CPS - Communication and Consultation Skills

- Inteference and distortion | \/ Person initiating communication->communication put into a suitable format—> communication is put into a suitable format—> takes in the message that the source has sent out - Draw the Shannon Weaver Model of Two Way Communication - For meaningful communication, the receiver needs to provide feedback to the source as to whether the ,essays has been understood and whether it's been interpreted accurately - A SENDER communicates a MESSAGE to a RECEIVER - Describe the linear model of communication - Examples= Lectures, TV, Email - Positives= The message of the sender is clear and there is no confusion - Positives and negatives of the linear model of communication? - Negatives= There is no feedback of the message of the receiver - A two way process where the participants take it turn to be a sender and receiver - Describe the Interaction Model of Communication - Examples= Instant Messaging - A process where participants communicate to create a connection. Thoughts, feelings, opinions and feedback with shared with each other in social, cultural - Describe Transaction Model of Commuand relational contexts nication - Examples= Skype calls/ FaceTime, face to face meetings where everyone participates 1/6 - Positives= Simultaneously talks about message sending, noise and feedback - Is said to be the most systematic model - Positives and negatives of The Transacof communication tional Model of Communication ? - Negatives= Doesn't take non verbal cues into account - Environment - Patient factors - Pharmacist and team factors - Time - What are the 4 main barriers to communication ? - What does "register" mean ? - The way you speak and the words you use in a particular situation - 2 types= formal and informal - An example of Non- Verbal Communication? - Body language - What kind of register is clearer, active or passive and why ? - Active register - Active= The boy threw the ball - Passive= The ball was thrown by the boy - 1) Try to write from patients point of view - 2) Use everyday language - 3) Use patient friendly text - Describe the NHS guidance about pro- - 4) Be relevant to individual patients viding written information for patients - 5) Make sure information is consistent - 6) Explain all instructions - 7) Be helpful - 8) Do not confuse people 2/6 - 9) Signpost additional resources - 10) Be up to date - Background - Purpose= Brings all of MHRA information together - Scope= The guidance has been drafted - What are the main 6 sections in a Pa- to support the legal framework set out in tient Information Leaflet (PIL) ? national legislation - General considerations= - Order and content of information= - Design layout= - Define 'consultation' - A meeting to discuss something or get advice with the goal of discovering the best course of action to take - Comes from HEE - Benefits for the patient= Better understanding, better relationship with health care professionals, Increased adherence, more responsibility - Benefits for the health care profession- What are the benefits of a person cen- al= Better relationship with the patient, tred approach ? better identification of patient concerns leading to fewer consultations needed, increased job satisfaction - Benefits for the NHS= Reduced wastage, fewer consultations, improved outcomes 3/6 - Originally developed in 1996 by Kurtz and Silverman - What is the Calgary- Cambridge Model - Was designed to integrate communi? cation skills with medical content and is widely used in medical education - 1) Initiation - What is the first stage of the Calgary Cambridge Model ? - Greet the patient - Introduce yourself - Establish a rapport - To identify and clarify the reasons for the consultation - Build a relationship with the patient by using open body language, lots of eye contact, showing empathy with the patient - Obtain consent, can be verbal or implied - Identity= Hello my name is...I am the pharmacist on duty, what is your name and date of birth, how would you like me to address you? - Inform= You are eligible for this flue vaccine....... - Consent= Is this ok with you? Are you - Describe the I2C6 guide used by IP happy for me to proceed ? pharmacists for consultations (vaccina- - Confidentiality= Our discussion is contion example) fidential, if I need to tell someone I'll let you know - Chaperone= Would you like anyone else to be present during the vaccination ? - Comfort= are you comfortable? Could you lift your sleeve up for me please? - Clean hands= - 2)Information 4/6 - We can explore the patients beliefs about their condition and it's treatment - The patients ideas, concerns and expectations are also explored - Describe the second stage of the Calgary Cambridge model - Explanation and planning - Give patients information in chunks/ categories and checking they understand it before moving on - Describe the third stage of the Calgary - Repetition, summarise information and Cambridge Model repeat it to them - Use visual methods such as diagrams - Reaching a shared decision - Using decision aids such as Statin choice or A-Z list - Closing and forward planning - Summarise the discussion and clarify - Describe Stage 4 of the Calgary Camwhat has been agreed bridge Model - Ask them to recap three key things they are going to take away from the consultation - What is safety netting ? - Safety netting is advice which ensures that a patient with unresolved or worsening symptoms knows what to do if their condition gets worse or if they get adverse effects - What sections make up the medical history of a patient ? - Personal details - Presenting complaint= try and ask open questions - History of presenting complaint= use SOCRATES to gather info about pain ( site, onset, character, radiation, associations, exacerbating, severity) - Patient medical history - Social history= Ask about details, how many/how long cigarettes have been smoked for 5/6 - Family history - Drug history - ROS and general physical examination= pharmacists only perform patient examination when they work in specialist roles relevant to their professional practice - Results - Problem list, diagnosis and plan - What is medicines reconciliation ? - The process of identifying an accurate list of patients current medications and comparing them with the current list in use , recognising any discrepancies, documenting any changes - Name - Strength - Form - Dosage - What should be recorded for each med- Frequency ication a patient is taking prior hospital - Route of administration admission for accurate drug history ? - Duration administration if it's known - Indication of the medication - Any herbal medicines, vitamins, nutritional supplements - Confirm patient identity - Introduce yourself - Inform the patient about the purpose of - What are the steps involved in taking the consultation medication history ? - Obtain consent - Ask about drug history - Close the consultation - What is congruence ? - When our verbal communication is backed up by our non-verbal communication 6/6