Improving Patient Safety in Long-
Term Care Facilities:
Communicating Change in a
Resident’s Condition
Student Version

A Safe Environment
Effectively communicating change in a resident’s condition is critical to patient safety.
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Case Study #1
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Ms. Malone
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Creating a Safe Environment
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Reporting changes helps keep resident’s safe.
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Learning and experience are what make safety possible.
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Openly reporting anything that might affect a resident’s well-being is essential for a safe environment.
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Change in a resident’s condition should be reported openly whenever it happens.
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Key Principles of Effective
Communication
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Teamwork
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Open reporting
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Reporting unwanted events
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Giving and receiving information
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Teamwork
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Report change across the care team.
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Work together to identify what the change may mean.
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Take action as a team.
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Reporting Unwanted Events
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Learn to communicate promptly and openly when something happens that might affect a resident’s well-being.
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Move beyond blaming anyone to being able to openly share experiences.
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Show you care by speaking up.
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Giving and Receiving Information
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Express information in a way that will be understood by others.
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Hear information as it is being reported.
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Make effective use both of verbal and nonverbal communication skills.
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Barriers to Communication
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Gender
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Age/generation
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Language
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Culture
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Status
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Interpersonal issues
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System barriers
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Case Study #2
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Case Study #2
Mrs. Brown
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Case #2
Min-Wa and Susan
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Case Study #2
Observations
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What Should Be Communicated?
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Physical changes
► Walking
► Urination/bowel patterns
► Skin quality
► Level of weakness
► Falls
► Vital signs
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Nonphysical changes
► Demeanor
► Appetite
► Sleep
► Confusion
► Agitation
► Pain
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Relevant external factors
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How Should Information Be
Communicated?
Reporting and communication tools:
► Early Warning Tool
► SBAR
► CUS
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Stop and Watch Early Warning Tool
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SBAR Tool
SBAR: http://interact2.net/docs/INTERACT%20Version%203.0%20Tools/Communication%20Tools/
Communication%20Within%20the%20Nursing%20Home/INTERACT%20SBAR%20Form%
20v8%20Jan%2014%202013.pdf
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Case Study #3
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Case Study #3
Mr. Harris
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Case #3
Observations, Day 4
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Case Study #4
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Case Study #4
Change-of-Shift Meeting (Min-Wa)
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The CUS Tool
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I am Concerned about my resident’s condition.
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I am Uncomfortable with my resident’s condition.
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I believe the Safety of the resident is at risk.
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Principles in Action
CUS: Min-Wa to RN Team Leader
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I'm concerned about Mr. Harris.
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I’m uncomfortable that his temperature is up and that he has developed diarrhea.
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I believe that he might be developing an infection that should be treated.
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Case Study #5
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Case Study #5: Mrs. Carver
February 2012 – March 2014
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Case Study #5: Mrs. Carver
April 1, 2014
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Case Study #5: Mrs. Carver
April 2, 2014
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Key Points
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Communicate changes promptly.
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Reports of change can come from many sources.
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Every team member is responsible for reporting changes.
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Everyone faces barriers to communication.
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Tools to break down barriers.
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