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CNA150 Foundations For Professional Practice 1

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  • Course Code: CNA150
  • University: University Of Tasmania
  • Country: Australia

Question:

Description

This task will assess your knowledge and understanding of how professional and therapeutic communication relates to the provision of patient care.

The written task requires you to discuss the following 3 topics:

1. Explain how therapeutic communication enables person centred care.

2. Discuss the role of inter/intra-professional communication in the provision of clinical handover.

3. Critically reflect on the potential communication barriers that may affect safety and quality in healthcare.

 

Answer:

Introduction:

The World Health Organisation mentions communicative care to be one of the essential elements of the modern health care system (Redley, 2017). Hospital management requires the implementation of different methods, modules, and therapies to reach patients and to allow them to avail of utmost care. One of the important nursing strategies would be to impart care and provide supporting words to the patients. In the field of nursing practices, communication always enhances the chances of better interpersonal relationships (Fan & Taylor, 2016). The rubric believed that interactive relationship like therapeutic communication is often a “powerful medicinal tool”. Therefore, through therapeutic communication, there are chances one can achieve certain positive outcomes. This goes back to the 19th-century methods of nursing where the use of good words was an important aspect of treating sick patients. Over time, it has been proven to have been promoting well-being and satisfaction amongst the care-receivers. This paper will discuss the influence of therapeutic communication on person-centred care, role of professional communication during handovers, and the communication barriers that can affect the quality of safety and care in healthcare.

 

The role of therapeutic communication in person-centred care:

Therapeutic communication is an important asset or method that allows the exchange of efficient information within the nurse and the patient (Foronda, MacWilliams & McArthur 2016). Therapeutic communication helps a person track their well-being and enables strong decision-making skills, not only in the periphery of health-care but allows them to mature in their personal life as well. Franz et al. 2018). In the field of nursing, Rubric believed that there is by default a therapeutic communication that follows within the nurse and the patient which in-turn turns into a therapeutic relationship between the two (Phillips et al., 2019). However, there are different forms of therapeutic communication one can benefit from (Fan & Taylor 2016). The three dimensions include the expression group, clarity group, and validation group (Foronda & MacWilliams, 2016). While expression groups within the grounds of health care simply mean expression of thoughts, clarity techniques are often used to help the patient clarify various problems they are facing regarding their ailment. On the other hand, validation techniques refer simply as the method used by the nurse or doctor, in certain situations, to help the person acknowledge their feelings (Fan & Taylor, 2016).

While many nurses had been shown to have used low levels of therapeutic communication in their workspace in the primary years of health care industry, it has been seen that about 39 per cent of patients had bettered themselves through medication and therapeutic communication alone (Donovan & Mullen, 2019). Ineffective communication has been one of the main factors that have caused medical errors and patient harm it is necessary as the need of each patient is different from one another, therefore it is important from patient-centred care to be introduced within the premises of health care. Therapeutic communication allows the medical representative to have a better knowledge of both the psychological and physical health of the patient, allowing a better scope of treatment (Fan & Taylor 2016). Ministry of Health in 2011 had reported that quality care is proportional to the therapeutic communication used while treating a patient (Donovan & Mullen, 2019). However, language and excellence of education are some of the features that accompany therapeutic communication.  It has been studied that a person who has a greater skill of language and has had a formal education, tend to receive therapeutic communication in relation to someone who does not have education in therapeutic communication (Abdolrahimi et al., 2017). Effective therapeutic communication recognises that in the field of healthcare, patients have different needs and each is unique to the other (Phillips et al., 2019). This allows nurses to avert from mistakes while dealing with a patient.

 

Role of inter and intra-professional communication in the provision of clinical handover:

The National League of Nursing defines inter and intra-professional communication as collaborative practices that are used to provide patients with self-centred care (Abdolrahimi et al. 2017). This is extremely important for patients as individuals as most patients have unique requirements when it comes to health care and treatment. Often conflict is a result of differences in opinions regarding methods of treatment and procedures between health care professionals like staff, doctors, and especially nurses, and the patient (Parker et al., 2019). This is why to mediate situations such as these inter and intra-professional communication becomes an extremely important part of nursing and management. With the help of such professional communication, conflict-management strategies come as an efficient character in the case of clinic handover (Foronda, MacWilliams & McArthur 2016). Boswell states in the situation of a clinical handover inter and interpersonal communication plays a major role (Boswell, 2014). It merely can be avoided with the help of communication between two hospitals exchanging a patient, a doctor referral to another doctor, and so on (Franz et al. 2018).

Estimates in studies conducted by the Ministry of Health 2011 have shown that about 30 million people go through avoidable circumstances in a situation of clinical handoff (Donovan, LM & Mullen ). Boswell calls clinical handover an "inherently communicative” event (Boswell, 2014). The handover of patients mostly takes place in terms of linguistic exchange and through written proposals. Therefore, implementing a systematic structure and providing referred doctors with proper verbal and clinical explanations of a patient’s ailment is often and mostly enforced by inter and intra-professional communication (Foronda, MacWilliams & McArthur, 2016). Inter-professional communication allows a clinician to provide details thoroughly to another clinician who is referred to about the patient. This should be mostly done by written records and confidential files. The problem with verbal communication in the line of work in health care often becomes challenging and unsafe in cases of ER patients who are under emergency situations. Even though verbal communication accelerates the process of treatment it also keeps scope for mishaps like wrong treatment. Risk of a failure in communication due to haste and critical situation is something most health care professionals want to abstain from (Manias et al. 2014). If the doctor-in-charge does not allow the other person to complete access, the regulation of the health care clinic's policy would be violated and the best treatment would not be available to the patient. Australian Privacy Principles under the Privacy Act 1981 condemns the use of frivolous use of patient records. Therefore, the onus of protecting patient confidentiality falls on the medical staffs, especially doctors and nurses who are responsible for clinical handovers. 

 

Critical reflection of the potential communication barriers in health care:

The role of effective communication within healthcare is an extremely important facet and one cannot doubt that. Without effective communication, outcome of a patient’s treatment could not just be disastrous, but even fatal (Donovan & Mullen, 2019). This is why it becomes important to understand the various barriers in effective communication one can see in the medical community. In cases of clinical handover or referral of cases, often physical distance can come as a huge challenge (Donovan & Mullen 2019). This is mostly because according to health care guidelines communication should not be performed based on verbal communication or through retaining information through memory (Boswell, Lowry & Wilhoit, 2014). This, therefore, can come as an enormous challenge as passing information of tangible hard copies of patient information could come off disastrously wrong (Franz et al. 2018). In such cases, clinics need to have virtual patient records that could be used in case of a clinical handover. Psychological or psychosocial barriers like different languages are often another challenge in the medical community. In cases of medical tourism, it is harder to refer a patient to another country without knowing the language (Hannaford et al., 2013) Even in different regions within the same country, referring a patient or communicating with the patient who speaks the same language can be difficult because of various dialects (Nilsson, From & Lindwall, 2013).

Nurses can also find problems in interacting and providing therapeutic attention to patients who are psychologically different or challenged (Donovan & Mullen, 2019). Apart from this, nurses often need to take care of people with special needs who have difficulty talking or hearing. In most cases finding an ASULAN Interpreter becomes difficult for primary health care institutions. This is a big loophole or a challenge that most health care clinics, hospitals, and institutions face with people with disabilities. It is to be understood that even in the 21st-century health care institutions have no access to helping people with neurological disabilities because of the prolonged hierarchal linguistic crisis that is a social phenomenon (Donovan & Mullen 2019). Apart from this, most hospitals and clinics do not have staff members who have special skills in understanding speech-less communication.

 

Conclusion:

Communication is an important factor when it comes to health care. Without the ability to have a connecting conversation with patients, a gap will remain that continues to impede the situations that needs effective communication between nurses and patients. An assumption by a health care professional could cause misunderstanding, financial distress, and emotional distress in both medical staff members and the patient themselves. In such cases, inter professional communication and therapeutic communication is a solution to the challenges within the health care system.

 

References:

Abdolrahimi, M, Ghiyasvandian, S, Zakerimoghadam, M & Ebadi, A 2017, ‘Therapeutic communication in nursing students: A Walker & Avant concept analysis’, Electronic Physician, vol. 9, no. 8, p. 4968, viewed 12 May 2020, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5614280/>.

Boswell, S., Lowry, L. W., & Wilhoit, K. (2014). New nurses' perceptions of nursing practice and quality patient care. Journal of Nursing Care Quality, 19(1), 76-81. https://journals.lww.com/thehearingjournal/00001786-200401000-00014.fulltext

Donovan, LM & Mullen, LK 2019, ‘Expanding nursing simulation programs with a standardized patient protocol on therapeutic communication’, Nurse education in practice, vol. 38, pp. 126-131, viewed 12 May 2020, <https://www.sciencedirect.com/science/article/abs/pii/S1471595318305651>.

Fan, CW & Taylor, RR 2016, ‘Assessing therapeutic communication during rehabilitation: The Clinical Assessment of Modes’, American Journal of Occupational Therapy, vol. 70, no. 4, pp. 7004280010p1-7004280010p10, viewed 12 May 2020, <https://ajot.aota.org/article.aspx?articleid=2525287>.

Foronda, C, MacWilliams, B & McArthur, E 2016, ‘Interprofessional communication in healthcare: An integrative review’, Nurse education in practice, vol. 19, pp. 36-40, viewed 12 May 2020, < https://www.sciencedirect.com/science/article/abs/pii/S1471595316300208>.

Franz, S, Muser, J, Thielhorn, U, Wallesch, CW & Behrens, J 2018, ‘Inter-professional communication and interaction in the neurological rehabilitation team: a literature review’, Disability and Rehabilitation, pp. 1-9, viewed 12 May 2020, <https://www.tandfonline.com/doi/abs/10.1080/09638288.2018.1528634>.

Hannaford, N., Mandel, C., Crock, C., Buckley, K., Magrabi, F., Ong, M., ... & Schultz, T. (2013). Learning from incident reports in the Australian medical imaging setting: handover and communication errors. The British journal of radiology, 86(1022), 20120336. https://www.birpublications.org/doi/abs/10.1259/bjr.20120336

Redley, B, Botti, M, Wood, B & Bucknall, T 2017, ‘Interprofessional communication supporting clinical handover in emergency departments: An observation study’, Australasian Emergency Nursing Journal, vol. 20, no. 3, pp. 122-130, viewed 12 May 2020, <https://www.sciencedirect.com/science/article/abs/pii/S1574626717300344>.

Manser, T., & Foster, S. (2011). Effective handover communication: an overview of research and improvement efforts. Best practice & research Clinical anaesthesiology, 25(2), 181-191. https://www.sciencedirect.com/science/article/pii/S1521689611000255

Manias, E., Geddes, F., Watson, B., Jones, D., & Della, P. (2015). Communication failures during clinical handovers lead to a poor patient outcome: Lessons from a case report. SAGE open medical case reports, 3, 2050313X15584859. https://doi.org/10.1177/2050313X15584859

Nilsson, M., From, I., & Lindwall, L. (2019). The significance of patient participation in nursing care–a concept analysis. Scandinavian journal of caring sciences, 33(1), 244-251. https://onlinelibrary.wiley.com/doi/abs/10.1111/scs.12609

Parker, V., Engle, R. L., Afable, M. K., Tyler, D. A., Gormley, K., Stolzmann, K., ... & Sullivan, J. L. (2019). Staff-perceived conflict between resident-centered care and quality in the skilled nursing facility: Are both possible?. Clinical gerontologist, 42(3), 267-276. https://www.tandfonline.com/doi/abs/10.1080/07317115.2018.1467522

Phillips, J. M., Stalter, A. M., Ruggiero, J. S., Bonnett, P. L., Brodhead, J., Merriam, D. H., ... & Winegardner, S. (2019). Systems Thinking for Transitions of Care: Reliability Testing for a Standardized Rubric. Clinical Nurse Specialist, 33(3), 128-135.

https://journals.lww.com/cns-journal/Abstract/2019/05000/Systems_Thinking_for_Transitions_of_Care_.8.aspx

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