Patient-Centred Communication In Nursing

Nurses have a high level of responsibility when it comes to patient assessment, communication, accurate data collection and interpretation (Considine & Currey, 2014). The primary survey and collection of medical history require the nurse to have a patient-centred approach and apply communication strategies that aid accurate diagnosis. Assessment of a patient's airway, breathing, circulation, disability and exposure (ABCDE approach) make up the essential steps of the primary survey. This approach provides nurses with a consistent, evidence-based and sequenced approach; assisting the nurse to collect data per clinical importance (Considine & Currey, 2014).

Patient Analysis

Airway
An airway may be patent, partially occluded or occluded.

Last night he was unable to sleep due to difficulty breathing and frequent coughing.

Communication strategies
Effective patient-centred communication is paramount to patient safety and should be adapted to the ABCDE approach and SAMPLE history. It involves a two-way exchange of information, provides necessary transparency and is customised to meet patient needs and values (Boykins, 2014). Atkins, Lacey & Britton (2014, pp. 125-126) contend that communication failures including not listening to patient concerns, not seeking timely medical advice and failure to document adequately are likely to contribute highly to breaches of duty of care.
A structured communication strategy used in healthcare is AIDET which considers five elements aimed at patient safety, improved patient compliance, reduced anxiety and patient satisfaction. The mnemonic AIDET stands for acknowledgement, introduction, duration and thank you. This provides a standardised communication approach to all patients and carers which can be used in several clinical settings (ACSQH standards, 2017).

Intact skin that is hot to touch. No pressure injuries, signs or wounds. No drains/invasive lines in situ. Requires assisted transfer. Patient reports bowels open 0700 yesterday, type 4. (Morgan) RN
0948 ABCDE complete. Patient exhibits 5 clinical review criterions. Nurse in charge notified. Clinical review called 0950. Await review. (Morgan) RN
0955 Informed patient of clinical review. Asked if next of kin could be contacted: reported wife on her way. (Morgan) RN
1010 SAMPLE completed. History of COPD with recurrent exacerbations. Call rapid response if MO not attended by 1015. Reassured patient. Asked if he had questions: reported no. Reassess vitals. (Morgan) RN

Summary
The primary survey approach as the first element provides the nurse with an evidence-based sequence to patient assessment. When combined with pertinent medical history the nurse is then able to initiate interventions based on clinical judgement. The use of patient-centred communication establishes a two-way exchange of communication whereby decisions can be made and documented based on the complete and accurate