A. Symptoms, Background, Alignment, and Referral
B. Site, Benefits, Agreement, and Resolution
*C. Situation, Background, Assessment, and Recommendation
D. Situation, Background, Assignment, and Reconciliation
RATIONALE: Effective communication among health care providers and other staff is necessary to ensure patient safety and to promote optimal outcomes. SBAR is an effective communication tool that helps the flow of standardized communication among all health care staff. SBAR stands for Situation, Background, Assessment, and Recommendation. S does not stand for Symptoms or Site. B does not stand for Benefits. A does not stand for Alignment, Agreement, or Assignment. R does not stand for Referral, Resolution, or Reconciliation.
(1) reviewing the patient for any family history of obesity,
(2) assessing the patient by checking body mass index and vital signs,
(3) encouraging the patient to self-explore by collecting information on lifestyle changes,
(4) instructing the patient to perform daily exercise and note the weight changes, and
(5) having the patient review the diet that should be followed after discharge to combat
obesity. The first phase of the nurse-patient relationship is the preinteraction phase, which occurs before meeting a patient. This phase involves reviewing available data, including the medical and nursing histories.
The second phase is the orientation phase, which involves assessing the health status of the patient such as body mass index and vital signs.
The third phase is the working phase, which involves problem solving and accomplishing goals. In this stage, the nurse would
encourage the patient to self-explore by collecting information on lifestyle changes. This is followed by instructing the patient to perform daily exercises and noting the weight changes. Both of these steps are involved in working phase. The fourth phase is the termination phase, which occurs before ending the relationship. This involves a brief review of the diet that should be followed after discharge to combat obesity.
"I should introduce myself by giving my name and title," "I will avoid referring to patients by diagnosis, room number, or other attributes," and "I should avoid terms such as 'honey,' 'dear,' or 'grandma' while addressing the patients." The nurse should introduce him- or herself by giving his or her name and status, such as nursing student, registered nurse (RN), or licensed practical nurse (LPN). It is important that the nurse avoid referring to patients by diagnosis, room number, or other attributes, because this approach would be demeaning to patients. The nurse should avoid terms of endearment while addressing patients, even with close nurse-patient relationships. Addressing patients by the last name is respectful in most cultures; nurses usually use a patient's last name in an initial interaction and then use the first name if the patient requests it. Using first names is appropriate for infants, young children, and patients who are confused or unconscious, as well as close team members.
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Terms in this set (36)
intrapersonal communication
your thoughts/inner communications that strongly influence perceptions, feelings, behavior, and self-esteem
interpersonal communication
one-on-one interaction between a nurse and another person that often occurs face to face
small group communication
interaction that occurs when a small number of persons meet
public communication
interaction with an audience
circular transactional communication process
shows the situational contextual inputs, channels of communication, interpersonal contextual concepts, and factors affecting the sender and receiver
-referent
-sender/receiver
-message
-channels
-context
-feedback
complementary role relationship
typically operate with one person holding a higher position than the other in the communication process
metacommunication
all factors that influence communication
motivation interviewing
encourages patients to share thoughts, beliefs, fears/concerns, with aim of changing behaviors
lateral violence
verbal, emotional, or physically abusive behavior of a registered nurse toward another staff member
therapeutic communication
responses that encourage the expression of feelings/ideas and convey acceptance or respect
active listening
being attentive to what a patient is saying both verbally and nonverbally
*S - sit facing patient @ angle
*U - uncross arms/legs
*R - relax
*E - eye contact
*T - touch
*Y - your intuition
perceptual bias
the tendency to see and understand something based on the way you expected it to be
symmetrical role relationships
sender and receiver are equal; Nurses assume a symmetrical role in working with a client as partner on developing mutually defined goals
what are the zones of personal space?
1) intimate distance (0-18 inches)
2) personal distance (18 inches-40 inches)
3) social distance (4-12 feet)
4) public distance (12+ feet)
what are the special zones of touch?
1) social zone (permission not needed): hands, arms, shoulders, back
2) consent zone (permission needed): mouth, wrists, feet
3) vulnerable zone (special care needed): face, neck, front of body
4) intimate zone (permission and great sensitivity needed): genitalia and rectum
what are the stages of the helping relationship?
1) preinteraction phase - before meeting a patient
2) orientation phase - when you and a and patient meet and get to know one another
3) working phase - when you and a patient work together to solve problems and accomplish goals
4) termination phase - during the ending of the relationship
what are elements of professional communication?
- courtesy
- use of names
- trustworthiness
- autonomy/responsibility
- assertiveness
how to focus on older adults who have hearing loss for improved communication
• Make sure the patient knows that you are
talking.
• Face the patient, be sure that your face/mouth is visible to him or her, and do not chew gum or talk while chewing.
• Speak clearly but do not exaggerate lip movement or shout.
• Speak a little more slowly but not excessively slow.
• Check whether patient uses hearing aids, glasses, or other adaptive equipment.
• Choose a quiet, well-lit environment with minimal distractions.
• Allow time for the patient to respond. Do not assume that patient is being uncooperative
if he or she does not reply or takes a long time to reply.
• Give the patient a chance to ask questions.
• Keep communication short and to the point. Ask one question at a time.
Which action would the nurse perform when communicating with a cognitively impaired patient?
Ask one question at a time
Use simple sentences to clarify
Allow time for patient to respond
What phase of a helping relationship involves activities such as reviewing available medical and nursing history?
pre-interaction
What observation of the patient's speech and behavior would lead the nurse to conclude the patient is having difficulty communicating?
Inappropriate verbalization
Inability to articulate words
Difficulty in comprehending
When caring for a patient, the nurse identifies factors that affect the outcomes of the treatment. To which phase of the nursing process does this nursing activity belong?
evaluation
Which action would the nurse perform when practicing active listening?
Establish eye contact
Sit facing the patient
Lean toward the patient
Be relaxed while communicating
The nurse plays music to promote a sense of joy in a child with cognitive impairment in a rehabilitation center. Which form of communication is the nurse using in this situation?
symbolic communication
Which therapeutic communication technique would the nurse apply in attending to an agitated patient?
Listen actively
Share empathy
Ask relevant questions
The nurse is asking a patient about pain in the abdomen. When asking a patient about abdominal pain, the nurse would use which method of effective communication?
Appropriate intonation
Properly paced statements
Clear and concise phrasing
When taking care of a patient from Thailand, the nurse notes that the patient looks relaxed and smiles but seldom looks at the nurse directly. Which response by the nurse is best?
deflect eyes downward to show respect
A patient with poorly controlled hypertension and diabetes expresses that it is difficult to choose a diet low in sugar as well as low in salt and carbohydrates. The patient reports working extra hours and not having the time to cook. Which information would the nurse report first to the dietitian using SBAR (Situation-Background-Assessment-Recommendation) technique?
The patient has chronic diabetes with hypertension
Which strategy would the nurse use when communicating with a patient who has difficulty speaking because of injuries caused by facial trauma?
Communicate directly to the patient
Review medical records to assess the level of sensory loss
Listen patiently when the patient speaks
The senior nurse is training a nursing student about the professional approach in communication. The nurse explains that the way one responds to a question or a situation indicates state of mind. Which statement is true about this explanation?
Passive responses serve to avoid conflict or sidestep issues
Aggressive responses provoke confrontation
Assertive responses are a more professional approach
Which action would the nurse perform during the working phase of a helping relationship in a hospital setting?
Work with patients to set their goals
Help patients express feelings
Take actions to help patients meet the goals
A patient has just been told that she has cancer, and she is crying. Which action facilitates therapeutic communication?
Pulling the curtain to provide privacy
Offering to discuss information about her condition
Sitting quietly by her bed and holding her hand
The nurse finds that a patient avoids taking painkillers because of a fear of drug addiction in accordance with the patient's cultural beliefs. Which level of communication would the nurse use for cultural assessment of the patient?
Interpersonal
The nurse summarizes a conversation with a patient to determine whether the patient has understood the nurse. Which element of the communication process does this illustrate?
Feedback
Which phase of a helping relationship involves activities such as reviewing available medical and nursing history?
Preinteraction
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