CCN in Medical Settings Flashcards
(19 cards)
Limited communication - patient impact
Limited self advocacy
Right to self determination
Understanding and cognition
Fear, isolation and confusion.
Limited communication - family impact
Need to advocate.
Liaise with staff.
Time off work or other commitments to care.
Limited communication - healthcare worker impact
Working in MDTs.
Developing a system to communicate across team.
Understanding patient’s communication.
Barriers to using AAC
Lack of understanding.
Fast paced environment - misunderstanding, feeling rushed.
Charging communication devices.
Storing communication devices safely.
Primary Causes for using AAC
Traumatic brain injury
Stroke
Oral-laryngeal cancer
Guillian Barre Syndrome
Etc.
Secondary Causes for using AAC
Surgery
Intubation
Tracheostomy
Etc
Reasons patients need to communicate:
Human rights
Consent
Holistic care
Dignity
Creates a positive experience
Builds rapport
Self advocacy
Discussing personal matters
AAC in acute contexts
Communication impairment usually new to family and patient, usually unfamiliar with AAC.
Benefit of AAC in hopsitals/ICU
Ease communication difficulties.
Allow pts to communicate pain and basic needs.
Pts can get reassurance through communicating with loved ones.
May be necessary for legal reasons - witness statements etc.
Low tech AAC boards - pros in ICU:
Do not need to be charged.
Usually mobile.
Provide autonomy.
Can feel easier to learn.
Low tech AAC in ICU: cons
Could get lost.
May be seen as “too slow” in ICU/fast paced environments.
Can place additional stress on pt. as they learn to use it.
High tech AAC suitability
Breathing and awake.
Unable to speak
Can use their hands
Environmental considerations
Mounting system if needed.
Ensuring access for pt.
Managing hygiene and cleanliness.
Vocabulary
Ease of use is priority.
Considerations for AAC selection with large MDTs
Easy to understand and use.
Must allow pt to express needs.
Be efficient
Need to have a back up
Pts with cognition + motor control can use:
Gestures
Mouthing speech with first letter supplementation
Alphabet boards
Writing supports
An electrolarynx
Complex or simple SGDs.
Pts with motor control + impaired cognition can use:
Simple communication boards
Simple SGDs
Mouthing with partner giving topic cues.
Pts with cognition + impaired motor control can use:
Alphabet boards
Whole message boards
Partner dependent scanning
Eye gaze techniques
Simple SGDs
Pts with impaired cognition and motor control can use:
Signal and gesture dictionaries
Tagged yes/no questions
Simplified partner dependent scanning.
Strategies to improve communication between staff and AAC using Pts:
Training to increase staff knowledge.
Acknowledge that pts who cannot speak might understand.
Collab to remove barriers
Share information on communicating with pt.
Strengthen advocacy role of relative/carer.
