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Chapter 2 The Patient-Safe Transformational Model of Communication

Chapter 2 The Patient-Safe Transformational Model of Communication. A framework for communicating with high-level competence. High-Level Communication Competence. Demonstrate communication behaviors that are effective and appropriate to the situation

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Chapter 2 The Patient-Safe Transformational Model of Communication

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  1. Chapter 2The Patient-Safe Transformational Model of Communication A framework for communicating with high-level competence

  2. High-Level Communication Competence • Demonstrate communication behaviors that are effective and appropriate to the situation • Demonstrate sensitivity to the perspectives of others • Demonstrate achieving communication goals in a manner that maintains or enhances relationships

  3. Communication as Defined in the Transformational Model • A goal-oriented interaction between two or more people • Where verbal and nonverbal behavior is exchanged simultaneously to: • Create common meaning • Create desired effects • Achieve specific outcomes • Attain transformation

  4. Transformational Model

  5. Element 1:Communicators • Communication is goal-oriented because • Two or more people communicate to meet human needs: • Physical • Social • Identity • Practical

  6. Element 2:Critical Thought Processing • Assess situational risk factors and context • Determine human needs • Determine desired outcomes • Select patient-safe communication strategies • Create the message using effective, appropriate, sensitive, and respectful verbal and nonverbal behaviors • Choose the best channel for conveying the message • Evaluate the effects of the message • Create common meaning

  7. Element 3:Message • Composed of words • Verbal or spoken • Written • Electronic • Composed of nonverbal behaviors • Gestures • Facial expressions • Tone of voice Note: Words or nonverbal behaviors themselves do not have meaning; meaning resides in the people who express and interpret them.

  8. Element 4:Channel • Method or pathway by which messages are communicated • Face to face • Telephone • Mass media • Television • Newspapers • Written • Physician order sheets • Nursing progress notes • Computer-medicated communication • Electronic • E-mail • Instant messaging

  9. Element 5:Assign Meaning • Individuals interpret messages based on meaning they have assigned to verbal and nonverbal behavior • Meaning assigned dependent on: • Communicator bio-psycho-social-cultural perspectives • Situational context • Content of message • Communicator risk factors • Physical and cognitive ability to: • Speak • Listen • Interpret

  10. Element 6:Effects of Message • All messages create effects • Effects are a means to an end (outcome) • Effects are conveyed through feedback • Effects may be intentional or unintentional, such as: • Excitement • Happiness • Anxiety • Disinterest Note: Carefully assess the effects of messages by looking for feedback

  11. Element 7:Feedback • The response to a message is: • Verbal • Nonverbal • Feedback conveys : • Thoughts on the content of the message • Feelings associated with the message • Feedback may be used to: • Clarify the interpretation of the message • Validate the meaning of the message • Correct misinterpretations

  12. Element 8:Validation • Validation is the negotiation between communicators to create common meaning • Communicators must negotiate agreed-upon meaning of messages using verbal and nonverbal behaviors to: • Mutually determine whether messages are understood • Verify and clarify the meaning of verbal and nonverbal messages Note: Validate both verbal and nonverbal messages to prevent making interpretation errors

  13. Element 9:Context • Tangible and intangible environment • Physical • Nurses work environment • Temporal • Timing of communication • Gender • Differences in styles of communication • Biological • Physical functioning • Cultural • Norms, traditions, customs • Psychological • Emotion, mood, personality • Social • Rules relative to status and interpersonal relationships • Spiritual • Meaning and purpose of life; includes religion • Professional • Rules relative to professional relationships Note: During any communication, several contexts interact at the same time

  14. Element 10:Communication Risk Factors • Risk factors potentially distort messages • Physical Risk Factors • External environment distractions • Background noise • Unfamiliar physical surroundings • Psychological Risk Factors • Emotional state of communicators • Physiological Risk Factors • Biological illness • Fatigue • Cognitive impairment • Semantic Risk Factors • Language or literacy issues • Illegible handwriting • Abbreviations

  15. Element 11:Patient-Safe Strategies • Specific patient-safe communication techniques used to overcome communication risk factors • Examples: • Touch • Humor • Empathy • Perception checking • Readback-Hearback • Patient handoff • SBAR

  16. Element 12:Transformation • Communication processes lead to changes within individuals that are transformational • Transformation is the outcome of the communication process • Based on the outcomes of communication, people grow and evolve, and transform: • Biologically • Psychologically • Socially • Culturally • Spiritually

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