1. Improving Patient Safety in Long- Term Care Facilities: Communicating Change in a Resident’s Condition Student Version

2. A Safe Environment Effectively communicating change in a resident’s condition is critical to patient safety. 2

3. Case Study #1 3

4. Ms. Malone 4

5. 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. 5

6. Key Principles of Effective Communication Teamwork Open reporting Reporting unwanted events Giving and receiving information 6

7. Teamwork Report change across the care team. Work together to identify what the change may mean. Take action as a team. 7

8. 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. 8

9. 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. 9

10. Barriers to Communication Gender Age/generation Language Culture Status Interpersonal issues System barriers 10

11. Case Study #2 11

12. Case Study #2 Mrs. Brown 12

13. Case #2 Min-Wa and Susan 13

14. Case Study #2 Observations 14

15. What Should Be Communicated? 15

16. How Should Information Be Communicated? Reporting and communication tools: ► Early Warning Tool ► SBAR ► CUS 16

17. Stop and Watch Early Warning Tool 17

18. SBAR Tool 18 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 http://interact2.net/docs/INTERACT%20Version%203.0%20Tools/Communication%20Tools/ Communication%20Within%20the%20Nursing%20Home/INTERACT%20SBAR%20Form% 20v8%20Jan%2014%202013.pdf

19. Case Study #3 19

20. Case Study #3 Mr. Harris 20

21. Case #3 Observations, Day 4 21

22. Case Study #4 22

23. Case Study #4 Change-of-Shift Meeting (Min-Wa) 23

24. 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. 24

25. 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. 25

26. Case Study #5 26

27. Case Study #5: Mrs. Carver February 2012 – March 2014 27

28. Case Study #5: Mrs. Carver April 1, 2014 28

29. Case Study #5: Mrs. Carver April 2, 2014 29

30. 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. 30