version

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A Safe Environment

• Effectively communicating change in a residents
  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 residents safe.
• Learning and experience are what make safety
  possible.
• Openly reporting anything that might affect a
  residents well-being is essential for a safe
  environment.
• Change in a residents 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 residents
  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/INTERACT20Version
  203.020Tools/Communication20Tools/Communication
  20Within20the20Nursing20Home/INTERACT20SBAR2
  0Form20v820Jan2014202013.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 residents condition.
• I am Uncomfortable with my residents 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.
• Im 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.