Question

1. Provide an example of when you had a communication problem; what happened as a result of the communication problem? (Must be a scenario)

2. What can be learned from the situation and be applied to your own interdisciplinary team nursing communication in the future?

Answer 1

Scenarion1. Mr. Clerk was posted for a surgery on left arm. The surgeon marked the surgical site and later the patient was shifted to Operating Room. Nurse A who is the perioperative nurse applied the BP cuff on the left arm, covering the marking by the surgeon. This lead to confusion at the time of surgery as the surgeon was not able to see the marking on the uncovered arm at the time of surgery. Later the problem was sorted out after talking with the nurse on duty in the orthopedic department.

Scenario 2. Mrs. Silvia 53 year old, diagnosed with uncontrolled diabetes mellitus. Nurse is providing her pre discharge education. Nurse educated her about the dietary restrictions, self administration of insulin, storage of insulin, self monitoring of blood glucose level and exercise. But forgot to mention about various sites of insulin administration and importance of rotation of site. Later after 6 months, Mrs. Silvia came for a visit complaining that even after regular injection with insulin, her glucometer shows increased blood sugar levels and she has also developed a  slight swelling over her left thighs where she usually injects insulin.

Both the scenarios shows errors due to miscommunication. In the first scenario as a reslt of improper communication regarding the site of surgery the patient must have probably got the wrong arm operated. In scenario two missing aspects in the health education during nurse patient communication has led to lipo hypertrophy and poor blood sugar control.

2. Both the scenarios suggests that communication must be clear, adequate and without any missing details.

• Patient records serves as a legal document as well as a non verbal form of communication. Along with verbal handing over and taking over a nurse must go through the minute details in the patient 's record too. This help to avoid the errors occurring due to missed details in oral communication as forgetfulness is human nature.
• Handing over along with patient's record and clearing the doubts at the time of hand over also helps to reduce confusions.
• Before providing patient teaching, the nurse must develop a teaching plan and cross check or take help from colleagues if needed, to identify whether all the necessary information are been incorporated.
• After the health teaching patient must be allowed to communicate his/her doubts and nurse must provide clarification in a simple and understandable manner.
• A proper nurse-nurse, nurse-physician and nurse-patient communication can prevent majority of the adverse events.
• In short, clarifying interdisciplinary patient related orders before implementing, collaborative with the health team, reaching out for help at times of need, proper communication with patient and family as well as evidence based practice guidelines are some factors that can prevent communication errors and improves patient safety.