Communication Process and Patient Safety: Structured Study Notes for Psychology and Nursing Students

Communication Process and Patient Safety

Introduction to Communication in Healthcare

Communication is a foundational skill for nurses and healthcare professionals, essential for building therapeutic relationships and ensuring patient safety. Effective communication fosters trust, understanding, and collaboration among patients, families, and interprofessional teams.

• Therapeutic Communication: Intentional use of communication to create a healing environment between nurse and patient.

• Relational Practice: Understanding patient needs within complex contexts, vital for family-centered care.

Communication and Interpersonal Relationships

Relational Communication

Interpersonal relationships in healthcare are established through communication, which is the means to provide help and healing.

• Initiative: Taking the first step to engage with patients.

• Authenticity: Being genuine in interactions.

• Mutuality: Building a two-way relationship.

• Questioning Beyond the Surface: Seeking deeper understanding of patient needs.

Specific Relational Capacities

• Collaboration

• Commitment

• Compassion

• Competence

• Leadership

• Orienting

• Scrutinizing

Developing Communication Skills

Key Components

Developing effective communication skills requires self-awareness and ongoing reflection.

• Perception: How information is interpreted by individuals.

• Perceptual Biases: Personal biases that affect understanding.

• Communication and the Nursing Process: Integrating communication into assessment, planning, implementation, and evaluation.

• Contextual Knowledge: Understanding the context in which communication occurs.

• Reflexivity: Reflecting on one's own communication style and effectiveness.

Levels of Communication

Communication occurs at multiple levels, each with distinct characteristics and applications in healthcare.

Level	Description
Intrapersonal	Occurs within an individual (self-talk or inner thought)
Interpersonal	One-to-one interaction between two people
Transpersonal	Interaction within a person's spiritual domain
Small-group	Interactions with a small number of people
Public	Interaction with an audience

Basic Elements of the Communication Process

The communication process involves several key elements that facilitate the exchange of information.

Element	Description
Referent	Motivates one to communicate with another
Sender and receiver	One who encodes and one who decodes the message
Message	Content of the communication
Channels	Means of conveying and receiving messages
Feedback	Message the receiver returns
Interpersonal variable	Factors that influence communication
Environment	The setting for sender-receiver interactions

Forms of Communication

Verbal Communication

• Vocabulary: Choice of words used in communication.

• Denotative and Connotative Meaning: Literal and implied meanings of words.

• Pacing: Speed and rhythm of speech.

• Intonation: Tone of voice.

• Clarity and Brevity: Clear and concise expression.

• Timing and Relevance: Appropriateness of message timing.

Nonverbal Communication

• Personal appearance

• Posture and gait

• Facial expressions

• Eye contact

• Gestures

• Sounds

• Personal space

Other Forms of Communication

• Symbolic Communication: Use of symbols (verbal and nonverbal) to convey meaning.

• Metacommunication: All factors that influence how a message is perceived.

Personal Space and Zones of Touch

Understanding personal space and appropriate touch is crucial in healthcare settings.

Zone of Personal Space	Examples
Intimate (0-45 cm)	Holding a crying infant, bathing, changing a patient
Personal (45 cm-1 m)	Sitting at bedside, teaching a patient
Social (1-4 m)	Participating in rounds, teaching a class
Public (4 m and greater)	Speaking at a forum, lecturing

Zone of Touch	Examples
Social Zone	Hands, arms, shoulders, back
Consent Zone	Mouth, wrists, feet
Vulnerable Zone	Face, neck, front of body
Intimate Zone	Genitals, rectum

Elements of Professional Communication

Professional communication in healthcare is characterized by several key elements that promote trust and safety.

• Courtesy: Polite and respectful interaction.

• Use of Names: Addressing individuals appropriately.

• Trustworthiness: Reliability and honesty in communication.

• Autonomy and Responsibility: Accountability for one's actions and decisions.

• Assertiveness: Expressing oneself confidently and respectfully.

Phases of Communication

The nurse-patient relationship progresses through distinct phases, each with specific tasks and goals.

Phase	Description
Pre-interaction	Preparation before meeting the patient (reviewing history, planning interaction)
Orientation	Establishing rapport, clarifying roles, identifying patient needs
Working	Collaborative problem-solving, supporting patient goals
Termination	Ending the relationship, summarizing progress, ensuring continuity of care

Therapeutic Communication Techniques

Therapeutic communication techniques are used to promote patient safety and well-being.

• Active Listening: Fully concentrating, understanding, and responding to the patient.

• Sharing Observations: Noticing and verbalizing observations about patient behavior.

• Sharing Empathy: Understanding and sharing the feelings of another.

• Sharing Hope: Encouraging optimism and positive outlook.

• Sharing Humour: Using appropriate humor to build rapport.

• Sharing Feelings: Expressing emotions appropriately.

• Using Touch: Providing comfort through physical contact when appropriate.

• Using Silence: Allowing time for reflection and response.

• Providing Information: Giving clear and relevant information to patients.

• Clarifying: Ensuring understanding of messages.

• Focusing: Directing conversation to important topics.

• Paraphrasing: Restating the patient's message in your own words.

• Asking Relevant Questions: Gathering necessary information.

• Summarizing: Reviewing key points of the conversation.

• Self-disclosure: Sharing personal experiences when appropriate.

• Confrontation: Addressing discrepancies in communication.

Nontherapeutic Communication Techniques

Nontherapeutic techniques can hinder effective communication and should be avoided in professional practice.

• Asking personal questions

• Giving personal opinions

• Changing the subject

• Automatic responses

• False reassurance

• Sympathy

• Asking for explanations

• Approval or disapproval

• Defensive responses

• Passive or aggressive responses

• Arguing

Adapting Communication Techniques for Patients with Special Needs

Effective communication must be adapted for patients with unique challenges, such as speech, cognitive, sensory, or language barriers.

Patient Group	Key Strategies
Cannot Speak Clearly	Listen attentively, use yes/no questions, allow time, use visual aids
Cognitively Impaired	Use simple sentences, ask one question at a time, allow time for response
Hearing Impaired	Face the patient, speak clearly, use sign language or written communication
Visually Impaired	Identify yourself, explain when leaving, use normal tone, orient patient to environment
Unresponsive	Call patient by name, communicate verbally and by touch, explain procedures
Do Not Speak English	Use professional interpreters, provide written materials in preferred language

Summary

Effective communication is central to safe, patient-centered care. Understanding the process, forms, and techniques of communication, as well as adapting to patient needs, is essential for healthcare professionals.

Additional info: These notes expand on the psychological principles of communication, including perception, bias, and relational practice, which are relevant to both psychology and nursing students studying therapeutic relationships and patient safety.