Week 3

Question 1

What is the definition of patient care?

Answer 1

“The provision of what is necessary for the health, welfare, maintenance, & protection of someone or something”
Patient care involves all aspects of care from when they arrive in the department for their scan to when they leave

Question 2

What does “to care for mean”?

Answer 2

To look after & provide for the needs of

Question 3

What is a holistic approach?

Answer 3

Holisim describes the interconnectedness of mind, body, spirit, emotions
Holistic health care is comprehensive or total health care that takes into consideration physical, emotional, cultural aspects, social aspects & environmental issues
Care for the whole person, not just the physical body
We want our care to be patient focussed

Question 4

What is the paternalistic health care model?

Answer 4

Based on the premise that the health professional is an expert in the field & one most informed to make the best decision for the patient

Dominant attitude of the healthcare worker over that patient

Question 5

What is the patient-focused care model?

Answer 5

“Patient-centred care is a model of care that respects the patients experiences, values, needs & preferences in the planning, coordination & delivery of care”

Question 6

What does the patient-focused care model look like in sonography?

Answer 6

Consider patients age, cultural traditions, personal values, lifestyle
Involves communicating well with patients & allowing them to express their individual problems, fears and frustrations
Cooperation with other healthcare professionals to deliver the best & most complete patient care through a team effort
Ensure patient safety throughout scan through diligent monitoring of their health & any changes as well as correct handling whilst in your care
Professionalism expected at all times

Question 7

What does basic patient care involved?

Answer 7

Patient safety needs to be ensured
Vital signs are observable & measurable signs of life
- Pulse, Respiratory rate, temperature, BP
Infection control
Professionalism
Communication skills
Cultural safety
Correct transfer
Correct consent

Question 8

What are the pre-scan, scanning skills and post scan procedures?

Answer 8

Pre scan: Room set up & infection control, referal interpretation, intro, explanation, history, patient care management & safety, professional care management & safety, professional behaviour (includes confidentiality), obtaining consent
Scanning skills: Practical skills for surveys & image acquisition, interpretation, image optimisation, instrumentation control & selection, patient care management & safety, professional behaviour
Post scan: Patient care management & safety for the dispatch, written technical impressions, room clean up & infection control, professional behaviour (includes confidentiality)

Question 9

What is patient care?

Answer 9

They’re a person not a case from a list
Recognise they could be frightened, in pain, unwell, anxious
Some may need more time than the previous patient
They may have other concerns
How would you like to be treated?
Ensure patient has a positive care experience
Smile & be professional
Treat each patient as an individual

Question 10

What is communication?

Answer 10

Method to convey info
A form of communication between individuals
A process to share or express feelings
Sharing of meaning
Creation of a shared understanding

Whilst we all might communicate in one way or another it might not be effective

Question 11

Why is communication so important?

Answer 11

It’s the 1st step in caring for our patients is in how we communicate with them
Allows us to establish a rapport with our patients by showing respect, actively listening & responding to them
Allows us to give clear and concise instructions/info

Question 12

What make listening effective? What is active listening?

Answer 12

For listening to be effective we need to actively listen

“The practice of engaging closely with what a speaker is saying & indicating understanding, typically by asking relevant questions, using gestures & summarising”

Active listening:
Conveys a mutual understanding of the feeling or message
Confirms the point is being understood
Better engagement & understanding
Respond appropriately

We need to gather accurate info & understand the feeling & meaning of the message the patient is trying to convey

Question 13

What are the 2 types of communication?

Answer 13

Verbal
Nonverbal

Question 14

What is verbal communication?

Answer 14

Much of our intntional communication with others is through verbal communication which is based upon language
Verbal communication can be further subdivided into:
Vocal:
- focussing on the spoken language
- includes words/sounds & intonation
Non vocal:
- language transmitted through written, sign language, braille

Question 15

How is information delivered?

Answer 15

Paralanguage & intnation has to do with the sound of speech rather than the content
-rate of speech, the volume of the voice, fluency & vocal patterns/tone

For verbal communication to be understood we need to:
-use appropriate tone of voice, speak clearly & consisely, don’t use unnecessary words/technical jargon, use clear articulation & pronounciation of words, use the correct inflection, use an appropriate rate of speech

Know the material to be communicated

Question 16

What is non-verbal communication?

Answer 16

A powerful form of human behaviour which involves a subtle, non-linguistic, multidimensional process
Non-verbal communication is interpreted through:
-body movements, facial communication, eye communication, touch, physical distance, appearance

Needs to be synchronous with the words spoken

Question 17

How may non verbal communication come across?

Answer 17

Unspoken messages often indicate how the patient feels more quickly than any words spoken

Non-verbal communication may:
Repeat or stress the spoken message, accent the spoken word, consolidate the spoken word, substitute for verbal communication

Question 18

What are the 9 categories of non-verbal communication?

Answer 18

1.appearance: clothing & physical appearance
2. Olfatics: smell
3. Kinesics: body language. Posture, facial expression, eye gestures, body movement/gestures
4. Oculesics: eye contact or lack of
5. Proxemics: social use of space in communication, innapropiate invasion of intimate space
6. Haptics: touch as a form of communication, low to high contact, appropriate vs inappropriate
7. Chronemics: time e.g late for appointment, slow or rushed, verbal & non-verbal mismatch
8. Observation: recognising non-verbal cues e.g pain/discomfort, scared, confused
9. Environment: the influence & choice of environment

Question 19

What does appearance involve?

Answer 19

Clothing & physical appearance includes:
Gender, jewellery, makeup, hairstyle, accessories, clothing, height, weight, skin colour, body shape

Question 20

What does kinesics (body language) include?

Answer 20

Posture, facial expressions, eye gestures, body movements/gestures

Question 21

What is oculesics?

Answer 21

The study of messages sent by the eyes, including eye-contact, blinks, eye movements & pupil dilation
Eye gaze- Direct eye contact
Blinking: Should be every so often

Question 22

What is proxemics?

Answer 22

The use of space & effects that has on communication
Be aware of inappropriate invasion of intimate space

Question 23

What are the types of proxemics?

Answer 23

Intimate- 2 fists away
Personal-1 handshake away
Social- 2 arm lengths away
Public- over 3.6m away

Question 24

What are haptics and what does is portray?

Answer 24

The way we communicate & interact through touch
In the work environment touch takes on an important role
Touch communicates:
-positive emotions, controls behaviour, may intrude, personal space, be aware of cultural differences, be aware of inappropriate touching

Question 25

How is environment an aspect of healthcare?

Answer 25

You should choose an appropriate and private setting to tell information. A quiet area where no one can overhear

Question 26

Why do we need to validate communication and how do we do this?

Answer 26

Very important t be correctly understood especially with essential information We need feedback that the information was correctly understood To demonstrate understanding th listener may: Repeat. Clarify. Summarise If info isn’t clearly understood,the speaker may need to rephrase & restate If points aren’t clear there is a large potential for error Response must indicate clear understanding

Question 27

What are some barriers to effective communication?

Answer 27

Anything that interferes with the communication These can be : Verbal or nonverbal Sender or receiver

Question 28

Barriers to effective communication (detailed)

Answer 28

Use of inpproprtiate language: Technical/medical jargon. Slang & broad generalisations Physical barriers (hearing & speech) “Talking down” & using hostile tone Talking to fast or too quickly Distractions or interference - Noise or behaviour Language and cultural differences Cutting off communication - Interupptinf, changing subject, judgemental responses, arguing, evasion and avoidance Attitude and feelings - Physical state (tired, pain, cold). Emotional state (fear, anger) Lack of feedback

Question 29

What to avoid when trying to effectively communicate

Answer 29

Riducle, lecturing, didactic Being aggressive (be assertive not aggressive) Assuming Controlling & coercive behaviour Strategic communication given for a reason Uncaring behaviour Superiority

Question 30

How to be an effective communicator

Answer 30

Appropriate appearance Positive body language that matches your words Patient is seated with you so eye level is same Attentive posture & avoid withdrawn body posture Be aware of your facial expressions Make eye contact Appropriate use of gestures Appropriate use of silence. Use tone, volume, modulation of voice, speech rate & pronounciation appropriately Be confident, clear & fluent. Use correct grammar and vocabulary according to patients level of comprehension Actively listen for patient response & repeat info to clarify. Respond appropriately Observe nonverbal cues Don’t interrupt or criticise Be professional & friendly Use empathy Build a rapport (relationship) with the patient

Question 31

How to communicate with a hearing impaired patient?

Answer 31

Make sure you have their attention Avoid background noise Speak clearly and at moderate pace Lower the tone of voice Allow patient to keep hearing aids on for as long a possible Make sure the patient has understood: –open ended questions –pt to repeat important instructions back to you –rephrase if necessary

Question 32

How to communicate with a lip reading or deaf patient?

Answer 32

Lip reading: Make sure the patient can see your face when speaking to them (don’t turn your back) –Ensure there’s enough light for them to see you clearly Deaf Be guided by the patient in how to communicate: -Lip reading, written communication, sign language (auslan)

Question 33

How to communicate with a vision impaired patient?

Answer 33

Find out from patient which form of assistance (if any) would be most appreciated Clear walking paths Adequate lighting More descriptive language use touch and tone of voice avoid non verbal responses like head shaking etc

Question 34

How to communicate with a speech impaired patient?

Answer 34

Multiple possible causes Different devices and techniques can allow patients to communicate verbally Be patient, allow time for them to communicate Simple gestures

Question 35

How to communicate with a mentally impaired patient?

Answer 35

Determine patient’s level of comprehension and ability to follow instructions Use simple, direct instructions Allow enough time for response May need to repeat yourself, be patient Address the patient with respect, as you would anyone their age

Question 36

How to communicate with a physically injured patient?

Answer 36

Sudden and unexpected for the patient Pain Altered emotional response Pain relief – nausea, dizziness Care in moving Often requires technical adaptation

Question 37

How to communicate when there is cultural differences?

Answer 37

Personal space •Family decision maker •Eye contact •Appropriate touch •Clothing Language barrier •Patient right to clear communication •Use of interpreter •Speak to the patient (not the interpreter)

Question 38

How to communicate with geriatric (older) patients?

Answer 38

Cognitive decline • May have hearing or sight loss • Postural hypotension • Multiple health conditions • Reduced mobility •give choices and explain carefully

Question 39

How to communicate with paediatric patients?

Answer 39

• Communication with child and parents •Consent • Be organised and calm • Build rapport!! Gain trust •eye level •very simple terms

Question 40

How do we communicate with staff?

Answer 40

Professionalism, clear & consise communication, use appropriate verbal & non verbal communication, demonstrate respect, common goal, appropriate time & place

Question 41

Who will you communicate with?

Answer 41

Administration, student, nurse, patient/family/carer, doctor, allied health professional, fellow team member/colleague

Question 42

How do we communicate about patients?

Answer 42

Professionalism Clear and concise communication Be accurate and thorough Ensure confidentiality Make sure information is current Use ISBAR method of communication

Question 43

What in the ISBAR communication technique?

Answer 43

Identify Situation Background Assesment Reccomend

Question 44

Explain the 5 components of ISBAR

Answer 44

I: Name, age, MRN, ward, team S: Symptoms, problem, patient stability/level of concern B: History of presentation, date of admission & diagnosis, relevant past medical hx A: What is your diagnosis/impression of situation? What have you done so far? R: What you want done. Treatment/investigations underway or that need monitoring. Review: by whom, when and of what? Plan depending on results /clinical course