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COMMUNICATIONCOMMUNICATION& Patient Interactions& Patient Interactions
Assessment & History TakingAssessment & History Taking
RT123/106 rev Fall 2011RT123/106 rev Fall 2011DCDC111111
CH. 11 & 12CH. 11 & 12
11
Patient Communication Patient Communication Ch. 11Ch. 11
Interacting with the patientInteracting with the patient
Interacting with family and friendsInteracting with family and friends
Methods of Effective CommunicationMethods of Effective Communication
Age as a factor in Patient InteractionsAge as a factor in Patient Interactions
22
Radiologic TechnologistRadiologic Technologist
Communicating Effectively :Communicating Effectively :
Helping othersHelping others
Working with peopleWorking with people
Making a differenceMaking a difference
Thinking criticallyThinking critically
Demonstrating creativity Demonstrating creativity
Achieving resultsAchieving results
33
Abraham Maslow’s4
Why is this important?Why is this important?PATIENT NEEDSPATIENT NEEDS
Patients may be in altered states of Patients may be in altered states of consciousnessconsciousness
Unfamiliar environmentUnfamiliar environment Fear of not knowing their state of Fear of not knowing their state of
healthhealth Patients do not have control of the Patients do not have control of the
situation – very vulnerablesituation – very vulnerable Pt Reactions: Inconsiderate, arrogant, Pt Reactions: Inconsiderate, arrogant,
impatient, rude – impatient, rude – coping mechanismscoping mechanisms55
Patient DignityPatient Dignity
Patients are usually in the lower levels Patients are usually in the lower levels of Maslow’s Hierarchy - Why?of Maslow’s Hierarchy - Why?
Patient dignity must always be Patient dignity must always be remembered and respectedremembered and respected
Difficult to maintain dignity Difficult to maintain dignity
when wearing flimsy gown, vomiting, when wearing flimsy gown, vomiting, making a run to the bathroommaking a run to the bathroom
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No No’s…..No No’s…..
Referring to a patient as: Referring to a patient as:
“ “the chest in room 2”the chest in room 2” Always use the patients name!*Always use the patients name!* *HIPAA Laws - *HIPAA Laws - Only discuss what Only discuss what you must know you must know to do your job. to do your job.
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ID Pt’s NeedsID Pt’s Needsshow sensitivityshow sensitivity
Ptalw/NG tube may normally be
friendly and outgoing may prefer to wait in a
location where they do not have to face the public
Other Examples?
88
ClassificationClassification of Patients of Patients
InpatientsInpatients
OutpatientsOutpatients
– Family Family
– FriendsFriends
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Methods of Methods of CommunicationCommunication
VerbalVerbal
HumorHumor
ParalanguageParalanguage
Body LanguageBody Language
TouchTouch
– PalpationPalpation
Professional Professional AppearanceAppearance
Physical Physical PresencePresence
Visual ContactVisual Contact
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Special Condition PatientsSpecial Condition Patients
Traumatized PatientsTraumatized Patients
Visually Impaired PatientsVisually Impaired Patients
Speech and Hearing Impaired PatientsSpeech and Hearing Impaired Patients
Non-English Speaking PatientsNon-English Speaking Patients
Mentally Impaired PatientsMentally Impaired Patients
Substance AbusersSubstance Abusers
“Pt Skills Lab – later this semester
1111
Communication Skills may have to be adapted for the
• AGE as a factor in Patient Interactions• This will be covered in detail during the
Spring semester – RT 124• Children• Elderly• Terminally Ill• Cultural Differences• (ch. 10)
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ChildrenChildren
Get down to child Get down to child sizesize
KindnessKindness
PatiencePatience
Never lie!Never lie!
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GOOD CommunicationGOOD Communication
The key to a The key to a successful exam for successful exam for Technologist and Technologist and Patient.Patient.
Fosters a Fosters a
TEAMWORK TEAMWORK approach to approach to accomplish the goalaccomplish the goal
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ReviewReview
CommunicationCommunication
Patient Patient AssessmentAssessment
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Which of the following is the professional/ respectful way to
greet the patient?A. Maria Gonzales
B. Maria
C. M. Gonzales
D. Maria the BE patient
E. Ms. Gonzales
How do you confirm that you have the correct patient?
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What is an NG tube?What is an NG tube?And what is it’s purpose?And what is it’s purpose?
1717
How does one communicate with non–English-speaking
patients? (HIPPA)
A. through an English-speaking family member
B. writing the information on a piece of paper
C. slowly enunciating the instructions
D. rescheduling the patient to go to another hospital
E. find a hospital staff member who can translate
1818
Which of the following statements reflect interactions
with substance abuse patients?
A. restraints may be used for their safety
B. the patient may become agitated or violent
C. the patient should never be unattended while developing films
D. all of the above
1919
HISTORY TAKING HISTORY TAKING (CH. 12)(CH. 12)
Describe the role of the radiologic technologist in taking patient clinical histories.
Describe the desirable qualities of a good patient interviewer.
Differentiate objective from subjective data.
Explain the value of each of the six categories of questions useful in obtaining patient histories.
Describe the importance of clarifying the chief complaint.
Detail the important elements of each of the sacred seven elements of the clinical history.
2020
Radiographer’s ResponsibilityRadiographer’s Responsibility
RT is responsible for insuring patient RT is responsible for insuring patient understands what to expect during understands what to expect during examination.examination.
IntroductionIntroduction
Explanation of exam Explanation of exam
Inform patient how they will receive Inform patient how they will receive their resultstheir results
Risks of examination Risks of examination
2121
HISTORY TAKING – Ch. Rad Tech’s Role in Clinical Hx
Extract as much information as possibleRadiologists often do not even speak
with the patient.Radiologist can be instructed to give
special attention to the exact anatomic area where pain is focused.
22
Desirable Qualities for Establishing Open Dialogue
RespectGenuinenessEmpathyPoliteProfessional
demeanor
23
Data Collection
Objective: Signs that can be seen
Subjective: Perceived by the affected individual
Examples?
24
Questioning Skills
Open-ended questions (let pt tell story)Facilitation – encourages pt to elaborateSilence – give pt time to rememberProbing questions – focus interview,
provide more informationRepetition – rewording, clarifies infoSummarization – verifies accuracy
25
Leading Questions
This is an UNDESIRABLE method of questioning. Introduces biases into the history.
Ex: Does the pain travel down your leg? Vs. Where does the pain start and
where does it end?
26
Chief Complaint
Focuses attention to the single most important issue.
Patients may have several complaints, but thorough history taking can reveal the main issue or why the patient is there for treatment.
27
Clinical Indication
Tech must collect a focused history specific to the procedure being performed.
Several elements comprise a “complete history”.
Sacred Seven…
28
Sacred Seven
1. Localization: exact & precise area
2. Chronology: duration, frequency, course
3. Quality: size, color, consistency
4. Severity: intensity, quantity, extensiveness
5. Onset: what was happening when condition occurred
6. Aggravating or Alleviating Factors
7. Associated Manifestations Has There Been Any Trauma? Has There Been Any Previous Surgery?
29
You never know what you are going to get?
30
Good Communication with your patient improves radiation protection
• How ?
• Any ideas?
31
Primary Role of the Radiographer
X-ray Order from the ED
• 24 year old• Female• 2 V Abdomen• Diag: Abd Pain X 2 days
• What questions are you going to ask her?
32
X-ray Order - Outpatient
• 86 year old• Female• RT Hand • Diag: Pain
• What questions are you going to ask her?
33
All of the following are used to provide a better history to the
radiologist except to:
A. encourage elaboration
B. use probing questions
C. summarize the details
D. ask close-ended questions
34
A clinical history for an abdominal x-ray should begin with which of the following
questions?
• A. “Specifically where is the abdominal pain?”
• B. “What type of abdominal problems are you having?”
• C. “How long have you been vomiting?”
• D. “When did you have gallbladder surgery?”
35
Why would it be beneficial to include the parents and child in the medical
history interview of the child (under 18) and explanation of the procedure?
• A. helps the child become familiar and comfortable with the radiographic staff
• B. expedites the time spent in the radiographic room
• C. ensures the technical competence of the staff
• D. allows the parents active participation with the exam
36
Who is responsible for obtaining the clinical history from the patient for the diagnostic radiographic procedure?
• A. the radiographer
• B. the radiologist
• C. the nurse
• D. the patient’s primary care physician
37
What is the significance of a good clinical history?
A. it provides the referring physician’s admitting diagnosis
B. it provides general information regarding the patient’s condition
C. it focuses the radiologist’s attention to a specific area
D. it translates the patient’s complaints into medical jargon
38
Primary Role of the Radiographer?Primary Role of the Radiographer?
3939
Be Cautious of WHAT you say….And HOW you say it!