Nurse’s Touch Professional Communication...Aspects that affect the development and maintenance of...

EDUCATORIMPLEMENTATION

GUIDE

Nurse’s Touch™

Professional Communication

Nurse’s Touch™

Educator Implementation Guide

Professional Communication

© 2012 Assessment Technologies Institute®, LLC

Nurse’s TouCh™: ProfessIoNAL CommuNICATIoN

© 2012 Assessment Technologies Institute®, LLC III

Table of Contents

Description .................................................................................................. 1

Features ...................................................................................................... 1

Benefits ....................................................................................................... 4

Recommended Use ..................................................................................... 6

Implementation Strategies ......................................................................... 6

Examples of Student Learning Activities .................................................... 7

Recommended Time Spent ........................................................................ 8

Product Support .......................................................................................... 9

Technical Requirements ............................................................................ 10

Details of Professional Communication .................................................... 11

The Communicator: Communication Simulator ....................................... 13

The Communicator: Technique Identifier ................................................. 23

References ................................................................................................ 28


© 2012 Assessment Technologies Institute®, LLC 1

Description

Nurse’s Touch is a suite of tutorials and interactive simulation products that will enhance students’ knowledge, skills, and attitudes in regard to the professional skills of communication, leadership, professionalism, informatics/technology, and wellness/self-care. The suite consists of four tutorials and two interactive simulation products. The four tutorials offer media-rich content that includes videos and video case studies. Access to a practice assessment and a standardized proctored assessment is provided with each tutorial. The two interactive simulation products deliver engaging client-related videos, examples of communication techniques, and charge nurse-related scenarios that demonstrate application of leadership concepts and decision-making. An educator package that includes an Educator Implementation Guide and a set of tutorial-related case studies and videos will also accompany each tutorial.

This Educator Implementation Guide will address the Professional Communication tutorial and The Communicator simulation products.

Features ● Instructional content is presented for each topic in an interactive, media-rich

manner.

● Videos that illustrate the content being presented are integrated throughout each module.

● Case studies at the end of each module apply the content to a client situation.

◯ Five to 10 test items follow each case study to test application-level knowledge.

● Ten-item tests with rationales accompany each module – score report available.

● One 50-item practice assessment and one 60-item standardized proctored assessment provide summative evaluation of content.

◯ Practice and proctored assessments follow NCLEX® format with alternate items.



◯ Outcomes will be provided for:

■ QSEN competencies

■ Priority setting

■ Thinking skills

■ NCLEX client need categories

■ Nursing process

■ Body function

● User-friendly navigation.

● Audio narration guides students through each module – closed caption option available with a click of the mouse.

● Educator Package

◯ Educator Implementation Guide

◯ Two sets of case studies – those presented in tutorial and new set for classroom use

◯ Set of videos used in each tutorial

● The Communicator (case overview, character backgrounds, questions with answers, and rationales at end of document)

◯ Communication Simulator

■ Five in-depth video case studies

� Case Study 1 – Inpatient: Student Nurse’s First Encounter with a Difficult Client

� Case Study 2 – Assisted Living Facility: The Geriatric Client with Visual Impairment and Cultural Considerations

� Case Study 3 – Same-Day Surgery: Client with Anxious Significant Other



� Case Study 4 – Emergency Department: Teamwork and Ensuring Client Safety

� Case Study 5 – Inpatient: The Dying Client and Her Family

■ Case Overview is provided for each case study.

■ Character Background (e.g., age, role, perspective) is provided for each person in the case study.

■ Each case study unfolds into several stages of video scenarios.

■ Each video scenario presents a 30-second to 1-min communication-related scene that involves multiple characters (e.g., student nurse, client, significant other, nurse, physician).

■ Student selects with whom to communicate at each stage.

■ Student must communicate with all individuals before moving to next video case study.

■ Communication options provide student the ability to select appropriate verbal and nonverbal responses for the individual selected.

■ Video of response by individual selected is provided after selection of option.

■ Text-based rationale for selected option is also provided.

■ Score report at conclusion of simulation provides date/time of interactions with product, percent correct in relation to first selected option for each item, and time spent in product.

■ Educator Package

� Educator Implementation Guide

� Case, stage, and character overviews

◯ Technique Identifier

■ Ten video case studies.



■ Each case study presents a 2- to 3-min scene that illustrates both therapeutic and non-therapeutic communication techniques.

� Students are provided a list of verbal and nonverbal exchanges.

� Students must identify if each one is therapeutic or non-therapeutic.

■ Score report at conclusion of simulation provides date/time of interactions with product, percent correct, and time spent in product.

■ Educator Package

� Educator Implementation Guide

� Case and character overviews

Benefits ● Promotes student success in nursing education.

◯ Facilitates mastery of professional and interpersonal skills.

◯ Improves student confidence.

◯ Supports student understanding and practice.

◯ Promotes student self-learning.

◯ Provides practice with examples and real-life scenarios.

◯ All students learn to:

■ Communicate using therapeutic verbal and nonverbal communication techniques.

■ Skills needed to establish therapeutic relationships.

■ Appreciate the various factors that can impact effective communication.

■ Use appropriate communication techniques when communicating with clients who have a barrier to effective communication.



■ Communicate with various members of the interprofessional team.

■ Understand the roles and responsibilities of individuals in a working group.

■ Engage in conflict negotiation using conflict resolution skills.

■ Establish interprofessional relationships.

■ Provide client education that is appropriate in relation to age, culture, learning style, readiness to learn, etc.

● Promotes student success in the clinical setting.

◯ Tutorial and simulations may be viewed repeatedly during the curriculum.

◯ Case studies and simulations provide opportunities for application of knowledge and skill practice.

◯ Rationales explain to students why communication viewed is therapeutic or non-therapeutic.

◯ Identified deficiencies can be remediated independently.

● Promotes success in nursing practice.

◯ Interprofessional communication skills will facilitate interdisciplinary relationships and teamwork.

◯ Understanding of organizational communication and conflict negotiation will enhance leadership skills.

● Supports faculty teaching practices.

◯ Learning objectives are provided for each module.

◯ Provides initial learning, in-time learning, and content review and practice.

◯ Assign selected modules as an adjunct to lecture in any course.



Recommended Use ● Lecture aid

● Classroom discussion

● Independent study

● Preparation for standardized exams

● Preparation for clinical

● Clinical post-conference

● Remediation activity

● Preparation for NCLEX

● Preparation for initial position post-graduation

Implementation Strategies ● Use during initial nursing courses to introduct students to communication

skills and the use of therapeutic communication.

● Review videos and case studies in class as a part of interactive discussions.

● Use as a replacement for a traditional process recording.

● Use as a basis for role-playing activities. Have students demonstrate both therapeutic and non-therapeutic communication techniques, and discuss differences between each as a group.

● Have students work in small groups, viewing videos in Technique Identifier and determining if examples are therapeutic or non-therapeutic communication techniques. Can also do as a large group with clickers.

● Discuss the cultural variations of clients in selected case studies, and how those variations impact communication.

● Provide examples of clients with health alterations that affect their ability to communicate, and have students develop a plan of care that addresses their communication needs.



● Role-play various members of the interprofessionial client care team, using assertive communication.

● Identify use of therapeutic and non-therapeutic communication during debriefing of a clinical simulation or clinical experience.

Examples of Student Learning Activities ● Assign students to review selected modules prior to class.

● Have students develop a process recording for one of the case studies.

● Identify strategies for client education that address developmental level, learning style, and learning domain.

● Require students to bring an evidence-based article to class or clinical that addresses how communication supports client safety, interprofessional communication, and quality improvement.

● Have students use therapeutic communication when communicating during simulation in a laboratory setting.

● Have a peer evaluate a student’s use of therapeutic communication during a simulation experience using a rubric.

● Require students to complete the Communication Simulator, selecting the appropriate response for each scenario, and copy score report. Then have students review scenarios again and select inappropriate responses to see how the target individual would respond.

● Have students identify components of organizational communication observed in their clinical setting.

● Have students provide an example of an assertive, aggressive, and passive-aggressive communication technique observed in the clinical setting.

● Have students develop teaching plans for child, adult, and older adult clients just diagnosed with type 1 diabetes mellitus who will require insulin injections.



Recommended Time Spent

Professional Communication Tutorial

Module Time Spent in Module

Time Spent in Case Studies

Time Spent in Test

Types of Communication 1.5 hr 10 min 10 min

Therapeutic/Non-therapeutic Communication

1.5 hr 10 min 10 min

factors that Affect Communication with Individuals and Groups

2 hr 10 min 10 min

organizational Communication

1.5 hr 10 min 10 min

Client education 1.5 hr 10 min 10 min

Communication Simulator

Case Case/Character Overview

Scenario Review Total

1 5 min 5 min 30 min





2.5 hr

*Remediation refers to review of rationales



Technique Identifier

Case Case/Character Overview

Scenario Review

Time Spent on Items (Includes Remediation*)

Total

1 5 min 3 min 12 min 20 min










3.3 hr

*Remediation refers to review of rationales

Product Support ● At ATI, we pride ourselves on timely and effective support to meet

your needs.

● Please contact us at 800-667-7531 if you need assistance with this product.



Technical Requirements ● For optimal testing experience, we recommend a wired network connection.

● Direct links to downloads for starred (*) programs are provided in the bottom right-hand corner of the ATI Student/Faculty Home Page under “Technical Requirements.”

● Silverlight 4 or higher*

● Adobe Acrobat Reader X or higher*

● Acobe Flash Player 11 or higher*

● Windows XP, Vista, or 7

◯ Internet Explorer 7 or higher*

◯ Mozilla Firefox 9 or higher*

● Mac OS X 10.5 (Leopard) or higher

◯ Mozilla Firefox 9 or higher*

◯ Safari 5 or higher*

● Session time-out counter

◯ Your browser must allow status bar updates via script for a session time-out counter to be visible.



Details of Professional Communication

Module 1: Types of Communication

● Introduction ● modes

◯ Verbal ◯ Nonverbal ◯ Written ◯ Computer-mediated

● Components of communication ◯ Communication process

● Components of nonverbal communication ● effective written communication ● Types of computer-mediated communication ● summary

Module 2: Therapeutic/Non-therapeutic Communication

● Introduction ● Therapeutic communication techniques ● Non-therapeutic communication techniques ● Aspects that affect the development and maintenance of therapeutic relationships ● summary

Module 3: Factors that Affect Communication with Individuals and Groups

● Introduction ● Cultural factors ● Age, generation, and developmental stage ● Gender ● Literacy ● Barriers to effective communication ● roles and responsibilities of individual working in a working group ● Types of conflict between individual and groups ● styles of conflict resolution ● Characteristics and outcomes of conflict negotiation ● summary

Module 4: Organizational Communication

● Introduction ● organizational structure ● organizational relationships ● Collaborative relationships ● Types of interpersonal and interprofessional communication ● Ineffective interpersonal and interprofessional communication ● summary



Module 5: Client Education

● Introduction ● role of the nurse ● Assessment of the client/client’s learning needs ● Promoting a positive learning environment ● Cultural variables that affect learning ● Teaching clients of different ages

◯ Pedagogy ◯ Andragogy ◯ Gerogogy

● Learning styles ◯ Visual ◯ Auditory ◯ Tactile

● Learning domains ◯ Cognitive ◯ Affective ◯ Psychomotor

● Teaching individual and groups ● Communication simulator ● evaluation strategies ● readiness to learn ● Barriers to learning ● summary



The Communicator: Communication Simulator

Case 1

Case overview Joe rogers is a construction worker who was doing roofing repair work when he lost his footing and fell from the second story of a building. he has been experiencing headaches and dizziness upon standing. The client does not want a student nurse caring for him. he is also insistent on leaving the hospital as soon as possible.

stage 1 overview student nurse ryan introduces himself to Joe rogers and his wife, Nikki rogers. mr. rogers appears upset at the news of having a student nurse care for him.

stage 2 overview mr. rogers has a dizzy episode and gets frustrated. he talks down to ryan and becomes demanding. mrs. rogers feels that he needs assistance and becomes upset with him toward the end.

stage 3 overview ryan brings a breakfast tray into mr. rogers’ room. mr. rogers is dissatisfied with his meal.

stage 4 overview mr. rogers wants to be discharged from the hospital. mrs. rogers is concerned about mr. rogers’ physical condition. she doesn’t think he’s ready to go home.

stage 5 overview student nurse ryan informs mr. rogers that there are no written discharge orders. mr. and mrs. rogers argue about his expectation to be discharged from the hospital.



Case 1 Character Overview

Character Name Character Age Character Background

Joe rogers 30 Joe is anxious to return home, and worried he could lose his job if he does not return to work soon. he has had minimal health care needs until now. he likes to do things for himself.

Nikki rogers 28 Nikki is the wife of Joe rogers. she is very concerned about his health and safety. she wants him to stay in the hospital as long as necessary for him to heal.

ryan Long 20 ryan is an eager, young student nurse. he faces adversity when mr. rogers makes it very clear that he has no interest in a student caring for him.

Dr. Deane 45 Joe rogers’ doctor.



Case 2

Case overview mr. and mrs. silver are elderly have been residents in the assisted living unit of a nursing facility for 5 years. mrs. silver has moderate dementia. The couple is moving to a higher level of care within the facility, as mrs. silver’s dementia is getting worse.

stage 1 overview Case management nurse Darcy and student nurse Jamie are visiting with mr. and mrs. silver.

stage 2 overview Darcy is meeting with staff regarding the transfer of mr. silver and mrs. silver to the skilled area.

stage 3 overview Nurse Darcy is visiting with the silvers. Nina and mr. silver are concerned about mrs. sliver’s change in behavior.

stage 4 overview mr. and mrs. silver have been living in the skilled facility. They are not receiving the requested foods for meals.

stage 5 overview Darcy is holding a care conference to discuss mrs. silver’s decline in cognitive function and physical strength.





steve silver 78 steve and Iris have been married for 55 years, and he’s protective of his wife. The couple is of Jewish faith and works to keep to a kosher diet. mr. silver’s eyesight has deteriorated.

Iris silver 76 Iris is experiencing a moderate level dementia (Alzheimer’s). she is more often confused and depends on steve.

Darcy Anderson 48 Darcy has been a case manager at the facility for more than 15 years. Prior to this, she was a staff nurse at the facility.

Jamie Kohlgrove 25 Jamie is a student nurse. she is eager to learn.

Nina stein 55 Daughter of steve and Iris silver. she is concerned about this transition.

Johanna Langdon 52 Johanna is a social worker.

Trudy mayer 36 Trudy is a confident and experienced AP.

Tim rath 30 Tim is a dietary aide.



Case 3

Case overview Nurse rose hall and student nurse heather Aspen are assigned to care for Alexa Travis in a preoperative setting. mr. Travis is anxious about his wife’s upcoming surgery.

stage 1 overview mr. and mrs. Travis arrive in the preoperative area for same-day surgery. mr. Travis is asked to step out for a moment as mrs. Travis is prepped. mr. Travis is very uncomfortable leaving his spouse.

stage 2 overview mrs. Travis is prepped and waiting in the pre-op area of same-day surgery. mr. Travis is with her; he is very anxious about her upcoming surgery and is pacing.

stage 3 overview mrs. Travis is still in the pre-op room. Nurse rose talks with mrs. Travis about mr. Travis’ anxiety and its effect on mrs. Travis.

stage 4 overview mr. Travis is in the surgical waiting area. he is very anxious as the surgery is taking longer than anticipated.

stage 5 overview Dr. Kovac delivers unexpected news to mr. and mrs. Travis.





Alexa Travis 26 Alexa is being admitted for an exploratory laparoscopy related to unrelieved abdominal pain. she is calm about having her surgery, but is worried about her husband’s reaction to everything.

mark Travis 28 mark is Alexa’s husband. he is very anxious about his wife’s upcoming surgery.

rose hall 50 rose is an experienced nurse. This type of preparation is routine for her.

heather Aspen 22 heather is a student nurse.

Anton Kovac 48 Anton is a surgeon.

Jake smith 22 Jake is an assistive personnel.



Case 4

Case overview Brianna Newcastle was a driver in a car that was involved in a motor vehicle accident. Brianna is taken to the emergency department of a local hospital via ambulance.

stage 1 overview Nurse marilyn is caring for Brianna in the emergency department following a motor vehicle accident.

stage 2 overview Brianna needs to go to diagnostics for tests.

stage 3 overview Dr. Cannon is consulting with michelle.

stage 4 overview michelle is in the waiting room and having conversation with Brianna’s friends.

stage 5 overview michelle has told Brianna that Joey was killed in the accident.





Brianna Newcastle 16 Brianna arrives at the hospital in an immobilizer due to being involved in a motor vehicle accident.

michelle Newcastle 48 michelle is Brianna’s mother.

marilyn hughes 38 Nurse who is caring for Brianna.

Cassie Bloomer 16 Cassie is a friend of Brianna.

Grace Cruz 16 Grace is a friend of Brianna.

Jose ramirez 16 Jose is a friend of Brianna.

stacy Cox 38 stacy is the mother of one of Brianna’s classmates.

Cheryl Cannon 45 Cheryl is Brianna’s provider.

Brandon Grant 28 Brandon is the radiologic technologist working on Brianna’s case.



Case 5

Case overview ms. Audra Longly is hospitalized and dying due to advanced CoPD and lung cancer. A do not resuscitate (DNr) order is in place, and family members are in disagreement about this order. Visitors are present.

stage 1 overview Nurse morgan is assigned to care for mrs. Longly, who is nearing the end of life. The family is discussing hospice care.

stage 2 overview mrs. Longly’s sister requests a visit from a chaplain.

stage 3 overview Nurse morgan is assigned to care for mrs. Longly, who is nearing the end of life. There are many visitors in the room.

stage 4 overview The family is discussing pain medications.

stage 5 overview Nurse morgan is discussing concerns with the provider, Dr. Donavan, and nurse manager, Debra.





Audra Longly 54 Audra is being hospitalized with advanced CoPD and lung cancer.

Karrie Perlman 32 Karrie is Audra’s daughter.

Tom Perlman 34 Tom is married to Karrie.

Claire fogel 30 Claire is Audra’s daughter.

morgan henshaw 48 morgan is the nurse caring for Audra.

Debra Carlson 45 Debra is the nurse manager.

Dr. Donavan 50 Dr. Donovan is Audra’s provider.

marge ehlers 50 marge is Audra’s sister.

Bradley 7 Bradley is Audra’s grandson.

Lily 9 Lily is Audra’s granddaughter.



The Communicator: Technique Identifier

(T=Therapeutic; NT=Non-therapeutic)

Case 1

Case overview Nurse sarah robinson, a newly licensed nurse, is caring for an aphasic client, Irene Connors. sarah is assisted in her care by more experienced nurse, rhonda Carlson.



sue robinson 22 sarah is a newly licensed nurse who is busy.

rhonda Carlson 50 rhonda is an experienced nurse who has a more laid back manner.

Irene Connors 72 Irene has recently suffered a massive intracranial bleed. she requires total care and is aphasic (unable to speak).

Case 2

Case overview ms. Doris ferguson is hospitalized with a deep vein thrombosis. she is currently on a continuous intravenous heparin infusion. The provider prescribes hourly laboratory testing of her blood until it reaches therapeutic levels of the heparin.



Angela Becker 30 Angela is a confident and experienced nurse.

Doris ferguson 82 Doris has been hospitalized with deep vein thrombosis. she is tired of being in the hospital.

Jake Kohler 24 Jake is a phlebotomist.



Case 3

Case overview Nurse David Carter is a charge nurse in a long-term care facility. AP Christina mcNeese is caring for mr. emerson who had a stroke a year ago. mr. emerson has left sided hemiplegia and has dysarthria. he uses an alpha board to communicate.



David Carter 40 David is an experienced LPN who is familiar with the facility’s routines.

steven emerson 57 steve experienced a stroke and is living in a long-term care facility.

Christina mcNeese 19 Christina just received her AP and has begun working at the long-term facility.

Case 4

Case overview AP Kammy Bergman is caring for mr. mcCafferty, who is 24 hour post-operative following abdominal surgery.



Kammy Bergman 23 Kammy is an AP administering care for mr. mcCafferty.

Dwight mcCafferty 64 Dwight is recovering from abdominal surgery.



Case 5

Case overview Nurse Cathy Gray Completes an initial home visit to client mr. Doka. he recently underwent a hip arthoplasty and is receiving home health nursing and physical therapy visits.



Cathy Gray 55 Cathy is a positive advocate for community home health care. she has been a nurse for 30 years.

Aamir Doka 60 Amir is recovering from hip arthoplasty.

Tate hines 28 Tate is a physical therapist who works part-time at the medical center in the physical therapy orthopedic rehabilitation clinic.

Case 6

Case overview Nurse Deb Norgaard is caring for Jessica Warren in a bariatric clinic. Nurse Deb consults Dietician monica milner to assist in teaching.



Deb Norgaard 30 Deb is an rN who has been working at the bariatric clinic for about 6 months.

Jessica Warren 34 Jessica is a client at the bariatric clinic. she is struggling to lose weight.

monica miller 46 monica is a dietician with over 20 years’ experience.



Case 7

Case overview Nurse Linda mann is caring for Curtis Taylor, a 9 year old, in the emergency department who is experiencing an asthma exacerbation.



Linda mann 35 Linda is the nurse caring for Curtis in the emergency department.

Curtis Taylor 9 Curtis is the emergency department because he is having trouble breathing.

Vanessa Taylor 27 Vanessa has brought her son to the emergency department and is concerned about his ongoing issues with asthma.

Case 8

Case overview Nurse Jody Garner and Nurse sharon stephens are preparing for melissa’s discharge from the hospital following surgery for an ileostomy.



Jody Garner 30 Jody is a nurse in the medical surgical unit.

sharon stephens 50 sharon is an ostomy care nurse who is preparing for melissa’s discharge from the hospital.

melissa Paulson 28 melissa is preparing to leave the hospital after an ileostomy.

Jenny Paulson 48 Jenny is melissa’s mother.



Case 9

Case overview mr. russell speeder is staying in a rehabilitation facility while receiving physical therapy after a total knee replacement. his family is anxious to have him home.



John Carpenter 40 John is mr. speeder’s nurse.

Valerie Zinn 26 Valerie is an AP in the rehabilitation facility.

russell speeder 80 russell is currently residing in a transitional care unit for physical therapy and strengthening prior to returning home. has been there 5 days.

Nancy Collins 56 Nancy is russell’s daughter. she is concerned that he is going to be ready to come home soon.

Dean Collins 59 Dean is Nancy’s husband.

mitch o’Dell 34 mitch is mr. speeder’s physical therapist.

Case 10

Case overview Nurse Inez Cesar is discussing home care with mr. and mrs. halvorsen before mrs. halvorsen’s discharge from the hospital.



Inez Cesar 46 Inez is the nurse caring for mrs. halvorsen.

ethel halverson 80 ethel has been hospitalized and is preparing to be discharged.

Arthur halverson 82 Arthur is concerned about being able to care for his wife at home independently.



References

Antai-Otong, D. (2007). Nurse-Client: A life Span Approach. Sudbury: Jones and Bartlett.

Bastable, S.B. (2006). Essentials of Client Education. Sudbury: Jones and Bartlett.

Berman, A., & Snyder, S. (2012). Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice. Upper Saddle River: Pearson.

Cherry, B., & Jacob, S.R. (2011). Contemporary Nursing: Issues, Trends, & Management. St. Louis: Elsevier.

Hart, V.A. (2010). Client-Provider Communications. Sudbury: Jones and Bartlett.

Marquis, B.L., & Huston, C.J. (2009). Leadership Roles and Management Functions in Nursing: Theory and Application. Philadelphia: Lippincott, Williams, & Wilkins.

Miller, M.A., & Stoeckel, P.R. (2011). Client Education: Theory and Practice. Sudbury: Jones and Bartlett.

Pagano, M.P. (2010). Interactive Case Studies in Health Communication. Sudbury: Jones and Bartlett.

Potter, P.A., & Perry, A.G. (2009) Fundamentals of Nursing. St. Louis: Mosby Elsevier.

Sheldon, L.K. (2009). Communication for Nurses: Talking with Clients. Sudbury: Jones and Bartlett.

Van Servellen, G. (2009). Communication Skills for the Health Care Professional: Concepts, Practice, and Evidence. Sudbury: Jones and Bartlett.

Varcarolis, E.M., & Halter, M.J. (2010). Foundations of Psychiatric Mental Health Nursing: A Clinical Approach. St. Louis: Saunders Elsevier.

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