Clinical Learning Activity

NGR 6714
January 20, 2015
Name of Experience: Communications Tools for Enhancing Nurse/Client and Colleague
Relationship
Global Goal: Upon completion of one 4 hour Sim lab and three 8 hour shifts at the VA clinic,
enhanced use of communication tools will be seen by the student nurse.
The Site: VA Urgent Care Clinic
Nature of the Experience: Purpose of assignment is for entry level student nurses to participate in
client care by using evidence based communication strategies to reduce health barriers that
increase risk of destabilization to populations with chronic illness.
Who the learners will be: Junior level student nurse actively enrolled in a BSN nursing program.

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Veterans Administration Urgent Care

Outpatient Clinic Services
Communications Tools for Enhancing Nurse/Client and Colleague Relationship
Clinical Learning Objectives: Communication tools will enhance primary health promotion
utilizing evidence based nurse/client communication to enhance better disease management in a
VA setting. Student nurse will meet the following learning objectives:
1.
2.
3.
4.
5.
6.
7.
8.

Describe the professional role of a primary nurse care manager in a community setting
Identify health risks in unfolding case studies in Sim lab
Identify health risks in actual case studies in VA clinic
Use motivational interviewing (MI) when performing health history
Promote client centered care by incorporating OARS
Evaluate client self-efficacy in health promotion and/or disease management
Implement client directed plan of care resulting from nurse- client MI interview
Promote nurse-client trust and accountability though accurate management of health
information technology (HIT)
9. Demonstrate SBAR technique using a client case study in a clinical post conference
Learning Tools: Student nurse will complete all reading and 4 hour SIM practice of MImotivational interviewing and SBAR with Sim lab case studies prior to community placement
rotation.
1. Read two journal article on library reserve prior to SIM lab practice:
a. Brobeck, E., Bergh, H., Odencrants, S., & Hildingh, C. (2011). Primary healthcare
nurses' experiences with motivational interviewing in health promotion practice. Journal Of
Clinical Nursing, 20(23/24), 3322-3330. doi:10.1111/j.1365-2702.2011.03874.
b. Callaghan, D. (2005). Healthy behaviors, self-efficacy, self-care, and basic
conditioning factors in older adults. (2005). Journal of Community Health Nursing, 22(3),
169-178.
2. Review VA website and services: http://www.va.gov/healthbenefits/.
3. Review three case studies in Sim practice with materials provided.
4. Watch video on motivational interviewing that utilizes OARS (16 min 56 sec).
http://youtu.be/-zEpwxJlRQI (Press control and click on hyperlink)
a. O - open ended questions
b. A - affirming
c. R - reflections
d. S - summarizing
5. Review SBAR example and practice using SBAR handout in Sim lab with case studies.
a. Listen to SBAR (1 min 27 sec) audio clip : (Click on links)
Unclear phone communication

Clear phone communication

https://www.youtube.com/watch?v=7qHCmJzJiAo

https://www.youtube.com/watch?v=y0OWoh6qQYQ

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Optional enrichment reading

1. Campinha-Bacote, J.. (2011). Delivering Patient-Centered Care in the Midst of a Cultural
Conflict: The Role of Cultural Competence. Online Journal of Issues in Nursing, 16(2),
1-1
2. Hardcastle, S., Blake, N., & Hagger, M. (2012). The effectiveness of a motivational
interviewing primary-care based intervention on physical activity and predictors of
change in a disadvantaged community. Journal Of Behavioral Medicine, 35(3), 318-333.
doi:10.1007/s10865-012-9417-1
3. Health.mil (2013). Situation, Background, Assessment, Recommendation (SBAR).
[online] Retrieved from:
http://www.health.mil/dodpatientsafety/ProductsandServices/Toolkits
4. Resnick, B. (2008). The theory of self-efficacy. In M.J. Smith and P.R. Liehr (eds).
Middle range theory for nursing. (2nd Ed) New York: Springer Publishing Company, Inc.
Activities:

Orient to clinic facility and policies

Shadow registered nurse in VA clinic setting
Collect and review patient history checklist form
Perform a mini-assessment eg. blood pressure, pulse, respiration, temp, pain scale,
height, weight- (BMI), note changes in vitals and weight since last visit
Observe primary nurse use motivational interviewing (MI) with a new client
Student nurse uses motivational interviewing (MI) with a returning client
Reflect and describe observational experiences weekly and submit in writing to
clinical instructor specific use of MI and SBAR in a case with chronic health issues
Evaluation feedback form completed

OVERVIEW STATE UNIVERSITY

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DEPARTMENT OF NURSING
BSN PROGRAM
Clinical Performance Evaluation Tool
NURS 255 Level I
Self Evaluation
____
Faculty Evaluation ____
Student Name__________________________________
Faculty_____________________________

Course: NURS 255

Semester________

Fill in appropriate fields to the right & below:

Student must obtain a S Satisfactory grade in all * competencies to pass this performance skill.

Core Competencies

NI

Primary health promotion utilizing wellness, episodic illness and chronic disease management
in a VA setting. Sensitively addresses the cultural diversity of VA clients who may or may not
exclusively use local services and health care providers, the student at the end of N255,
should be able to:

Patient-Centered Care (Objectives 1, 3, 4, 5, 6, 7)

Incorporates the nursing process in client's plan of care with assessment and planning as the
focus of visit

Implement psychosocial interventions that address pain or chief complaint from both a
physical and emotional framework using motivational interviewing (MI)

Describe the various client's complaints and disease pathophysiology screened and treated in
VA clinic

Performs client history in assessment data that is inclusive of client's preferences, values, and
cultural needs

Teamwork and Collaboration (Objectives 1, 9)

Recognize personal strengths and limitations as seen within the healthcare team
Initiates appropriate requests for help when appropriate
Utilizes (SBAR) communication to make clear and effective transition care plans across
medical disciplines

Evidence-Based Practice (Objectives 1, 2, 3, 6)

Recognize subjective opinion from researched evidenced based care

Quality Improvement (Objective 5,8,9)

Identify how VA ensures continuous quality improvement (CQI)

Safety (Objective 3,7,8,9)

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Core Competencies

S
*

Performs risk reduction strategies that promote safety of self and others.

NI

Informatics (Objective 8,9)

Demonstrate basic computer skills navigating within the electronic health record,
safeguarding access and password protection measures for VA clinical setting

Maintain HIPAA compliance regarding confidentiality of electronic health records

Professionalism (Objectives 1,8,9)

Adheres to professional behavior, and OSU dress code appearance

Uplift Code of Ethics, VA clinic policies and procedures, and Overview State University (OSU),
Department of Nursing

Participate in self evaluation

Take responsibility for learning opportunities

Accept constructive criticism and develop plan of action for improvement
Complete clinical assignments in a timely fashion

Arrive on time to clinical and demonstrate good time management skills

Comments (Address strengths and weaknesses)

Faculty

Student

Student Signature ____________________________

Date ____________________

Faculty Signature ____________________________

Date ____________________

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References
Boult, C. (2009). Guided care : A new nurse-physician partnership in chronic care. New
York: Springer.
Brobeck, E., Bergh, H., Odencrants, S., & Hildingh, C. (2011). Primary healthcare nurses'
experiences with motivational interviewing in health promotion practice. Journal Of Clinical
Nursing, 20(23/24), 3322-3330. doi:10.1111/j.1365-2702.2011.03874.
Hardcastle, S., Blake, N., & Hagger, M. (2012). The effectiveness of a motivational
interviewing primary-care based intervention on physical activity and predictors of change in a
disadvantaged community. Journal Of Behavioral Medicine, 35(3), 318-333.
doi:10.1007/s10865-012-9417-1
Health.mil (2013). Situation, Background, Assessment, Recommendation (SBAR).
[online] Retrieved from: http://www.health.mil/dodpatientsafety/ProductsandServices/Toolkits
Ironside, P.M. Exploring the Complexity of Advocacy: Balancing Patient-Centered Care
and Safety. (n.d.). Retrieved May 21, 2007, from http://www.qsen.org/teachingstrategy.php?
id=58
Nln.org (2013). National League for Nursing - Faculty Programs & Resources. [online]
Retrieved from: http://www.nln.org/facultyprograms/facultyresources/ace-v/index.htm
"Patient safety: The Human Factor: Effective teamwork and Communications" (2005).
[video] Michael Leonard, M.D. ; Available through www.errormedicine.com
Qsen.org (2013). Clinical Performance Evaluation Tools Utilizing the QSEN
Competencies | QSEN. [online] Retrieved from: http://qsen.org/clinical-performance-evaluationtools-utilizing-the-qsen-competencies/
YouTube. 2013. 5.Motivational Interviewing: Core clinician skills -- Introducing OARS.
[online] Available at: http://youtu.be/-zEpwxJlRQI

Educational use of material: Materials may be used without permission for educational
purposes as long as credit is made to the author as follows:
Hargraves, C. (2013). Orientation Tools to Enhance Nurse/Client and Colleague
Communications. University of Central Florida - Graduate Nursing School.