Improving Patient Safety in Long-Term Care Facilities:

Communicating Change in a Resident’s Condition

Student Version

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A Safe Environment

Effectively communicating change in a resident’s condition is critical to

patient safety.

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Case Study #1

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Ms. Malone

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Creating a Safe Environment

• Reporting changes helps keep resident’s safe.

• Learning and experience are what make safety possible.

• Openly reporting anything that might affect a resident’s well-being is essential for a safe environment.

• Change in a resident’s condition should be reported openly whenever it happens.

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Key Principles of Effective Communication

• Teamwork

• Open reporting

• Reporting unwanted events

• Giving and receiving information

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Teamwork

• Report change across the care team.

• Work together to identify what the change may mean.

• Take action as a team.

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Reporting Unwanted Events

• Learn to communicate promptly and openly when something happens that might affect a resident’s well-being.

• Move beyond blaming anyone to being able to openly share experiences.

• Show you care by speaking up.

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Giving and Receiving Information

• Express information in a way that will be understood by others.

• Hear information as it is being reported.

• Make effective use both of verbal and nonverbal communication skills.

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Barriers to Communication

• Gender

• Age/generation

• Language

• Culture

• Status

• Interpersonal issues

• System barriers

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Case Study #2

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Case Study #2Mrs. Brown

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Case #2Min-Wa and Susan

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Case Study #2Observations

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What Should Be Communicated?

• Physical changes

► Walking

► Urination/bowel patterns

► Skin quality

► Level of weakness

► Falls

► Vital signs

• Nonphysical changes

► Demeanor

► Appetite

► Sleep

► Confusion

► Agitation

► Pain

• Relevant external factors

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How Should Information Be Communicated?

• Reporting and communication tools:►Early Warning Tool►SBAR►CUS

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Stop and Watch Early Warning Tool

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SBAR Tool

SBAR: http://interact2.net/docs/INTERACT%20Version%203.0%20Tools/Communication%20Tools/Communication%20Within%20the%20Nursing%20Home/INTERACT%20SBAR%20Form%20v8%20Jan%2014%202013.pdf

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Case Study #3

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Case Study #3 Mr. Harris

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Case #3 Observations, Day 4

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Case Study #4

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Case Study #4Change-of-Shift Meeting (Min-Wa)

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The CUS Tool

• I am Concerned about my resident’s condition.

• I am Uncomfortable with my resident’s condition.

• I believe the Safety of the resident is at risk.

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Principles in Action CUS: Min-Wa to RN Team Leader

• I'm concerned about Mr. Harris. • I’m uncomfortable that his temperature is up and

that he has developed diarrhea. • I believe that he might be developing an

infection that should be treated.

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Case Study #5

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Case Study #5: Mrs. CarverFebruary 2012 – March 2014

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Case Study #5: Mrs. CarverApril 1, 2014

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Case Study #5: Mrs. CarverApril 2, 2014

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Key Points

• Communicate changes promptly.

• Reports of change can come from many sources.

• Every team member is responsible for reporting changes.

• Everyone faces barriers to communication.

• Tools to break down barriers.