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Foundations for Professional Practice

Contents

Introduction:

Use of therapeutic communications in person centred care:

Role of inter / intra professional communication in clinical handover:

Reflection on potential communication barriers affecting safety and quality in healthcare:

Conclusion:

Reference:

Introduction to Clinical Practice in Healthcare

The assignment highlights the topic of clinical practices along with the significance of therapeutic communication that enhances the person centred car. The role of inter/intra professional communication are discussed along with potential barriers in communication barriers in clinical practice.

Use of Therapeutic Communications in Person Centred Care

As per the guidelines of Brownie, Scott, and Rossiter (2016), patient centred care (PCC) is provided to individuals with particular health needs and specific health outcomes. The health requirements of patients are driving force for every quality measurement and decisions in patient centred care. In this type of care plan, patients have to become partners and associate with their health care providers. Meanwhile, it is also the duty of the health care providers to treat the patients not only from clinical perspectives but also from financial, social, spiritual, mental, and emotional perspectives.

According to Haley, et al., (2017), there are four principles of person centred care which should be maintained by the health care service providers. They are to offer personalised treatment and support, provide coordinate care, treatment, or support, respect and compassion for patients, and affording dignity of people. The application of these four principles in patient centred care is only possible with effective communication that allows to understand the perspective of patients by the health care providers.Sorour (2019), marked that therapeutic communication is the best way to communicate with patients in PCC. It is a face to a face communication method of interaction that concentrates on the emotional and physical wellbeing of patients. Nurses often use therapeutic communication to provide information and support to patients.

Therapeutic communication includes the exchange of information through verbal and non – verbal levels. Verbal communication involves the arrangement of words, sentences, content and text to communicate with patients that satisfythe cultural, emotional, social, and physical environment of the patient. Nonverbal communication involves behaviour along with verbal content like tone of voice, facial expression, eye content, body language, etc. It subconsciously satisfies feelings of clients and their thoughts. For instance, patients with a hearing disability could be communicated through sign language, body language, or written notes (Haley, et al., 2017). However, the nurses must not show any hesitation or irritation while communicating with patients, as it might hurt the emotional feelings of patients.

There are five main elements of the therapeutic relationship, regardless of the length of interactions in healthcare and they are –

  • Professional intimacy – It is an inherent kind of services and careslike physical activities example bathing that care providers perform to increase closeness with patients. Professional intimacy includes social, spiritual, and psychological elements getting added in the care plan (Brownie, Scott, and Rossiter, 2016).
  • Power – Care providers have the power to take specialised medical decisions for the patients and get access to personal information. Misuse of power is considered as abuse.
  • Empathy – It means analysing the perspective of patients along with resonating and validating their experience (Sorour, 2019).
  • Trust – it is difficult to re-establish once it is broken, but is crucial in a therapeutic relationship.
  • Respect – It is considered as inherent dignity, and worth for every patient, regardless of social economic status and personal attributes of patients in their health problems.

Role of Inter / Intra Professional Communication in Clinical Handover

Inter professional communication takes place when health care provider’s communication among themselves and with families, people, and communities in an open responsible and collaborative manner. Mutual respect is essential while communicating. Starkweather, et al., (2019), specified that interprofessional communication in nursing helps in evolving good communication between health care providers and patients and further added to health benefits of patients. It greatly contributes to PCC as care providers can get more information about the patient’s spiritual, social, medical, and emotional background and apply it in the care plan. Moreover, as the care providers can access more information, medication errors are avoided and empower care providers to give better health outcomes and construct effective health care plans.

Intraprofessional communication takes place within the health care providers only. In this type of communication, it is important to respect your colleague and treat them fairly, enjoy friendship, honestly disagree with them, explore thoughts candidly, work together for common goals, and help one another. Javadi, Ashrafi, and Salari (2018), stated that intraprofessional communication is vital in nursing to enhance confidence and decrease errors in the treatment process. It eventually assist to enhance and develop skills and knowledge through support of one another. PCC requires intraprofessional communication as it evolves a collaborative team and builds a positive work environment.

The Australian Commission on safety and quality in healthcare has introduced the National Safety and Quality Health Services Standards (NSQHS) to establish a nationwide communicating statement that could be expected by patients from health service organisations (Javadi, Ashrafi, and Salari, 2018). The legislation aims to assure effective, purpose driven, and timely communication and documentation that assist coordinated, continuous, and safe care for patients. These guidelines are acknowledged by nurses while inter / intra professional communication.

The Australian healthcare commission suggested that care providers considering ISOBAR are well suited to indigenous conditions and easy to assimilate to present work processes to decrease the repetition of processes and administration (Starkweather, et al., 2019). ISOBAR is a checklist that enhances the safety of patients and decreases adverse outcomes that could appear. The ISOBAR framework standards for –

I

Identification

Get identify of the patient and introduce self and the team

S

Situation

Provide present working concerns, particular clinical problems, and working diagnosis and laboratory results

O

Observation

Discuss, update, and check present vital signs

B

Background history

Discuss and update relevant information and support medical process

A

Agree with actions or plans

Outline treatment and discharge and care plan for assessment

R

Risk and responsibility management

Assure shard understanding, and confirm transferred responsibility and timing

Reflection on Potential Communication Barriers Affecting Safety and Quality in Healthcare

Barriers to potential communication barriers increase healthcare risks like lack of access to information, the participation of patients in treatment, the difference in perception and receptivity, and unable to associate with the emotional and societal background of patients. Moore, et al., (2017), highlighted that barriers to communication lead to harm of patients, lengthy stay and misuse of resources and dissatisfaction of caregivers and rapid turnover. The authors further marked four barriers to communication and they are –

  1. Poor communication skills – Mental or physical illness of patients might restrict them to communicate. It includes symptoms like depression, pain, inability to listen or focus or talk.
  2. Personal characteristics –The patient or the care providers could have a lack of empathy, active listening skills, ability to overcome language barriers, or have poor conflict management skills and inability to set boundaries (Moore, et al., 2017).
  3. Personal Characteristics – The care providers or patients suffer from personal cultural taboos, have unknown or hidden agendas, unresolved emotional issue, or poor self – esteem.
  4. Environment – The surroundings might have huge noise orlack of privacy for nurse or patient. The nurses could have huge workloads and not sufficient time to communicate patiently.

However, Sethi and Rani (2017) worked on means to overcome communication barriers in nursing and found therapeutic communication has the potential enable nurses to actively listen, observe, smile, and show empathy and enthusiasm towards patients that help to overcome language barriers and involve patients in the treatment process. Meanwhile, personal characteristics like effective decision making, maintaining boundaries and privacy with patients, and appropriate nursing interventions like evidence based support and appropriate work load assist care providers to overcome communication barriers.

Conclusion on Clinical Practice in Healthcare

Clinical practitioners providing PCC have to associate with effective therapeutic communication to create an emotional and psychological relationship with patients that enable the active involvement of patients in care plan. Inter and intra professional communication of care providers assures active health care support. Communication barriers need to be overcome as it hindersthe best health outcomes in PCC and clinical practices.

Reference for Clinical Practice in Healthcare

Brownie, S., Scott, R. and Rossiter, R., 2016. Therapeutic communication and relationships in chronic and complex care. Nursing Standard31(6), p.54.

Haley, B., Heo, S., Wright, P., Barone, C., Rettiganti, M.R. and Anders, M., 2017. Relationships among active listening, self-awareness, empathy, and patient-centered care in associate and baccalaureate degree nursing students. NursingPlus Open3, pp.11-16.

Javadi, M., Ashrafi, N. and Salari, P., 2018. Assessment of pharmacists experiences and attitudes toward professionalism and its challenges in pharmacy practice. Iranian journal of pharmaceutical research: IJPR17(Suppl), p.168.

Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M. and Wolf, A., 2017. Barriers and facilitators to the implementation of person‐centred care in different healthcare contexts. Scandinavian journal of caring sciences31(4), pp.662-673.

Sethi, D. and Rani, M.K., 2017. Communication barrier in health care setting as perceived by nurses and patient. International Journal of Nursing Education9(4), pp.30-35.

Sorour, M.S., 2019. Effect of Nurse's Therapeutic Communication and Protecting Patient's Rights on Patient's Satisfaction. Tanta Scientific Nursing Journal16(7), pp.113-131.

Starkweather, A.R., Colloca, L., Dorsey, S.G., Griffioen, M., Lyon, D. and Renn, C., 2019. Strengthening Inter‐and Intraprofessional Collaborations to Advance Biobehavioral Symptom Science. Journal of Nursing Scholarship51(1), pp.9-16.

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