1. The health care worker should understand that there are many factors in communication. A knowledge of the techniques of communication will increase your skills in communicating with co-workers and patients/clients. With this knowledge, you will be able to do a better job and to make good observations about your patients.
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2. Communication can be Verbal communication: Nonverbal communication:
Spoken
Written
Nonverbal communication:
Eye contact
Facial expression
Gestures
Touch
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3. To communicate effectively, you need to work through a process that includes:
Engagement
Connection between the health care professional and the patient that sets the stage for establishing partnership
Understanding
Makes patients feel accepted
Education
Help increase knowledge and understanding and minimize anxiety
Creating a sense of partnership
Good communication, work with patient regarding problem and the treatment plan
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4. Use active listening skills. Use a positive tone.
Watch your body language.
Treat patients and co-workers with respect.
Be precise and detailed about what you expect.
Model the behavior you want others to follow.
Explain your reasoning.
Discuss any conflicts in a calm and rational way.
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5. Prejudice Frustrations Attitudes Life Experiences
Affects how you feel about other people and how you relate to them
Frustrations
Impatience, annoyance, anger
Interferes with your ability to communicate
Attitudes
If you are disinterested or in a bad mood, communication breaks down.
Life Experiences
Helps us know what to expect in day-to-day living and how to act in certain situations
Most effective communication is based on shared experiences
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6. Labeling Sensory impairment Talking too fast Cognitive impairment
Describing a person with a word that limits them
Sensory impairment
Deafness or blindness can be a communication barrier
Talking too fast
Speak slowly, communication can breakdown when the message is delivery to rapidly
Cognitive impairment
Memory, perception problem solving, emotional reaction, and idea formulation
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7. The message must be clear.
The sender must deliver the message in a clear and concise manner.
The receiver must be able to hear and receive the message.
The receiver must be able to understand the message.
Interruptions or distractions must be avoided.
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8. Maintain a positive attitude
Show interest
Hear the message
Do not interrupt
Pay attention
Maintain a positive attitude
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9. Unassertive/passive Assertive Aggressive
allows others to control the conversation
Assertive
does not take power or authority away from others
Empowers individuals to speak up and be heard
Aggressive
occurs when power is taken away from others and communication breaks down
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10. Look for all visible signs of a problem
Sight
Smell
Hearing
Taste
Touch
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11. Subjective Observation Objective Observation
You can’t see pain.
You see it.
You hear it.
You can’t hear pain.
You feel it.
You can’t feel the pain experienced by others.
You smell it.
You can’t smell pain.
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12. SOAP Note Medical professionals record their notes in this format:
Subjective - ex. what the patient complains of
Objective - ex. specific observations of the health care worker, like coloration, temperature, heart/lung sounds, etc.
Assessment - What the health care worker concludes (diagnosis)
Plan - How they are going to treat the problem (course of action - medicine, surgery, patient education, diet, etc) 12

13. Case Study #1
Cassie is an 8 year old female who complained of pain in her ear. Her mother said she was cranky and irritable, and had not slept well. Her temperature measured F. The doctor observed redness and swelling of the inner ear. He concluded that Cassie has a bacterial infection in her inner ear and prescribed a course of antibiotics, plenty of fluids, and rest. 13

14. Case Study #2
Halle is a 28 year old female who complained of frequent urination and constant thirst. Her weight was 125 lbs. (her normal weight was previously recorded as 138 lbs.), and the lab reports her fasting glucose (FPG) was 159 (normal level <100). The doctor diagnosed her with Type II diabetes and prescribed insulin treatment. She was also given information resources on diabetes. 14

15. Case Study #3
Wendell is a 57 year old man who complains of headaches, dizziness, and shortness of breath. He weighs 275 lbs. with a blood pressure of 180 over The doctor diagnoses hypertension (high blood pressure) and prescribes Verapamil. He also provides education on proper diet (including lowering sodium intake) and exercise. Follow up in 3 months. 15

16. Communication between health care providers is vital to patient care
Communication between health care providers is vital to patient care. Today’s technology has helped to improve the efficiency and the speed at which a message or file can be sent to another person. A worker in the health care environment needs to know how to use common software programs in order to access and record important patient information. In addition, workers need to be well-trained to work with phones, fax machines, , and the Internet in order to complete daily tasks.
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17. Answer the phone by the third ring. Smile when you answer the phone.
Identify your department or office.
Identify yourself, and give your title.
Speak clearly.
Be courteous.
Be confident.
Be patient.
Thank caller for returning the call.
Get as much information as possible.
Ask for assistance if needed.
Give the caller other options before placing him or her on hold.
Always read the message back to the caller.
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18. Always include:
The caller’s name (ask for correct spelling if necessary)
The caller’s phone number and area code
The date and time
All of the information that the caller gives (read the message back for accuracy)
Allow the caller to hang up first
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19. Sends and receives printed pages of images over telephone lines
When sending a fax:
Use a cover page
Name
Contact number
Number of pages
Name of recipient
Confirm that the intended recipient received the fax
If confidential, call ahead to let the recipient be ready
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20. Begin with a salutation.
Include short, simple, and straight-forward information.
Read your aloud to check the tone of your message.
Proof the content for spelling and grammar mistakes.
Insert a subject into the subject line of the .
Use features such as blind carbon copy and carbon copy, when appropriate.
Carbon copy (Cc) is used to send a copy of your to another recipient.
Blind carbon copy (Bcc) is used when an is sent to multiple people. Blind carbon copy allows a recipient to read the message, but they cannot see the other addresses to which the message was sent.
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21. Respond to e-mails within 24 hours.
Answer all questions when responding to an .
Allow one or two days for a response.
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22. When sending a memo via e-mail:
Used as reminders to:
Persuade an action
Issue a directive
Provide a report
When sending a memo via
Confirm the memo looks as intended in print as well as on screen
Use fonts/graphics that are common to all recipients’ computers
Ensure attachments are readable by all recipients
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23. Worldwide computer network that provides information on many subjects
Usernames are names used to gain access to a computer system
Domain name is used as an Internet address to indentify the location of a particular Web page
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24. Charting and Observation24

25. Observation and documentation of your observations are key components of health care. Your ability to observe patient/client behavior and symptoms will directly affect their care. Accurate documentation provides information needed to make decisions about their care. It is important that you develop sharp observation, reporting, and documentation skills.
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26. Match key terms with their correct meanings.
Explain the difference between subjective and objective observations.
Explain which type of reporting allows immediate feedback and action.
List information that must be on all health records.
Apply five general charting guidelines.
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27. Record of the patients’ progress throughout treatment
Many people may be responsible for documenting information on a single patient
Provides information needed to allow each health care provider to give the care that best benefits the patient
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28. All medical records must contain:
Client’s name
Client’s address
Diagnosis
Client’s age
Identification number
Physician’s orders
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29. Notations should contain specific information about the patient:
Care or treatment given
Time of treatment
How the patient tolerated the care or treatment
Any observations that would be helpful to other health care workers
Information that the patient has given that would affect treatment
Documentation is admissible in a court of law
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30. Use ink for record keeping
Use ink for record keeping. In some facilities, different colors are used for different shifts.
Entries must be legible. If your writing is difficult to read, you should print.
If you make an error, do not erase it or scratch it out or cover it up. Draw a single line through the error, so that it can still be read. Write “error” next to it, and then place your initials next to the correction.
Entries should be in short phrases. You do not need to write complete sentences. You do not need to use the patient’s name because you are writing in the patient’s chart. Your entries should be concise, clear, and meaningful.
All entries that you make are followed by your signature. You sign with your first initial, your last name, and your title.
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31. May be in narrative or check-off form:
What personal care was given
What activities the client participated in
The patient’s skin condition
General observations about the client
Any unusual occurrences
Any complaints expressed by the client
What treatments were given
Any information that is important to the patient’s well- being
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32. Signature (first initial, full last name) and certification
Date
Military time
A description of the care or treatment given, complaints and problems, all written as ordinary sentences
Signature (first initial, full last name) and certification
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33. Record of the patient’s vital signs
Useful because it contains like measurements over time
Time blocks and numbers that relate to temperature, pulse and respiration
Also include a:
Front sheet with personal information
Physical examination and medical history
Daily progress report written by physician
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