Read “Case Study: Communicating Accurate Information in a Care Situation” at the beginning of Chapter 12 in the textbook. Prepare a communication plan or memo to share what you have found with a physician and post this information in the discussion forum. Identify similarities and differences between your response and those of your peers.
Memo: Communication Plan – Case Study: Communicating Accurate Information in a Care Situation
To: Attending Physician
From: [Your Name], RN
Date: [Insert Date]
Subject: Communication of Patient Status – Case Study Reflection and Plan
Background:
The case study presented in Chapter 12 of the textbook illustrates a situation where a nurse inaccurately reports a patient’s level of consciousness to a physician. The nurse claims the patient is “alert and oriented,” while the patient in fact shows signs of confusion and disorientation. The physician, relying on this inaccurate report, discharges the patient prematurely, placing the patient at risk. This situation underscores the critical importance of precise, timely, and honest communication in healthcare settings.
Communication Plan Summary:
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Assessment Before Reporting:
Nurses must ensure they conduct a full patient assessment before communicating with a provider. In this case, the nurse should have documented and communicated objective findings: e.g., “Patient oriented to person only, unable to state place and time.” -
Use of SBAR Protocol:
To avoid miscommunication, we recommend using the SBAR (Situation, Background, Assessment, Recommendation) framework in all provider communications. For example:-
Situation: “I am calling about Mr. Jones, who was admitted for confusion.”
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Background: “He has a history of dementia, and this is his third episode this month.”
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Assessment: “Currently, the patient is only oriented to self. He does not know where he is or the current date.”
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Recommendation: “I recommend further neuro evaluation and delaying discharge until mental status stabilizes.”
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Documentation Alignment:
All verbal communication must be consistent with nursing documentation in the patient’s chart. Discrepancies between verbal reports and documentation can lead to liability and patient harm. -
Team Rounding Participation:
Encourage interdisciplinary rounding where nurses, physicians, pharmacists, and therapists jointly evaluate and share input. This prevents gaps in understanding and builds a collective picture of the patient’s condition. -
Education and Reflection:
All staff should receive regular training on clinical communication best practices. Reflective debriefings on communication errors can foster a culture of continuous improvement.
Discussion of Peer Similarities and Differences:
Similarities:
In comparing peer responses in the discussion forum, I noticed common agreement on the importance of SBAR as a best-practice communication model. Most responses emphasized the need for honest and detailed communication, accurate reporting of orientation status, and documenting assessments prior to physician consultation. Many peers also noted that errors like the one in the case could have legal and ethical ramifications for nurses and providers.
Differences:
While my approach centered on structured communication and team-based care, some peers focused more on emotional intelligence, including how fear of physician response might prevent accurate reporting. Others discussed the use of technology (e.g., EHR alerts or standardized forms) to ensure clarity. A few responses proposed organizational changes such as mandating co-signs on discharge decisions for cognitively impaired patients.
One interesting contrast was a peer suggestion to involve family members more actively in the discharge planning process, especially when patients display confusion—something I did not consider in my plan but find highly relevant.
Conclusion:
Effective communication in healthcare is essential to patient safety. This case study reinforces that assumptions and vague reporting can lead to serious consequences. A structured communication plan, such as SBAR, paired with full assessment and team collaboration, significantly improves care quality. Reflecting on peer insights further enhances our understanding of diverse strategies and potential blind spots in clinical practice.
References:
American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). ANA.
The Joint Commission. (2023). Improving communication to enhance patient safety. https://www.jointcommission.org
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