Clinical Issue for Communication Skill in Emergency Department Reflective Report Answer

Introduction

Continuous improvement is critical in the ever-changing world of healthcare and specialized practice. This reflective plan focuses on addressing a specific clinical issue that has arisen in my specialty practice area. This strategy seeks to delve into the depths of this issue, examine its dimensions, and eventually devise evidence-based strategies for improvement by applying the reflective model called Gibbs' Reflective Cycle. The subsequent sections will begin by examining a clinical issue in emergency healthcare, emphasizing its impact on patient care. To guide analysis, a chosen reflective model will be introduced. Gibbs' Reflective Cycle model will facilitate a systematic exploration of personal experiences and professional practice, and foster a deeper understanding of critical incidents and their underlying faactors. It can be said that this reflective plan will be supported by incorporating citations of relevant literature studies such as journals and articles in order to enhance its quality. The plan will conclude by proposing strategies to improve care quality in my specialty area based on literature and reflective practice.

Aim and Objectives

The aim of this reflective plan is to enhance communication practices within the emergency department to improve patient care outcomes and overall healthcare quality. Based on the main aim of the paper, the objectives can be framed.

• To identify and describe the specific clinical issue within the emergency specialty practice that requires improvement.
• To determine a reflective model or theory so as to analyze these communication challenges systematically.
• To conduct a comprehensive literature review to gather evidence-based insights into effective communication strategies.

Identification of a Clinical Issue or Situation

In the high-pressure setting of the emergency department (ED), effective communication has become essential to provide quality patient care. The complex network of communication issues that may impede the seamless provision of care to patients in the ED environment is the clinical issue that requires attention and improvement in my specialty practice. Timely and precise communication is crucial in the emergency department for several critical components of patient care. The ED is supported by a diverse team of healthcare professionals, including physicians, nurses, paramedics, and support workers. Effective communication and collaboration between these roles are critical to ensuring that patients receive prompt assessments, interventions, and follow-up care (Kourkouta, & Papathanasiou, 2014). Moreover, during shift changes or when patients are transferred to other departments or facilities, it is critical to convey accurate and thorough patient information, such as medical history, allergies, and current medications. Incomplete or inaccurate information can lead to adverse events. In order to explain the diagnosis, treatment options, and potential risks to patients and their families, clear communication is necessary (Shin, & Yoo, 2023). In the emergency department, rapid communication of critical test results, changes in patient condition, and is imperative to facilitate quick decision-making and interventions (Shin, & Yoo, 2023). Delays or miscommunication in these situations might have fatal implications.

Identifying a Reflective Model

I will utilize Gibbs' Reflective Cycle in this plan which composes of six stages: Description, Feelings, Evaluation, Analysis, Conclusion, and Action Plan. This reflective model provides a structured framework used to systematically explore and reflect on experiences. This model is well-suited to guide me through critical reflection and evidence-based action to help me completely assess and enhance my communication within the emergency department.

Stage 1: Description

In a recent evening shift in the emergency department (ED), I encountered a vivid example of the critical communication issue that plagues our fast-paced and demanding work environment. A patient aged 50 years above, had been admitted with symptoms indicating a possible cardiac attack. While preliminary assessments and diagnostic tests revealed that immediate action was required, the handoff process between the paramedic team and the ED staff proved chaotic and fragmented. The arrival of the patient was characterized as urgency, with paramedics swiftly transporting him from the scene. They had successfully stabilized him during transport, but the transition from the healthcare team to the ED staff was far from smooth. As the patient was wheeled into the emergency department, a sense of urgency hung in the air, but effective communication was notably lacking.

The emergency personnel struggled to communicate essential patient data to the arriving ED staff, as they focused on the immediate issue of patient stabilization. Amid the flurry of activity and urgency, vital details about patient’s medical history, allergies, and medication regimen were lost in the shuffle. The lack of key data required to initiate appropriate interventions produced an unnerving sense of bewilderment among ED staff (Kourkouta, & Papathanasiou, 2014). The ensuing minutes were marked by heightened tension and increased stress as healthcare professionals tried to narrow down the information gap through rapid questioning and a hasty review of the scant available records (). This disorganized approach not only strained the already chaotic environment of the ED, but also delayed the administration of a crucial drug, potentially threatening the patient’s well-being.

The scenario of the patient suffering from cardiac arrest underscored the critical nature of communication in the ED, where time is a precious commodity and swift decision-making is highly essential. In the emergency department, every second matters, and delays in patient assessment or care can be fatal (Shin, & Yoo, 2023). As per the research works of authors Murphy et al., (2014), it can be said that delays caused by communication breakdowns can impede the swift delivery of interventions, potentially compromising patient safety. A study conducted by Foronda  et al., (2016) links effective communication in the ED to improved patient outcomes. The study found that clear and concise communication among healthcare teams is associated with fewer errors in medicine and better patient care. Effective communication has an impact not only on clinical outcomes but also on patient satisfaction. A research work by Kolanowski  et al., (2015) reveals that the perceptions of patients on the quality of care in emergency department are directly related to healthcare workers' communication skills. By fostering a culture of clear and efficient communication, the healthcare professionals in the ED can able to enhance patient safety, reduce medical errors, along with improve the overall quality of care.

Stage 2: Feelings

A complex tapestry of emotions overwhelmed me in the midst of the tumultuous clinical issue of communication breakdown in the emergency department (ED). In corresponding to the rich literature, I will highlight the emotional landscape of healthcare providers in high-pressure environments.

I became more frustrated as I saw the effects of communication errors on the patient’s health, resonating with the research study that highlighted frustration among the ED staffs due to suboptimal communication processes (Amudha et al., 2018). The conflicting emotions of acknowledging the value of effective communication while dealing with its breakdown causes irritation among the healthcare providers especially the ED nurses while providing care to the severe patients (Kolanowski et al., 2015). According to me, this feeling of frustration arises from a deep-rooted belief that indicates that optimal patient care should never be compromised.

Another strong emotion that poured over me during this encounter was anxiety. The emergency department is recognized for its high-stress environment, where swift decisions are required. The communication breakdown placed a cloud of doubt over our course of action. Knowing that these are often life-defining moments for patients, and that delays can have serious implications, was a source of tangible concern. The literature supports this, underscoring the feeling of anxiety which healthcare workers suffer while dealing with high-stress situations (Jordan et al., 2016). Anxiety is an ever-present companion at the emergency department (ED), but it came to the forefront of my emotions in this specific instance (d’Ettorre et al., 2018). The emergency room is known for its frenetic speed, where every second has the power to change the direction of a patient's life. In this environment, rapid decision-making isn't merely a convenience; it's a requirement. It is what separates effective intervention and missed opportunities, between life and death.

Despite these negative sentiments, there was a strong determination to address the issue head-on. This commitment was founded on the notion that we had a collective responsibility to impact change as ED healthcare professionals. The episode emphasized the significance of finding answers as a cohesive unit working toward a single objective of providing optimal care, rather than as individuals (Chatziioannidis et al., 2017). Following the occurrence of the communication breakdown in the emergency department (ED), an amazing feeling of determination bloomed within the extremely stressed atmosphere. It was a determination that transcended the initial frustration and anxiety, and it was grounded in a shared belief among healthcare professionals that we had a collective obligation to impact change (Amudha et al., 2018). This determination feeling did not arise as just a reaction; rather, it matured into a firm commitment to address the issue in a systematic manner. Problem-solving became a central aspect of this determination (Chatziioannidis et al., 2017). As a team, we attempted to deconstruct the incident, find core reasons, and envision a future in which similar breakdowns were less likely. The decision was not merely theoretical; it took the form of tangible actions—discussions, brainstorming sessions, and a desire to learn from this unpleasant experience.

Simultaneously, there was a strong sense of sympathy for the patient and his family. They were unwittingly drawn into the turmoil created by the communication gaps between the healthcare professionals (Van der Wath et al., 2013). This incident exposed them in a vulnerable position, and their fear and concern were evident. Empathy inspired a desire to ensure that future patients and their families would not have to endure similar ordeals. As per the research works of Wu, (2021) it is realized that this feeling of empathy and demonstrating it can help the healthcare workers to engage on a deeper level with patients and their families decrease anxiety, and develop trust in the emergency department. Demonstrating empathy sends a powerful message that their concerns are acknowledged and that their well-being is the top priority (Wu, 2021).

Stage 3: Evaluation

An in-depth evaluation of the impact of this clinical issue surrounding communication breakdown in the emergency department (ED) will be explored in this stage. A thorough analysis of the literature confirms the magnitude of this issue and reveals a landscape full of challenges that go far beyond isolated events. From the research works of Lee et al., (2016) it is acknowledged that unclear handoff communication results in care delays and potential mistakes, seriously jeopardizing patient safety. The research work highlighted the vulnerability of patients during handoffs, where essential information can be lost in translation, thereby compromising patient’s overall well-being  (Lee et al., 2016).

Inadequate documentation appears as a significant component of the communication breakdown issue in ED. The need of accurate and comprehensive records cannot be overstated, and its implications reverberate across all facets of patient care. In the research work of Sujan  et al., (2014) it is comprehended that effective documentation is, first and foremost, essential for continuity of care. It serves as a connection for the patient's experience inside the ED and beyond. Healthcare professionals subsequently face the challenging task of decoding an incomplete narrative when documentation is lacking or wrong, which may lead to misunderstandings and disruptions in the seamless delivery of care (Braaf et al., 2015). Additionally, the consequences of poor documentation also lead to cause diagnostic mistakes (Goedecke et al., 2016). Critical patient data may be missed or incorrectly interpreted as a result of imprecise documentation. This increases the likelihood of misdiagnosis. Such mistakes can have adverse impacts on patients, resulting in inadequate treatment plans and possibly jeopardizing their wellbeing.

In the emergency department (ED), hierarchical communication barriers constitute a difficult and ingrained issue that transcends organizational structure. These barriers have broad implications on how healthcare workers communicate and work together, which may have an impact on patient care (Nuckols et al.,2016). In healthcare settings, especially the ED, hierarchical arrangements may unintentionally impede honest and efficient communication. The junior healthcare professionals may feel reluctant to disagree with the judgments or viewpoints of more experienced colleagues. This hesitation may prevent important information or different viewpoints from being conveyed, which could have a significant impact on patient care (Nuckols et al.,2016). Furthermore, the implications of these hierarchical communication barriers extend to the concept of teamwork within the ED. From the research works of Moore et al., (2018) it can be said that delivering high-quality treatment, especially under pressure, requires effective teamwork. The collaborative efforts of healthcare teams can be disrupted when hierarchical obstacles prevent the flow of crucial information to be communicated.

The impact of poor communication within the emergency department (ED) extends far beyond the clinical environment. Many research works indicates that poor communication issue impose a direct impact on patient satisfaction and can lead to unfavorable outcomes (Vermeir et al., 2015). The emergency room (ED) experience is inherently stressful for patients, and the effectiveness of communication is crucial in shaping their perception of care. As per the views of Sujan et al., (2014), it can be said that poor communication between healthcare providers and patients can result in patient dissatisfaction which is more than just a single cause for concern.

Stage 4: Analysis

In this stage, the several root-causes as well as the contributing factors underlying this multifaceted clinical issue will be discussed.

Workload Pressure: The intense speed and frequently stressful environment of the emergency department (ED) generates massive workload pressures on the healthcare workers and pervades every element of healthcare delivery (Havens et al., 2018). In the ED, medical staff frequently deal with a deluge of cases, each requiring quick and accurate assessment and intervention. Time is a valuable resource in this setting, and the need to care for several patients at once can impede effective communication. Due to the necessity of handling crucial cases, handoffs may be hurried or incomplete, and communication may suffer (Seymour et al., 2017).

Lack of knowledge regarding communication protocols: Lack of knowledge about standardized communication protocols exacerbates issues with communication in the emergency department (ED). While standardized protocols can provide a structured framework for effective communication, healthcare providers such as nurses often lack awareness or understanding of such protocols (Sujan et al., 2014). As team members may not be completely knowledgeable in implementing these standards, this knowledge gap might lead to inconsistent communication practices within the ED (Seymour et al., 2017). Miscommunication and errors increase when there is no shared understanding of established communication methods, compromising the goal of seamless and unambiguous information flow (Lee et al., 2016). Responding to this issue necessitates comprehensive training and education on the use of standardized communication protocols within the ED (Sujan et al., 2014).

Varying styles of communication: Variable communication styles among healthcare workers in the ED add another layer of complication to the task of proper communication (Wu, 2021). Different specialties and backgrounds bring diverse communication approaches to the table. Nonverbal cues, tone, and linguistic proficiency can all be affected by these disparities (Foronda et al., 2016). A nurse from one cultural background, for example, may use subtle nonverbal clues to convey agreement or disagreement, but a colleague from another cultural background may express the same thoughts more overtly. These differences might lead to misinterpretations and communication breakdowns (Foronda et al., 2016). Language proficiency, also, plays a crucial role. Nurses whose first language is not the prevailing language in the ED may struggle to articulate complex medical information or comprehend intricacies in patient communication (Hull, 2016).

High Staff Turnover: High staff turnover is a recurring issue within the emergency department. Each new team member brings their own set of communication preferences and practices, creating a learning curve for comprehending the complexities of the team's dynamics (Morley et al., 2018). As the medical staffs seek to align their communication styles with their new colleagues, this ever-changing roster can lead to a lack of coherence. This adjustment period might unwittingly lead to blunders and misconceptions, perhaps contributing to communication breakdowns in the ED's fast-paced environment.

Limited Training in Effective Communication: Healthcare workers often receive minimal training in effective communication, despite the fact that it is a skill that needs to be developed. Medical education and training programs often prioritize clinical skills over communication skills (Foronda et al., 2016). This training gap may show up in healthcare professionals who are extremely skilled in clinical areas but lack the interpersonal and communication abilities necessary to negotiate the intricate web of relationships within the ED (Nuckols et al.,2016).

Stage 5: Conclusion

In light of the analysis conducted, it is evident that addressing communication issues within the emergency department (ED) is crucial for patient safety and the standard of treatment. This multifaceted challenge necessitates a comprehensive approach encompassing both organizational and individual adjustments. Effective solutions must be evidence-based and rooted in research. Ultimately, improving communication within the ED is not just a goal; it is a necessity. It represents a dedication to improving patient experiences, healthcare results, and the effectiveness of the healthcare system as a whole. Achieving this goal is essential to delivering the best treatment because of the special communication requirements of the ED.

Stage 6: Action Plan

In this final stage, I will outline a comprehensive action plan comprised of some recommended strategies to address the communication challenges identified within the emergency department (ED). These strategies are rooted in evidence-based practices and aim to enhance patient safety and the quality of care.

Communication Skills Training: A comprehensive program of ongoing training and workshops will be implemented to improve the communication skills of ED staffs especially the nurses (Pehrson et akl., 2016). Key concepts like active listening, precise documentation, and conflict resolution will be emphasized during these sessions. The training will be specifically designed to meet the requirements and difficulties identified within the ED, with an emphasis on building an environment of effective communication and improving interpersonal communication (Amudha et al., 2018).

Interdisciplinary Meetings: t is essential to establish regular interdisciplinary meetings to promote cooperation and open lines of communication among healthcare professionals. These meetings will act as platforms for discussing patient cases, exchanging knowledge, and resolving any potential communication problems. The objective of this strategy is to eliminate organizational silos inside the ED and advance a unified philosophy of patient care (Foronda et al., 2016).

Promoting awareness of communication protocols: It is crucial to make sure that every member of the ED team is knowledgeable with the recently set standardized communication protocols (Amudha et al., 2018). To promote consistency and effective communication methods throughout the department, regular training sessions and seminars will be held to inform personnel about the significance of adhering to these guidelines (Pehrson et akl., 2016).

Feedback Mechanisms: A system of feedback mechanisms will be implemented to guarantee continuous improvement (Pehrson et akl., 2016). Employees will have the option to anonymously report communication problems, promoting an open and educational atmosphere. The feedback mechanisms will help the emergency department to identify recurring challenges and address them proactively (Nuckols et al.,2016).

This action plan demonstrates a dedication to enhancing patient safety, maximizing care quality, and promoting an environment where good communication is valued in the emergency department. It makes use of the knowledge acquired from the analysis of pertinent literature, highlighting the effectiveness of these strategies in healthcare settings, particularly the ED.

Conclusion of Report

Ultimately, this task examined the crucial problem of communication breakdown in the emergency department (ED) using Gibbs' Reflective Model. Extensive literature review highlighted key challenges, including workload pressures, lack of standardized protocols, varying communication styles, high staff turnover, and limited training. Moreover, the impact of the poor communication issues in the emergency department was also discussed in this task. An action plan was devised to implement evidence-based strategies addressing these issues. The task intends to improve patient safety and quality of treatment in the ED by using promoting awareness about communication protocols, communication skills training, interdisciplinary meetings, and feedback systems.

References

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