Obstetrical Nursing Communication for nurses, midwifes and healthcare providers working in women's health or the hospital setting. Student nurses will also benefit with the latest information in communication in healthcare.

1. Nursing CommunicationNursing Communication

2. CommunicationCommunication
From 1995-2005 JCAHO reviewed
over 2537 sentinel events in General Hospital and
Emergency Departments.
Found…
Ineffective communication is a root cause of nearly
66 percent of all sentinel events reported
(The Joint Commission Root Causes and Percentages for Sentinel Events (All Categories)
January 1995 December 2005)−

3. CommunicationCommunication
Communication can be defined
as the process by which people
share ideas, experience,
knowledge and feelings
through the transmission of
symbolic messages.

4. Key Elements ofKey Elements of
CommunicationCommunication
•Message
•Source
•Channel
•Receiver
•Filter
•Feedback

5. Standards ofStandards of
communicationcommunication
•Complete
-Communicate all relevant information
•Clear
-Convey information that is plainly understood
•Brief
-Communicate the information in a concise manner
•Timely
-Offer and request information in an appropriate
timeframe
-Validate authenticity or acknowledge information

6. CommunicationCommunication
Chain of CommandChain of Command
• One of the most common areas
leading to OB claims.
• Lack of policies on chain of command.
• Chain of command was not followed according
to policy.

7. CommunicationCommunication
Chain of CommandChain of Command
• Chain of command protocols
meant to empower nurses
• Nurses hesitate to use chain of
command

8. Communication Chain of CommandCommunication Chain of Command

9. Chain of commandChain of command
Delegation and downsizing
◦ Nurse responsible for own act of negligence.
◦ Hospital is legally accountable to provide an
adequate number of staff.
◦ Hospital is legally accountable that unlicensed
professionals are qualified.
◦ Nurse has legal duty to communicate with
administration if there are concerns.
◦ Administrator is responsible for solving problem
and continuing up the chain of command.

10. The Association of Women's Health,
Obstetrics and Neonatal Nurses (AWHONN)
published the following statement related
to the chain of command:
"The nurse must initiate an appropriate
course of action when, after careful
deliberation, the issue is determined to be
a matter of maternal/fetal well being...”
(Association of Women's Health, Obstetrics and Neonatal Nurses, 2003, p. 232).

11. S.B.A.R.S.B.A.R.
• Framework for communicating.
• Universal way of addressing issues
within healthcare.
• Helps create an environment where individauls can
expression their concern.
• Helps ensure that patient’s get what the need, when
the need.

12. S.B.A.R.S.B.A.R.
Situation – What is happening?
Background – What is the background?
Assessment – What do I think the problem is?
Recommendation – What would I recommend?

13. S.B.A.R.S.B.A.R.
• Assess patient yourself
• Discuss situation with another colleague
• Organize information before with physician.
• Chart
• Allergies
• Medication list
• Current list of IV meds and fluids
• Pertinent lab results
• Primary physician name
• Code status

14. SituationSituation
• State you name and unit.
• Identify the person you are
talking to
• “I am calling about (state
patient and room).
• State the problem you are
calling about

15. BackgroundBackground
• State admission diagnosis and date
of admission.
• State any other pertinent diagnosis
or medical problems.
• State medical history
• State brief synopsis of current
treatment

16. AssessmentAssessment
• Analysis of the situation
• What is you clinical impression?
• Severity of the patient
• Metal Status any neurological changes
• Vital signs of mother
• Fetal heart rate
• Contractions
• Discharge
• Pain level

17. RecommendationRecommendation
• Explanation of what you are requiring.
• Change in treatment
• Ask for consultation
• What test you believe is needed.
• Clarification of how urgent the action needs to
occur.
• If changes have occurred need follow plans
• How often for vital signs
• If no improvement what next?
• Document change in condition
• Document physician notification

18. CommunicationCommunication
• The Joint Commission has set a
standard for communication.
• The nurse transferring care must give the nurse
taking responsibility for the patient all
appropriate information about his condition.
• The nurse transferring care must give the nurse
taking responsibility for the patient all
appropriate information about his condition.

19. Two-WayTwo-Way
CommunicationCommunication
• The objective is
to engage in a
two way flow
with responses to
questions.

20. Two-WayTwo-Way
CommunicationCommunication
• In 2011the U.S. Department of Health and
Human Services' (HHS) Agency for Healthcare
Research and Quality (AHRQ) launched an
initiative to encourage clinicians and patients to
engage in effective two-way communication.
• Better communication with patients shown to
increase compliance with treatment plans.

22. Low HealthLow Health
LiteracyLiteracy
“It is likely the almost everyone has been, at
some time, put off by densely worded forms,
and confused by complex medical regimens,
conflicting health care advice, poorly
worded instructions, and medical speak that
few on the receiving side of health care can
understand.”
What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety, The Joint Commission, 2007
www.jointcommission.org

23. Low HealthLow Health
LiteracyLiteracy
“The communications gap between the abilities
of ordinary citizens, and especially those with
low health literacy and low English proficiency,
and the skills required to comprehend everyday
health care information must be narrowed.”
What Did the Doctor Say?: Improving Health Literacy to Protect Patient Safety, The Joint Commission, 2007
www.jointcommission.org

24. Low HealthLow Health
LiteracyLiteracy
•Health literacy is the degree to which individuals have the
capacity to obtain, process, and understand basic health
information and services needed to make appropriate health
decisions (Institute of Medicine, 2004)
•Health literacy is dependent on both individual and systemic
factors
Communication skills of lay people and professionals
Knowledge of lay people and professionals of health topics
Culture
Demands of the healthcare and public health systems
Demands of the situation/context

25. Teach BackTeach Back
• Nurses have an ethical and legal duty
to validate a patients understanding of the treatment
offered.
• A health literacy tool to ensure patient understanding
• Asking patients to repeat in their own words what
they need to know or do, in a non-shaming way.
• NOT a test of the patient, but of how well you
explained a concept.
• A chance to check for understanding and, if necessary,
re-teach the information.

26. Non-EnglishNon-English
Speaking patientSpeaking patient
• Joint Commission Guidelines promote care that is
culturally and linguistically sensitive.
• Nurses must provide patients with resources necessary to
communicate with their healthcare providers.
• All hospital should ensure non-English patients are offered
translation services.
• On admission patient’s preferred language must be
identified for discussing healthcare.
• Patients need to be notified of their right for an interpreter.
• Free services