Nur1010- Competency 4: "ISBARR: Effective Communication", "Critical Thinking", "Communication"

What is the ISBARR and what is it used for?

ISBARR is a communication tool that helps healthcare professionals convey information to their patients

- used during "handoffs" between EMTS & Nurses

- essentially "streamline thinking", where one person is talking & the other is listening.

What is streamline thinking?

simplifying your thought process to focus only on what's important and necessary.

What does "I" stand for?

Identify

What are some questions to ask when you want to "identify" yourself or a patient?

"Who are you?"

"Where are you?"

"Is this for you or someone else?"

"Name, age, gender, and location"

What does "S" stand for?

Situation

What are some statements to state a "situation"?

"I'm calling because....(describe)"

"I have observed , major changes..."

"I have measured the following values..."

"I have received results..."

What does B stand for?

Background

What are ways to state a "background" on a patient?

Brief and relevant case history

Admission diagnosis and date

Previous illnesses of significance

Relevant problems and treatment/interventions to date

Allergies

What does the "A" stand for?

Assessment

What are some situations pertaining to an "assessment"?

"I think the problem is related to..."

"I don't know what the problem is but a change in..."

"We need to do something..."

"I am concerned about..."

What does the "R" stand for?

Recommendations

What could you consider to give a "recommendation"?

Request specific advice and interventions

"I suggest..."

"How often should I..."

"When should I next make contact?"

"When will you be here?"

What does the second "R" stand for?

Read-back

What are 3 things you should do to practice "read-back"?

-Clarify expectations

-Have pen in hand to write-down what is discussed

-Restate and clarify when to call back

-Confirm messages and interventions with a closed loop

What's an example scenario of "ISBARR"?

I - "Hi, I'm Joe, an intern in the ED at PGCC hospital."

S - "I would like to refer a 66 year old man who presents with pneumonia."

B - " He has been on oral antibiotics for 1 week with no improvement. He is stable and we have commenced IV antibiotics."

A - "His presentation of pneumonia is classic"

R - "Are you able to see him prior to admission?"

What is critical thinking involve?

A) Searching, plotting, making associations, and analyzing information

B) Thinking about something from different angles

C) Making informed, educated, and open-minded decisions

D) Justifying and scrutinizing ideas before forming conclusions

E) All of the above

E) All of the above

What are the 4 parts to using critical thinking?

Goal Setting

Decision Making

Problem Solving

Planning Strategies

What are the parts of the critical thinking process?

-Take in Information

-Ask questions about information

-Draw conclusions based on questions asked

-Use what you learn

-Evaluate your results

How can you develop critical thinking?

Restrain emotions

look at things differently

Analyze questions

Ask questions

Solving problems

Distinguish Fact from fiction

Seek truth in argument/persuasion

What does it mean to "restrain emotions"?

Identify personal biases

What does it mean to "look at things differently"?

Perspectives, open-minded

How do you "analyze questions"?

Clarify facts, what is being asked

Why do we need to "ask questions"?

Curiosity, increase knowledge

How can you "solve problems"?

Identify actual problem, more than one possible solution (brainstorming), identify expected outcome

What does it mean to distinguish fact from fiction?

Can be objectively proven/verified

Assumptions; Reliance on Authority

What does it mean to seek truth in an argument?

Reliance on Authority, develop objective and logical arguments

What are some characteristics/attitudes for critical thinking?

(Do not have to remember all of these)

Confidence

Independent thinking

Fairness

Responsibility & Authority

Discipline

Perseverance

Creativity

Curiosity

Integrity

Humility

What are the two aspects of critical thinking?

-Reflection

-Intuition

What is intuition?

The direct understanding of particulars in a situation without conscious deliberation. It's an inner sense that something is so

What are 6 ways you can implement critical thinking?

-Anticipate questions others might ask

-Anticipate what's next

-Look for ways to improve

-Ask someone else - get a second opinion

-Replace "I don't know" with "Let's find out"

-Turn Errors into learning opportunities

What are the barriers to critical thinking?

◦Personal Beliefs

◦Resistance to Change

◦Wishful Thinking/Avoidance

◦Ethnocentricity (stereotyping)

◦Reliance on Authority

How can creativity play a role in critical thinking?

A) By creating something new out of existing resources

B) By using imagination and innovation

C) By being associated with critical thinking to develop new ideas and solutions

D) All of the above

D) All of the above

What are some qualities of a creative and critical thinker?

Compassion

Courage

Truth

Dreams

Risk Taking

Innovation

What are some ways you can problem solve?

-Identify the problem accurately

-Analyze the problem

-Brainstorm possible solutions

-Explore each solution

-Choose/implement: most positive effect

-Evaluate/refine solution

What is communication?

A simple act of transferring information from one place to another.

What is the difference between verbal and non-verbal communication?

Verbal communication uses words to share messages, while non-verbal communication uses body language, facial expressions, and tone to convey meaning without words.

What are examples of verbal communication?

-Consists of speaking, listening, writing and reading

-Face-to-face, group discussions (counselling, interviews, etc)

-Exchange of information between 2 or more individuals

What are examples of non-verbal communication?

-No spoken or written word

-Wordless message

-Gestures, facial expressions, eye contact and touching

-Also includes pitch, speed, tone and volume of voice, dress and appearance, etc

What are some advantages of verbal communication?

-Personal and informal

-Immediate impact

-Opportunity for interaction and feedback

-Very fast and non-expensive

-Foster better relationships

-Inform, inquire, argue and discuss topic of all kinds

What are some disadvantages of verbal communcation?

-Words once spoken can't be taken back

-Forgotten easily

-No legal evidence of oral communication

What are some advantages of non-verbal communication?

-Hard of hearing or deaf

-Helps communicate in silent zones

-Help us to communicate with a distant person

-Bridge language barrier

-Culturally determined

-Captures feelings and emotions

What are some disadvantages of non-verbal communication?

-Cannot be used as a public tool of communication

-Cannot create an impression upon people/listeners

-Misperception of body language or gestures