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TSELVIN SUBRAMANIAM

LJM / NURSING DIVISION


23.08.2014

CONTENTS
Definition of Nursing
Fundamental principles in
nursing
Evidences of SIQ in
communication among nurses
Challenges
Strategies & Initiatives
6 Cs
10 steps to good listening
Conclusion
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NURSING STATISTICS

MOH
RN : 57510
JM: 24826
AN:341

PRIVATE
RN: 31081
AN : 1667
JM 299

RN in Public Sector: 5517


119863
Nurse Population Ratio

DEFINITION
"The unique function of the nurse is to
assist the individual, sick or well, in the
performance of those activities
contributing to health or its recovery(or
to peaceful death) that he would perform
unaided if he had the necessary strength,
will, or knowledge, and to do this in such
a way as to help him gain independence
as rapidly as possible
(Henderson,1966,p.3).

Henderson described nursing in


relation to the client and the client's
environment. Henderson saw the
nurse as concerned with both
healthy and ill individuals,
acknowledged that nurses interact
with clients even when recovery
may not be feasible, and mentioned
the teaching and advocacy roles of
the nurse.
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What is Nursing about?


A responsible nurse is not simply the
ability to successfully carry out a
series of procedures
Nursing is a holistic process
You will have to look at your patient
from.
You need to engage with your clients.

HOLISTIC NURSING
Holistic nursing is a specialty in the field of
nursing.
A holistic nurse will not simply attempt to treat
the physical symptoms of a disease or
condition, but will consider the totality of the
person being treated: mental, emotional,
spiritual, social, cultural, relational,
contextual and environmental aspects.
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The Patient Experience of Care is


Fundamental to Clinical Improvement
Understanding the patient experience of care is
not an add-on activity: it should be used as a
fundamental element when providing care.
Patient-centered care is a driver of clinical
outcomes
Nurse and patient engagement are 2 sides of
one coin

10

Public Expectation
There is increasing consumer demand for the high quality
services, technological developments and different type of
specialist services from all sectors public and private

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Communication
is the Key to Quality and Safety
Inadequate communication between care
providers or between care providers and
patients/families is consistently the main root
cause of sentinel events.
Improving Americas Hospitals: The Joint Commissions Annual Report on
Quality and Safety 2007

In focus groups conducted during survey, patients


emphasized that communication was the

most important characteristic of


hospital quality
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Kekurangan
soft skills

Tidak senyum
Cakap kasar
Kata-kata kesat
Kata-kata menghina
Layanan kasar
Sikap sambil lewa
Tidak prihatin
Wargatua
OKU
Pilih kasih
Merungut

(22%)
(7%)

(11%)
(7%)
(13%)

(20%)
(33%)

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Kekurangan
soft skills

kaunter staf tidak mesra pelanggan

11%

penerangan tidak jelas

8.8%

informasi yang diberi tidak tepat / betul 8%


penerangan di farmasi kurang jelas

9%
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JUMLAH ADUAN DAN MENGIKUT


KATEGORI JAWATAN JANUARI MEI
2014 (ISPAA)
Bil

Kategori

Jumlah

Peratusan

1.

Ketua Jururawat

2.

Jururawat Terlatih

75

4.55 %

3.

Jururawat
Masyarakat

51

3.09 %

4.

Jumlah

129

HOSPITAL
KESIHATAN

0.18 %

7.83 %

= 59
= 70
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PRESTASI ADUAN MENGIKUT KATEGORI


BIL
1.

2.

KATEGORI ADUAN

Tatatertib Dan Displin Serta Kecuaian


Dalam Mematuhi Arahan Dan Peraturan
Kegagalan komunikasi

JUMLAH

64

3.

Pematuhan Undang-Undang

4.

Salah Faham/Arahan kurang jelas

5.

Salah Guna Kuasa

Kegagalan Mengikut Prosidur Yang


Ditetapkan

12

6.

7.

Pilih Kasih Dan Double Standard

8.

Layanan Tidak Memuaskan

16

9.

Pelbagai Aduan

PERATUSAN

30
JUMLAH

129
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12/5/2014
INTERNATIONAL NURSES
DAY CELEBRATION AT PWTC

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IT IS A FACT
The Nursing Profession requires
a high degree of emotional labor
where nurses are expected to
display emotions that convey
caring, understanding, empathy
towards patients and their loved
ones.
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Remember You Are Always


Communicating

Words

Action
s

Attitude

Message

There are no other


area of work where
soft skills competence
more critical, more
intense and more
required than in
nursing.
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Communication
Soft Skills
Not Being Nice

Being Nice

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Be a bridge, not a wall!

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OUR STRENGTHS:
They may forget your
name but they will
never forget how you
made them feel.
~Maya Angelou~

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23

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10 steps to good listening


10. Stop talking
9. Ask questions
8. Go easy on argument and criticism
7. Dont get mad; hold your temper
6. Dont respond too quickly; be patient
5. Empathise with the other person
4. Remove any potential distractions
3. Show that you want to listen
2. Put the other person at ease
1. Stop talking

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Do you know .
In a day.
Female talks about
15,000 to 20,000
words
but..

Male talks about


7,000 to 12,000
words

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Evidence Based Facts


You CANNOT LISTEN and SPEAK at
the same time
HCP interrupt patients 18 seconds
after asking the first questions
Patients remember only 25% of any 20
minutes consultation
Therefore REPEAT,REPEAT,REPEAT.
Patient should speak 80% of
consultation

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What is
EFFECTIVE COMMUNICATION ???

If you can

visualise

the words,
you will
remember
the message

28

What is
EFFECTIVE COMMUNICATION ???

Intended meaning
of the source

Perceived
meaning of the
receiver

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To communicate ..

Know your
listener
knowledge
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CHALLENGES

WORKLOAD
STAFF SHORTAGE
PATIENTS EXPECTATION

32

On our Journey to Improved


Nurse Communication

WALKING THE EXTRA MILE


33

On our Journey to Improved


Nurse Communication
10

S
CORPORATE CULTURE
POLICY
ISPAA (new)

34

NURSING CARE VALUES

SENYUM
SEMANGAT

SALAM

SELIDIK

SEGERA

SELIA

SENSITIF

SEGAK

SOPAN
SENTUH

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TELEPHONE COMMUNICATION
POLICY
PKPA bil.1 tahun
1991
Panduan
meningkatkan
kualiti layanan
urusan melalui
telefon
PKPA = Pekeliling Kemajuan Pentadbiran Awam

4 peringkat:
1. Persediaan*
2. Sambutan
panggilan
3. Pengendalian
panggilan
4. Menamatkan
panggilan
36

On our Journey to Improved


Nurse Communication
PERFORMANCE APPRAISAL (new)
-COMMUNICATION LOG BOOK
-REPORT CARD

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SULIT

BUKU PEMANTAUAN
KOMUNIKASI BERKESANJURURAWAT
DI HOSPITAL DAN KESIHATAN AWAM
SULIT
BAHAGIAN KEJURURAWATAN
KEMENTERIAN KESIHATAN MALAYSIA

BUKU PEMANTAUAN
KOMUNIKASI BERKESAN JURURAWAT

DI HOSPITAL DAN KESIHATAN AWAM

BAHAGIAN KEJURURAWATAN
KEMENTERIAN KESIHATAN MALAYSIA

SULIT

BUKU PEMANTAUAN

KOMUNIKASI BERKESANJURURAWAT
DI HOSPITAL DAN KESIHATAN AWAM

BAHAGIAN KEJURURAWATAN
KEMENTERIAN KESIHATAN MALAYSIA

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KAD LAPORAN PERFORMA


KETUA PENYELIA JURURAWAT NEGERI/HOSPITAL/DAERAH
Nama
:
Negeri / Hospital :
Tempoh
: 1/1/2014 - 30/6/2014
Bil

Quality
Improvement Activities
QIA

1.

Pementoran

2.

Thrombophlebitis

3.

Pressure Ulcer

4.

National Nursing Audit

5.

National Operating Room


Nursing Audit

Grading
Baik

Memuas
kan

Catatan
Lemah

6. Pengurusan Aduan
39

Performa terhadap aktiviti adalah berdasarkan


kepada perkara berikut:
Proses Perlaksanaan
Proses Kutipan Data
Analisa terhadap data yang diperolehi
Laporan terhadap pencapaian
Tindakan Penambahbaikan
Penetapan Grading
Pemarkahan
Baik
3

Grading
Baik
Memuaskan
Lemah

Memuaskan

Lemah

Markah
12 - 15
9 - 11
5 - 8

Peratus
80 100%
60 79%
33 59%
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CONTINUING NURSING
EDUCATION
INTEGRATION INTO THE NURSING
EDUCATION:
REFINING BASICS : orientation /
workshops
LEARN FROM THE SME
41

Workshop:
How Part 1: Technique

Identify and address communication barriers


E.g. cultural, language, health literacy, patient
priorities

Teach staff communication skills


E.g. words/phrases that do and dont work
E.g. Using technology as an asset, not a barrier

42

Workshop:
Part 2: Creating a Conversation
Establish a relationship
Be fully present
e.g. reflect and connect

Encourage dialogue
e.g. teach-back

43

Workshop:
Part 3: Reinforcing the Foundation
Foundational Elements
of Patient-Centered Care
Leadership
Patient/Family Partnership
Workforce Engagement
Data Use/Performance Improvement

44

HOSPITAL-WIDE INITIATIVE
Bedside Shift Report
Acknowledge the patient by name
Introduce yourself
Duration tell them how long it will take to
do what you are there to do
Explain the procedure
Thank you for being patient during the
procedure
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CLINICAL GOVERNANCE
Ongoing monitoring performance for
excellence for excellence.

Integral to all Nurse Leaders

46

AN INNOVATIVE & CREATIVE


WAY OF COMMUNICATION
White Board installation !!
Communication between HCP, patients and
family
Standard content
Updated at shift change
Continuing audits to ensure updated
information

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48

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CONCLUSION

Who
What
Where
When
Why
How
50

Tselvin.moh@1govuc.gov.my
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