CNA150 Foundations For Professional Practice 2

Role of Therapeutic Communication in enabling Person Centred Care:

Patient centred care and therapeutic communication are some of the important components of quality care in the field of health care (Newell and Jordan 2015). Therapeutic communication is conducted between healthcare staff and the patient (Arnold and Boggs 2019). The importance of this communication approach has been established in many scholarly studies in delivering an appropriate level of care to the patient. The approach not only helps the healthcare staffs to understand and identify the physical and emotional problems their patients, but it also enable the patients to communicate with the staff (Arnold and Boggs 2019).

The person centred care is a specific care approach that is focused on a specific patient. The healthcare staff make assessments on the health requirements of a specific patient and afterwards they develop a care plan specifically addressing the specific requirements of that particular patient to promote the person centred care (Ogden, Barr and Greenfield 2017). The approach is considered to be important in the field of healthcare, as every patient is a different individual with their respective requirements. Even though two patients might have developed the same disease conditions, their physical, emotional and social needs for coping with the disease condition would not be the same. This is why, every care plan addressed at the patient’s health should be person centred (Ogden, Barr and Greenfield 2017).

The implementation of the person centred care requires the knowledge of the specific requirements of the patient. Therapeutic communication is the key approach for acquiring the knowledge apart from physical assessments and documentation of past medical conditions (Kornhaber et al. 2016). Thus the approach can be considered as an important tool for making assessments on the patient needs in patient centred care. There are various modes and elements of therapeutic communication. The verbal and non-verbal communication are two common modes of the communication. The different modes of communication are applicable according to the requirements of the patient to promote person centred care (Vogel, Meyer and Harendza 2018). The elements or the components of effective therapeutic communication include active listening, display of compassion, mutual respect and thorough understanding of the condition of the patient (Chichirez and Purc?rea 2018). All these components promote the appropriate assessment of the patient’s requirements promoting the person centred care. The therapeutic relationship is not only a tool for making assessments, it can also be used for ensuring a successful implication of the care plan developed for a specific patient as a part of the patient centred care.

Importance of Inter/Intra-Professional Communication in the Context of Clinical Handover:

Inter-professional communication in the field of healthcare is an important concept, which suggests an effective communication between the patients and their respective families, the healthcare professionals themselves along with the other community members. The intra-professional communication, on the other hand, is a communication restricted between the healthcare professionals only. The importance of both approaches for communication is undeniable in the field of healthcare, especially during the clinical handover of a patient. The approach not only saves time in the patient care, but it also promotes patient safety (Watson, Jones and Cretchley 2014). Clinical handover of a patient is an event of moving a patient from one department of a medical facility to another department. The handover event requires consultation between the healthcare professionals themselves to determine the reasons and the requirement of the handover. It has been found from the studies that ineffective intra-professional communication is one of the leading cause of impaired patient safety (Raeisi, Rarani and Soltani 2019). The lack of communication between two healthcare professionals prevents one healthcare professional from acquiring sufficient knowledge of the specific requirements of the patient, which compromises patient safety. Inter-professional communication is also important during a clinical handover. The communication event helps in improving the patient satisfaction and experience of care, reducing the possibilities of medication error and also in improving the inter-professional relationships between the staff themselves (Redley et al. 2017). Intra-professional communication is actually a part of inter-professional communication. Thus the entire communication approach can be considered as an important approach for improving the health outcome in patients and quality care during clinical handover.

During an event of the clinical handover of the patient, apart from the electronic medical record (EMR), the ISBAR documentation is often used. The abbreviation ISBAR stands for Identification, Situation, Background, Agreed plan and Recommendations (Ramasubbu, Stewart and Spiritoso 2017). This documentation is actually a format for the inter/intra-professional communication between the healthcare professionals. The format ensures the exchange of knowledge between the healthcare professionals about the patient. The documentation is a part of legislation or the organisational policy that records the communication approach. The patient specific data that is shared between the healthcare professionals via ISBAR documentation contains all the necessary information about the patient, enabling the hand over staff to minimise the error in their practice and promote the quality care (Ramasubbu, Stewart and Spiritoso 2017).

Critical Reflection on the Potential Communication Barrier that might affect the Quality and Safety in Healthcare:

There are many communication barriers that might play important roles in compromising safety and quality care in the field of healthcare. The first potential barrier can be considered as the language barrier. The language barrier is an important barrier that affects every type of communication that is conducted in the field of healthcare. This barrier prevents the important exchange of information between the healthcare professionals themselves along with their patients. The ineffective exchange of vital information on the patient increases the risk of error in healthcare practice and decreased patient safety and quality care as a result (De Moissac and Bowen 2019). This is why all the healthcare facilities should possess some infrastructure or arrange some ways to nullify this barrier.

The next potential barrier can be a cultural barrier. The barrier is mainly applicable for the therapeutic communication between the patient and the healthcare professionals. The cultural beliefs and values widely vary from one culture to another. The healthcare professionals, who lack sufficient cultural competency skills often make a mistake of offending some specific cultural beliefs or values during the care procedure or therapeutic communication (Vidaeff, Kerrigan and Monga 2015). This event compromises the patient satisfaction reducing the quality care. Thus, it is important for the healthcare professionals to develop skills for cultural competency.

The third potential barrier can be a psychological barrier. This barrier covers a wide range of area and applies to every type of communication in healthcare. The therapeutic relationship becomes impaired if the patient does not feel comfortable to communicate with the healthcare staff. The emotional exhaustion or burn out among the healthcare staff might also affect the efficacy of both therapeutic communication and the inter/intra-professional communication (Norouzinia et al. 2016). The ineffective communication results in an ineffective exchange of vital information on the patient. Thus for ensuring the patient safety and quality care, this barrier should also be addressed.

Health literacy is another potential communication barrier that can be discussed in the context of compromised healthcare quality and patient safety. The lack of sufficient health literacy among the patient affects the therapeutic communication between the patients and the healthcare staff (Allenbaugh et al. 2019). To overcome this barrier, the healthcare staff must estimate the level of health literacy in their patients to ensure the level of efficacy of the communication.

References:

Allenbaugh, J., Spagnoletti, C.L., Rack, L., Rubio, D. and Corbelli, J., 2019. Health Literacy and Clear Bedside Communication: A Curricular Intervention for Internal Medicine Physicians and Medicine Nurses. MedEdPORTAL: the journal of teaching and learning resources, 15.

Arnold, E.C. and Boggs, K.U., 2019. Interpersonal Relationships E-Book: Professional Communication Skills for Nurses. Elsevier Health Sciences.

Chichirez, C.M. and Purc?rea, V.L., 2018. Interpersonal communication in healthcare. Journal of medicine and life, 11(2), p.119.

De Moissac, D. and Bowen, S., 2019. Impact of language barriers on quality of care and patient safety for official language minority francophones in Canada. Journal of Patient Experience, 6(1), pp.24-32.

Kornhaber, R., Walsh, K., Duff, J. and Walker, K., 2016. Enhancing adult therapeutic interpersonal relationships in the acute health care setting: An integrative review. Journal of multidisciplinary healthcare, 9, p.537.

Newell, S. and Jordan, Z., 2015. The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol. JBI database of systematic reviews and implementation reports, 13(1), pp.76-87.

Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M. and Samami, E., 2016. Communication barriers perceived by nurses and patients. Global journal of health science, 8(6), p.65.

Ogden, K., Barr, J. and Greenfield, D., 2017. Determining requirements for patient-centred care: a participatory concept mapping study. BMC health services research, 17(1), p.780.

Raeisi, A., Rarani, M.A. and Soltani, F., 2019. Challenges of patient handover process in healthcare services: A systematic review. Journal of Education and Health Promotion, 8.

Ramasubbu, B., Stewart, E. and Spiritoso, R., 2017. Introduction of the identification, situation, background, assessment, recommendations tool to improve the quality of information transfer during medical handover in intensive care. Journal of the intensive care society, 18(1), pp.17-23.

Redley, B., Botti, M., Wood, B. and Bucknall, T., 2017. Interprofessional communication supporting clinical handover in emergency departments: An observation study. Australasian Emergency Nursing Journal, 20(3), pp.122-130.

Vidaeff, A.C., Kerrigan, A.J. and Monga, M., 2015. Cross-cultural barriers to health care. Southern medical journal, 108(1), pp.1-4.

Vogel, D., Meyer, M. and Harendza, S., 2018. Verbal and non-verbal communication skills including empathy during history taking of undergraduate medical students. BMC medical education, 18(1), p.157.

Watson, B.M., Jones, L. and Cretchley, J., 2014. Time as a key topic in health professionals’ perceptions of clinical handovers. Global qualitative nursing research, 1, p.2333393614550162.