Komunikasi Efektif Dan Keselamatan Pasien - Bahan Bu Tika

8/11/2019 Komunikasi Efektif Dan Keselamatan Pasien - Bahan Bu Tika

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Communication problems Inadequate information flow

Human problems

Patient-related issues Organizational transfer of knowledge

Staffing patterns/work flow

Technical failures Inadequate policies and procedures

(AHRQ Publication No. 04-RG005, December2003) Agency for Healthcare Research and

Quality


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1. Communication

2. Patient Assessment

3. Procedural Compliance

4. Environmental Safety/Security

5. LeadershipSources: Michael S. Woods, M.D., How Communication Complicates the PatientSafety Movement, Patient Safety & Quality Healthcare, May/June 2006; Joint

Commission on Accreditation of Healthcare Organizations, 2006; H&HN

research, 2006


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STIMULUS

ENCODER

STIMULUS

DECODERUMPAN BALIK


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The Joint Commission for Accreditation forHealth Organization has listed effectivecommunication as goal no.2 of the 2006National Safety Goals.

Effective communication depends on clarity: thespeaker must convey his or her message insuch a way that the listener clearly understandsthat message.

But the truth is communication is influenced by a

host of factors: gender, ethnicity, culture,professional dynamics. So a speakers intendedmessage may not be what the listener hears orunderstands, which can compromise patientsafety.


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Effective communication must meet certainstandard when delivering information from thesender to the receiver. Information that is beingcommunicated must be clear and easily

understood. Some buzzwords are confusing andmight lead to misunderstanding, so use it withcaution.

Effective communication must be complete. All

pertinent information must be said with lessunnecessary details. Too much use of the detailscan also confuse the receiver instead of helpingone to understand.


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Timeliness of giving the information is

important especially when communicatingwith patient care related issues. Timelinessalso gives a true sense of urgency. Anydelays in patient-related communicationwill often lead to patient beingcompromised.

The information communicated must beacknowledged and verified by the receiverin order for the exchange of information tobe effective.


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Improved communication is one of the Joint Commissions 2006National Patient Safety Goals. JCAHO requires organizations to

establish processes that will help eliminate communication errors, such

as:

Have individuals verify verbal and telephone orders and critical test

results by reading back the complete order or test result.

Standardize a list of abbreviations, acronyms and symbols that are

not to be used throughout the organization.

Measure, assess and, if appropriate, take action to improve the

timeliness of reporting, and the timeliness of receipt by the

responsible licensed caregiver, of critical test results and values. Implement a standardized approach to hand off communications,

including an opportunity to ask and respond to questions.

Source: Joint Commission on Accreditation of Healthcare Organizations, 2006; H&HNresearch, 2006


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1. Culture/Ethnicity

A patients culture may influence how he or she interacts

with caregivers. Language barriers can cause

misunderstandings and miscommunications.2. Socioeconomics

Levels of education, literacy, economics, beliefs and

behaviors can differ tremendously among patients, can

affect the ability of staff to communicate with one another(e.g., nurses and doctors) and can lead to

miscommunication.

3. Literacy

How well does the patient understand medical terms? Canthe patient follow take-home instructions?


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4. Gender Gender influences relationships among staff and

between caregivers and patients.

5. Personality/Behavior

Individuals personalities color their dailycommunication and influence how others perceivethem.

Urgency affects a speakers tone. For example, ahurried doctor or a stressed-out nurse may be perceivedas curt by the patient or other staff.

Sources: Michael S. Woods, M.D., How Communication Complicates the Patient Safety Movement, Patient Safety &Quality Healthcare, May/June 2006; H&HN research, 2006


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Lack of structure, policies, and proceduresrelated to the content, timing, or purpose ofverbal reports.

No shared mental model or framework for verbal

healthcare communication. No rules for verbal transmission of information,

either face-to-face or over the telephone.

Differing opinions, even among nurses, as to

what information should be communicated duringa verbal report.

Frequent interruptions and distractions.

Frequency of communication.


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KOLABORASI

AREA KELABU PADAT RISIKO/ ERROR

( PELIMPAHAN SECARA TERTULIS / STANDING ORDER dan

SESUAI KOMPETENSI)

PRAKTIK

KEPERAWATANPRAKTIK

KEDOKTERAN

PERAWAT DOKTER

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For verbal or telephone orders

For reporting critical results

Method:

The individual receiving the information Writes down the complete order or test result, or

Enters it into the computer

The individual receiving the information

Reads back what has been written

The individual who gave the order

Verifies the correctness


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Check-back is a good way to verify

information especially when transcribing

a doctors order.

Medical orders must be reviewed forcompleteness and clarity.

The medical orders must be questioned

if penmanship is illegible orabbreviations are used that are not

acceptable by the institution.


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Call-out is another technique when

a critical information is called out

during an emergency situation.

The critical information is said aloud

so that any team members present

during an emergency that are

hearing and listening to theinformation.


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Hand-off is another technique of verbally transferringinformation, responsibility, and accountability of patient care

to another staff.

This includes the review of written report on the pertinent

patient information, the latest significant changes in patientstatus, and the latest recommendation on the plan of care.

The receiving staff has to acknowledge the completeness,

pertinence of information, and accepts the responsibilities

in providing patient care. Using the S-B-A-R method in hand-off will enhance

communication and promote a culture of patient safety.


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S-B-A-Ris an abbreviation for : Situation,

Background, Assessment and

Recommendation.

Giving information systematically andconsistently

SBAR should be used when giving patient

information between primary caregiversregardless of discipline.


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SBAR is a technique that

provides a framework.

easy-to-rememberallows for an easy and focused

way to set expectations


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Communication Tools :

SBAR Situation:What is going on with the patient?

What is happening at the present time?

Background:What are the circumstancesleading up to this situation?What is the clinical

background? Assessment:What is the problem? What is

the current situation?

Recommendation:What should be done to

correct the problem?------- Response/Repeat back: Repeat back the

plan of care


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S : Situation

Kondisi terkini yg terjadi

pada pasien

B : Background

Informasi penting apa ygberhubungan dg kondisi

pasien terkini

A : Assessment

hasil pengkajian kondisi

pasien terkini

R : Recommendation

apa yg perlu dilakukan

Untuk mengatasi masalah

Dapat digunakan

saat serah terimaperawat antar

shift, perawat ke

doktersaat

melaporkankondisi pasien,

dokter ke dokter.


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S SITUATION

-nama. Umur, tgl masuk, hari

perawatan, dr yg merawat- diagnosa medis dan masalahkep yg belum dan sdh teratasi

B BACKGROUND- keluhan uatama, intervensi ygtelah dilakukan, respon psn diagnosa kep.

- riwayat alergi, rwyt pembedahan,pemasangan alat invasif dan obat/infuus

- pengetahuan pasien/ kel D/ medis


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AASSESSMENT

- jelaskan hasil pengkajian pasienterkinitanda vital, pain score, tkkesadaran, status restrain, risiko

jatuh, status nutrisi, eliminasi, halyg kritis, dll.

- hasil investigasi yg abnormal- informasi klnik lain yg mendukung

RRECOMMENDATION- rekomendasi intervensi keperawatan

yg perlu dilanjutkan ( refer ke nursingcare plan) termasuk discharge

planning- edukasi pasien/ keluarga


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example

S = Dr. Smith, this is Mary at General Hospital

calling regarding Mr. Cook in 212. His temperature is up to 103.5.

B = He is POD #2 S/P right knee replacement.

A = The wound is red; pulse is up to 115 from baseline of 80; his

pain level has increased to 9/10 despite increasing his Vicodin dosingto ii tabs Q4.

Specific numerical values are given in the assessment

R = I would like you to come see him. When can I expect you?

Asking for a specific time frame

R = I will be there in 15 minutes, I am in the PACU.


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MENINGKATKAN KOMUNIKASI PADA

SAAT OPERAN / HAND- Off

GUNAKAN BAHASA YANG JELAS

GUNAKAN TEHNIK KOMUNIKASI YGEFEKTIF : kurangi interupsi, alokasikan

waktu yg cukup , terapkan read backataucheck backtehnik,

Standarisasi laporanantar shift / antar unit

Saat transisi ==> pasien mau pulang/

pindah, berikan informasi yg jelas kpdpasien/ kel: obat, diagnosa pulang,hasil pemeriksaan, kapan dan dimanakonsultasi fo llow up

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Standardized abbreviations, acronyms,

symbols, and dose designations

Do Not Use list

Do not use in medication orders

Do not use in medication-related

documentation

Do not use on pre-printed forms

Do not use in handoff communications to

other providers


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Limit Abbreviations The Joint Commission has a list of abbreviations that should not be used

on orders or on any medication-related documentation that is handwrittenor on preprinted forms. The list below provides the following substitutions:

JCAHO Do Not Use List

*Exception: Use a trailing zero where required to demonstrate the level of precision of the value being reported,such as for laboratory results. It may not be used in medication orders or other medication-relateddocumentation.

Source: Joint Commission on Accreditation of Healthcare Organizations, 2006; H&HNresearch, 2006


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Poor handwriting

Lotrison or Lotrimin ? Coumadin or Kemadrin ?

Doxorubicin or Daunorubicin ? Pentobarbital or Phenobarbital ?


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Komunikasi Efektif Dan Keselamatan Pasien - Bahan Bu Tika

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