1. 4 Communication and Cultural Diversity 1. Define the term communication Define the following term: communication the process of exchanging information with others by sending and receiving messages.

2. 4 Communication and Cultural Diversity Transparency 4-1: Communication Process

3. 4 Communication and Cultural Diversity 1. Define the term communication Remember these points about the communication process: All three steps must occur before the process is complete. During a conversation the process is repeated over and over. Effective communication is a critical part of an NA’s job.

4. 4 Communication and Cultural Diversity 2. Explain verbal and nonverbal communication Define the following terms: verbal communication communication involving the use of spoken or written words or sounds. nonverbal communication communicating without using words.

5. 4 Communication and Cultural Diversity Transparency 4-2: Body Language

6. 4 Communication and Cultural Diversity 2. Explain verbal and nonverbal communication Think about these questions: Are there ever conflicts between what a person is communicating verbally and nonverbally? How can an NA use observation as a form of nonverbal communication with a resident?

7. 4 Communication and Cultural Diversity 3. Describe ways different cultures communicate Define the following term: cultural diversity the different groups of people with varied backgrounds and experiences who live together in the world. bias prejudice. culture a system of learned behaviors, practiced by a group of people, that is considered to be the tradition of that people and is passed on from one generation to the next.

8. 4 Communication and Cultural Diversity 3. Describe ways different cultures communicate Think about this question: How might culture influence or affect communication between an NA and a resident?

9. 4 Communication and Cultural Diversity 3. Describe ways different cultures communicate Cultural background can affect all of these communication issues: Distance/personal space Touch Eye contact

10. 4 Communication and Cultural Diversity 4. Identify barriers to communication Define the following term: clichés phrases that are used over and over again and do not really mean anything.

11. 4 Communication and Cultural Diversity Transparency 4-3: Barriers to Communication

12. 4 Communication and Cultural Diversity 4. Identify barriers to communication Think about this question: What are some examples of slang expressions? Do residents and NAs have the same understanding of slang?

13. 4 Communication and Cultural Diversity 5. List ways to make communication accurate and explain how to develop effective interpersonal relationships These techniques can help an NA communicate clearly and effectively: Be a good listener. Provide feedback. Bring up topics of concern. Allow pauses. Tune in to other cultures.

14. 4 Communication and Cultural Diversity 5. List ways to make communication accurate and explain how to develop effective interpersonal relationships Techniques to help an NA communicate clearly and effectively (cont’d): Accept residents’ religion or lack of religion. Understand touch. Ask for more information. Make sure communication aids are clean and working.

15. 4 Communication and Cultural Diversity 5. List ways to make communication accurate and explain how to develop effective interpersonal relationships REMEMBER: Providing excellent care requires good communication and also requires that NAs build effective relationships with residents, family members, and the care team.

16. 4 Communication and Cultural Diversity 5. List ways to make communication accurate and explain how to develop effective interpersonal relationships The following tips are helpful in building positive relationships: Avoid changing the subject. Do not ignore requests. Do not talk down to people. Sit near the resident. Lean forward when a resident is speaking.

17. 4 Communication and Cultural Diversity 5. List ways to make communication accurate and explain how to develop effective interpersonal relationships Tips for building positive relationships (cont’d): Talk directly to the resident you are assisting. Approach the person who is talking. Be empathetic. Have time for residents’ families and friends too.

18. 4 Communication and Cultural Diversity 6. Explain the difference between facts and opinions Think about this question: What are some examples of facts? Examples of opinions?

19. 4 Communication and Cultural Diversity 6. Explain the difference between facts and opinions REMEMBER: Understanding the difference between facts and opinions will help an NA communicate her observations of residents in a more professional way.

20. 4 Communication and Cultural Diversity 7. Explain objective and subjective information and describe how to observe and report accurately Define the following terms: objective information information based on what a person sees, hears, touches, or smells; also called signs. subjective information information that a person cannot or did not observe, but is based on something reported to the person that may or may not be true; also called symptoms. incontinence the inability to control the bladder or bowels.

21. 4 Communication and Cultural Diversity Transparency 4-4: Using Your Senses

22. 4 Communication and Cultural Diversity 7. Explain objective and subjective information and describe how to observe and report accurately Think about this question: What are some specific observations an NA might make using each of the senses shown on the transparency (smell, sight, hearing, touch)?

23. 4 Communication and Cultural Diversity 8. Explain how to communicate with other team members NAs should keep the following in mind when communicating with their team members: Keep the nurse informed of all important issues during the shift. Communicate with other care team members as needed to provide quality care. Always respect residents’ privacy when communicating with other care team members. Be careful with communication—do not share information about diagnoses/condition changes. When in doubt about what you can or should communicate, ask the nurse. Use the chain of command to voice complaints.

24. 4 Communication and Cultural Diversity 9. Describe basic medical terminology and abbreviations Define the following terms: cyanotic skin that is blue or gray. root part of a word that contains its basic meaning or definition. prefix the word part that precedes the root to help form a new word. suffix the word part added to the end of a root that helps form a new word.

25. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations abefore AAROMactive-assistive range of motion abdabdomen ABRabsolute bedrest ac, a.c.before meals ADAlzheimer’s disease ADCAIDS dementia complex ad libas desired ADLsactivities of daily living adm.admission AEDautomated external defribrillator AHAAmerican Heart Association AIDSacquired immune deficiency syndrome AIIRairborne infection isolation room AKAabove-knee amputation, also known as am, AMmorning AMAagainst medical advice, American Medical Association ambambulate, ambulatory AMDage-related macular degeneration amt.amount ANSautonomic nervous system ant.anterior a.p./APapical pulse approx.approximately AROMactive range of motion ASAPas soon as possible assistassistance as tolas tolerated A, T, Dadmission, transfer, and discharge axaxillary BID, b.i.d.two times a day

26. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations BKAbelow-knee amputation bldblood BLSbasic life support BMbowel movement BP, B/Pblood pressure BPHbenign prostatic hypertrophy BPMbeats per minute BRbedrest BRPbathroom privileges BSCbedside commode BSEbreast self examination Ccentigrade, Celsius cwith Ca/CAcalcium, cancer, carcinoma CADcoronary artery disease calcalorie cath.catheter CBCcomplete blood count CBIcontinuous bladder irrigation CBRcomplete bedrest CCMSclean-catch midstream CDCCenters for Disease Control and Prevention CDEcertified diabetes educator C. diffclostridium difficile CEPcompetency evaluation (testing) programs CEUcontinuing education unit CHDcoronary heart disease CHFcongestive heart failure cholcholesterol ckcheck cl liqclear liquid cmcentimeter

27. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations CMSCenters for Medicare and Medicaid Services CNAcertified nursing assistant CNPcertified nurse practitioner CNScentral nervous system c/ocomplains of, in care of CO2 carbon dioxide COLDchronic obstructive lung disease COPDchronic obstructive pulmonary disease CP cerebral palsy CPMcontinuous passive motion CPRcardiopulmonary resuscitation CRF chronic renal failure C.S. Central Supply CSF cerebrospinal fluid CVA cerebrovascular accident, stroke CVP central venous pressure CVS cardiovascular system CXR chest x-ray DAT diet as tolerated DJD degenerative joint disease DKA diabetic ketoacidosis DM diabetes mellitus DNR do not resuscitate DO doctor of osteopathy DOA dead on arrival DOB date of birth DONdirector of nursing Dr. doctor DRG diagnostic related group drsg dressing DVT deep vein thrombosis Dx/dx diagnosis

28. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations ECG, EKG electrocardiogram ED emergency department EENTeye, ear, nose, and throat e.g. for example EMS emergency medical services ER emergency room ESRD end-stage renal disease et al. and other things ETOH alcohol exam examination F Fahrenheit, female FBS fasting blood sugar FDA Food and Drug Administration Fe iron FF force fluids FH family history fld fluid FS fingerstick FSBS fingerstick blood sugar ft foot F/U, f/u follow-up FUO fever of unknown origin FWB full weight-bearing fx fracture FYI for your information GAD generalized anxiety disorder gal gallon GB gallbladder GERD gastroesophageal reflux disease geri chair geriatric chair GI gastrointestinal g gram GP general practitioner GSW gunshot wound GTT glucose tolerance test

29. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations GU genitourinary GYN/gyn gynecology h, hr, hr. hour H 2 0 water H 2 0 2 hydrogen peroxide H/A headache HAART highly active anti- retroviral therapy HAV hepatitis A virus HBV hepatitis B virus HCV hepatitis C virus HDV hepatitis D virus HEV hepatitis E virus Hg mercury HHA home health aide Hi-cal high calorie HIPAA Health Insurance Portability and Accountability Act HIV human immunodeficiency virus HMO health maintenance organization HOB head of bed HOH hard of hearing H&P history and physical HPV human papillomavirus HS/hs hours of sleep ht height HTN hypertension H.U.C. Health Unit Coordinator Hx history hyper above normal, too fast, rapid hypo low, less than normal IBD irritable bowel disease IBS irritable bowel syndrome

30. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations IICU intermediate intensive care unit ICU intensive care unit ID identification I&D incision and drainage i.e.that is IM intramuscular In inch inc incontinent inf inferior I&O intake and output IQ intelligence quotient irr., irrig irrigation isol isolation I.V., IV intravenous K+ potassium kg kilogram KS Kaposi’s sarcoma l, L liter L, lt left lab laboratory lb pound LBP low back pain LE lower extremity lg large liq liquid LLE left lower extremity LLQ left lower quadrant LOC level of consciousness, level of care Low-cal low-calorie Low-fat/low-fat, low-calorie Low-cal Low-Na low-sodium LPN Licensed Practical Nurse LTC long-term care LTCFlong-term care facility LUQ left upper quadrant

31. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations LVN Licensed Vocational Nurse M.D. medical doctor MD muscular dystrophy MDROs multidrug-resistant organisms MDR-TB multidrug-resistant tuberculosis MDS minimum data set meds medications med-surg medical-surgical mg milligram MI myocardial infarction min minute mLmilliliter mmmillimeter mm Hgmillimeters of mercury MOmicroorganism modmoderate MRImagnetic resonance imaging MRSAmethicillin-resistant staphylococcus aureus MSmultiple sclerosis MSDsmusculoskeletal disorders MSDSmaterial safety data sheet MSWmedical social worker MUFAmonounsaturated fat MVAmotor vehicle accident Nasodium N/Anot applicable NAnursing assistant NaClsodium chloride NASno added salt NATCEPNurse Aide Training and Competency Evaluation Program N/C no complaints, no call NCSno concentrated sweets

32. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations negnegative NFnursing facility NG, ngnasogastric NIBPnon-invasive blood pressure monitoring NKAno known allergies NKDAno known drug allergies nonumber nocnight NPOnothing by mouth NVDnausea, vomiting, and diarrhea NWBnon-weight-bearing O 2 oxygen OBobstetrics ob/gynobstetrics and gynecology OBRAOmnibus Budget Reconciliation Act occoccasionally OCDobsessive-compulsive disorder ODoverdose O.D.right eye OGorogastric OOBout of bed O&Pova and parasites OPDoutpatient department O.R.operating room ord.orderly, ordered ORIFopen reduction, internal fixation orthoorthopedics osmouth O.S.left eye OSHAOccupational Safety and Health Administration OToccupational therapist, occupational therapy

33. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations OTCover-the-counter (medication) O.U.both eyes ozounce pafter P.A.physician’s assistant PADperipheral artery disease pc, p.c.after meals PCApatient-controlled anesthesia PDRPhysician’s Desk Reference PE pulmonary embolism Peds/pedspediatrics PEGpercutaneous endoscopic gastrostomy peri careperineal care per osby mouth PETpositron emission tomography pHparts hydrogen PHpast history PHIprotected health information phy. ex.physical exam PIDpelvic inflammatory disease PM/pmafternoon PMHpast medical history PNSperipheral nervous system PO(per os) by mouth pos.positive post opafter surgery PPDpurified protein derivative (test for tuberculosis) PPEpersonal protective equipment pre opbefore surgery preppreparation

34. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations p.r.n., prnwhen necessary prog.Progress PROMpassive range of motion Pt/ptpatient pt.pint PTphysical therapist, physical therapy PTHparathyroid hormone PTSDpost-traumatic stress disorder PUFApolyunsaturated fat PVDperipheral vascular disease PWBpartial weight-bearing qevery q2h, q3h, every two hours, q4h every three hours, every four hours QAquality assurance Q&Aquestions and answers qamevery morning qdevery day qh, qhrevery hour qhsevery night at bedtime q.o.d.every other day qt.quart quadquadrant, quadriplegic Rrespirations, rectal R, rt.right RArheumatoid arthritis RBCred blood cell RDTregistered dietician reg.regular rehabrehabilitation REMrapid eye movement req.requisition res.resident resp.respiration RFrestrict fluids RLEright lower extremity

35. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations RLQright lower quadrant RNregistered nurse RNArestorative nursing assistant R/Orule out ROMrange of motion RRrespiratory rate RTrespiratory therapy/therapist RUEright upper extremity RUQright upper quadrant Rxprescription, treatment s without S&Asugar and acetone s.c.subcutaneously SCAsudden cardiac arrest SCDssequential compression devices SIDSsudden infant death syndrome slsublingually SLEsystemic lupus erythematosus SLPspeech-language pathologist sm.small SNAFUsituation normal, all fouled up (slang) SNFskilled nursing facility SNSsomatic nervous system SOBshortness of breath SPStandard Precautions S.P.D.Supply, Processing, and Distribution spec.specimen ssone-half S&S, S/Ssigns and symptoms SSEsoapsuds enema STstandard, speech therapy staphstaphylococcus

36. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations STAT/statimmediately Std precStandard Precautions STDssexually-transmitted diseases STIssexually-transmitted infections strepstreptococcus supp.suppository surg.surgery T., temptemperature TBtuberculosis tbsp.tablespoon T, C, DBturn, cough, and deep breathe THRtotal hip replacement TIAtransient ischemic attack t.i.d., tidthree times a day TKRtotal knee replacement TLCtender loving care TPNtotal parenteral nutrition T.P.R.temperature, pulse, and respiration trach.tracheostomy tsp.teaspoon TWEtap water enema Tx, txtraction, treatment U/A, u/aurinalysis UEupper extremity UGIupper gastrointestinal UNK, unkunknown URIupper respiratory infection USultrasound USDAUnited States Department of Agriculture UTIurinary tract infection vag.vaginal VAPventilator-acquired pneumonia

37. 4 Communication and Cultural Diversity Handout 4-1: Abbreviations VREvancomycin-resistant enterococcus VS, vsvital signs W/A, WAwhile awake WBCwhite blood cell/count w/c, W/Cwheelchair WNLwithin normal limits wt.weight yr.year

38. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Prefixes a, an: without, not, lack of analgesic = without pain ante: before, in front of antepartum = before delivery bi: two, twice, double bifocal = two lenses brady: slow bradycardia = slow pulse, heartbeat contra: against contraceptive = prevents pregnancy dis: apart, free from disinfected = free from microorganisms dys: bad, painful dysuria = painful urination endo: inner endoscope = instrument for examining the inside of an organ epi: on, upon, over epidermis = outer layer of skin erythro: red erythrocyte = red blood cell ex: out, away from exhale = to breathe out hemi: half hemisphere = one of two parts of the brain hyper: too much, high hypertension = high blood pressure

39. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Prefixes (cont’d) hyper: too much, high hypertension = high blood pressure hypo: below, under hypotension = low blood pressure inter: between, within interdisciplinary = between disciplines leuk: white leukocyte = white blood cell mal: bad, illness, disorder malformed = badly made micro: small microscopic = too small for the eye to see olig: small, scant oliguria = small amount of urine patho: disease, suffering pathology = study of disease per: by, through perforate = to make a hole through peri: around pericardium = sac around the heart poly: many, much polyuria = much urine post: after, behind postmortem = period after death

40. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Prefixes (cont’d) pre: before, in front of prenatal = period before birth sub: under, beneath subcutaneous = beneath the skin supra: above, over suprapelvic = located above the pelvis tachy: swift, fast, rapid tachycardia = rapid heartbeat

41. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Roots abdomin(o): abdomen abdominal = pertaining to the abdomen aden(o): gland adenitis = inflammation of a gland angi(o): vessel angioplasty = surgical repair of a vessel using a balloon arterio: artery arteriosclerosis = hardening of artery walls arthr(o): joint arthrotomy = cut into a joint brachi(o): arm brachial = pertaining to the arm bronchi, bronch(o): bronchus bronchopneumonia = inflammation of lungs card, cardi(o): heart cardiology = study of the heart cephal(o): head cephalalgia = headache cerebr(o): cerebrum cerebrospinal = pertaining to the brain and spinal cord

42. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Roots (cont’d) chole, chol(o): bile cholecystitis = inflammation of the gall bladder colo: colon colonoscopy = examination of the large intestine or colon with a scope cost(o): rib costochondral = pertaining to a rib crani(o): skull craniotomy = cutting into the skull cyan(o): blue cyanosis = blue, gray, or purple tinge to the skin due to lack of oxygen in the blood cyst(o): bladder, cyst cystitis = inflammation of the bladder derm, derma: skin dermatitis = inflammation of the skin duoden(o): duodenum duodenal = pertaining to the duodenum, the first part of the small intestine

43. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Roots (cont’d) encephal(o): brain encephalitis = inflammation of the brain gaster(o), gastro: stomach gastritis = inflammation of the stomach geron: aged gerontology = study of the aged gluco: sweet glucometer = device used to measure blood glucose glyco, glyc: sweet glycosuria = glucose (sugar) in the urine gyneco, gyno: woman gynecology = study of diseases of the female reproductive organs hema, hemato, hemo: blood hematuria = blood in the urine hepato: liver hepatomegaly = enlargement of the liver hyster(o): uterus hysterectomy = surgical removal of the uterus

44. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Roots (cont’d) ile(o), ili(o): ileum ileorrhaphy = surgical repair of the ileum laryng(o): larynx laryngectomy = excision of the larynx lymph(o): lymph lymphocyte = type of white blood cell mamm(o): breast mammogram = x-ray of the breast mast(o): breast mastectomy = excision of the breast melan(o): black melanoma = mole or tumor, may be cancerous mening(o): meninges; membranes covering the spinal cord and brain meningitis = inflammation of the membranes of the spinal cord or brain necro: death necrotic = dead tissue

45. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Roots (cont’d) nephr(o): kidney nephrectomy = removal of a kidney neur(o): nerve neuritis = inflammation of a nerve onc(o): tumor oncology = study of tumors ophthalm(o): eye ophthalmologist = eye doctor oste(o): bone osteoarthritis = disease of the joints ot(o): ear otology = science of the ear pharyng(o): pharynx pharyngitis = inflammation of the throat, sore throat phleb(o): vein phlebitis = inflammation of a vein pneo/pnea: breathing tachypnea = rapid breathing pneum: air, gas, respiration pneumonia = inflammation of the lung pod(o): foot podiatrist = foot doctor

46. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Roots (cont’d) proct(o): anus, rectum proctology = study of the rectum pulm(o): lung pulmonary = relating to the lungs splen(o): spleen splenomegaly = enlarged spleen stomat(o): mouth stomatitis = inflammation of mouth therm(o): hot, heat thermoplegia = heatstroke thorac(o): chest thoracotomy = incision into chest wall thromb(o): blood clot thrombus = blood clot blocking a vessel toxic(o), tox(o): poison toxicology = study of poisons trache(o): trachea, windpipe tracheostomy = incision to make an artificial airway urethr(o): urethra urethritis = inflammation of urethra

47. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Suffixes -cyte: cell leukocyte = white blood cell -ectomy: excision, removal of splenectomy = removal of spleen -emesis: vomiting hyperemesis = excessive vomiting -emia: blood condition anemia = lack of red blood cells -ism: a condition hyperthyroidism = condition caused by an excessive production of thyroid hormones -itis: inflammation stomatitis = inflammation of the mouth -logy: study of hematology = study of the blood -megaly: enlargement splenomegaly = enlarged spleen -oma: tumor melanoma = mole or tumor, may be cancerous -osis: condition halitosis = bad breath

48. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Suffixes (cont’d) -ostomy: creation of an opening ileostomy = creation of an opening into the ileum -otomy: cut into laparotomy = cutting into the abdomen -pathy: disease myopathy = disease of the muscle -penia: lack leukopenia = a lack of white blood cells -phagia: to eat dysphagia = difficulty swallowing -phasia: speaking aphasia = absence of speaking -phobia: exaggerated fear acrophobia = fear of high places -plasty: surgical repair angioplasty = surgical repair of a vessel using a balloon -plegia: paralysis paraplegia = paralysis of lower portion of the body -rrhage: excessive flow hemorrhage = excessive flow of blood

49. 4 Communication and Cultural Diversity Handout 4-2: Prefixes, Roots, Suffixes Suffixes (cont’d) -scopy: examination using a scope colonoscopy = examination of the large intestine or colon with a scope -stomy: creation of an opening colostomy = opening into the colon -tomy: incision, cutting into thoracotomy = incision into chest wall -uria: condition of the urine dysuria = painful urination

50. 4 Communication and Cultural Diversity 10. Explain how to give and receive an accurate report of a resident’s status All of the following occurrences should be reported immediately: Falls Chest pain Severe headache Difficulty breathing Abnormal pulse, respiration, or blood pressure Change in mental status Sudden weakness or loss of mobility

51. 4 Communication and Cultural Diversity 10. Explain how to give and receive an accurate report of a resident’s status Occurrences to report immediately (cont’d): High fever Loss of or change in consciousness Bleeding Change in condition Signs of abuse

52. 4 Communication and Cultural Diversity 10. Explain how to give and receive an accurate report of a resident’s status REMEMBER: An NA must use facts, not opinions, in making reports.

53. 4 Communication and Cultural Diversity 10. Explain how to give and receive an accurate report of a resident’s status Think about this question: Why should an NA make written notes about reports given to a supervisor?

54. 4 Communication and Cultural Diversity 10. Explain how to give and receive an accurate report of a resident’s status An NA should document the following about an oral report: When Why About what To whom

55. 4 Communication and Cultural Diversity 11. Explain documentation and describe related terms and forms A medical chart is a legal record of a resident’s care. It includes the following information: Admission sheet Resident’s medical history Doctor’s orders Progress notes Lab/test results Graphic sheet Nurse’s notes Flow sheet/ADL sheet (see Figure 4-9, p. 44 of text)

56. 4 Communication and Cultural Diversity 11. Explain documentation and describe related terms and forms Current documentation is very important for many reasons: Guarantees clear and complete communication Provides legal record of treatment Protects NA and employer Provides up-to-date record of resident’s status

57. 4 Communication and Cultural Diversity 11. Explain documentation and describe related terms and forms NAs should always follow these guidelines for documentation: Document care immediately after it is given. Think before writing. Be brief and clear. Use facts, not opinions. Write neatly with black ink. Correct errors properly (see Figure 4-10, p. 45 of text). Sign full name and title. Document per care plan.

58. 4 Communication and Cultural Diversity 11. Explain documentation and describe related terms and forms REMEMBER: If something is not documented, legally speaking it was not done. It is very important for NAs to document carefully, and immediately after care is given.

59. 4 Communication and Cultural Diversity Transparency 4-5: 24-hour Clock

60. 4 Communication and Cultural Diversity 11. Explain documentation and describe related terms and forms These guidelines are helpful when converting regular time to military time: To change the regular hours between 1:00 p.m. to 11:59 p.m. to military time, add 12 to the regular time. Minutes and seconds do not change. Midnight may be written as 0000 or 2400; NAs should follow facility policy.

61. 4 Communication and Cultural Diversity 12. Describe incident reporting and recording Define the following terms: incident an accident, problem, or unexpected event during the course of care that is not part of the normal routine in a healthcare facility. sentinel event an accident or incident that results in grave physical or psychological injury or death.

62. 4 Communication and Cultural Diversity 12. Describe incident reporting and recording The following events are considered incidents: Falls Damage Mistakes in care Requests outside scope of practice Sexual advances or remarks Unsafe or uncomfortable situations Injuries Blood or body fluids exposure

63. 4 Communication and Cultural Diversity 12. Describe incident reporting and recording NAs must follow these guidelines for incident reporting: Tell what happened. Tell how the person tolerated the incident. State facts only. Do not write about anything in the incident report on the medical record. Describe action taken. Include suggestions for change.

64. 4 Communication and Cultural Diversity 13. Demonstrate effective communication on the telephone Effective telephone communication involves the following steps: Identify yourself politely before asking to speak to someone. Ask for the person with whom you need to speak. State the reason for your call. Leave a brief message if the person you are calling is not available. Thank the person who takes the message for you.

65. 4 Communication and Cultural Diversity 13. Demonstrate effective communication on the telephone The following steps are important when answering the telephone: Identify the facility’s name, self, and position. Place caller on hold if necessary. Write down messages. Ask for correct spelling of names. Get a number. Say, “Thank you,” and “Goodbye.”

66. 4 Communication and Cultural Diversity 13. Demonstrate effective communication on the telephone REMEMBER: NAs should never give out information about staff or residents over the phone.

67. 4 Communication and Cultural Diversity 14. Understand guidelines for basic office machines and computers The following office machines may be in use at LTCFs: Photocopier Fax machine Calculator Computer

68. 4 Communication and Cultural Diversity 14. Understand guidelines for basic office machines and computers REMEMBER: HIPAA privacy guidelines apply to computer use. If a facility uses computers for documentation, the NAs must make sure that nobody can see private information on the screen.

69. 4 Communication and Cultural Diversity 15. Explain the resident call system REMEMBER: An NA must always answer call lights, no matter what. Call lights must be left within residents’ reach and answered promptly every time the resident pushes the button.

70. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs Define the following terms: impairment a loss of function or ability. farsightedness the ability to see objects in the distance better than objects nearby; also known as hyperopia. nearsightedness the ability to see things near but not far; also known as myopia.

71. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs Define the following terms: cerebrovascular accident (CVA) a condition that occurs when blood supply to a part of the brain is blocked or a blood vessel leaks or ruptures within the brain; also called a stroke. hemiplegia paralysis on one side of the body. hemiparesis weakness on one side of the body.

72. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs Define the following terms: expressive aphasia slurred speech or an inability to speak. receptive aphasia inability to understand spoken or written words. emotional lability laughing or crying without any reason, or when it is inappropriate.

73. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs Define the following terms: dysphagia difficulty swallowing. combative violent or hostile behavior.

74. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs The following guidelines are important when communicating with residents with hearing impairment: Make sure hearing aid is on and working. Clean hearing aid as instructed. Reduce or remove noise. Get residents’ attention first. Speak clearly, slowly, and in good lighting. Do not shout or mouth words in an exaggerated way. Lower pitch of voice. Keep hands away from face while talking.

75. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs Guidelines for communicating with residents with hearing impairment (cont’d): Speak to side with better hearing. Use short sentences and simple words. Repeat what was said using different words if necessary. Use picture cards or notepads. Be patient and empathetic. Ask resident to repeat what was said when necessary. Observe body language. Be understanding and supportive.

76. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs The following guidelines are important when communicating with residents with vision impairment: Make sure eyeglasses are on, clean, and in good condition. Identify self when entering room. Make sure there is proper lighting. Face resident when speaking. Orient residents to new areas. Use imaginary clock as a guide. Tell resident what you are doing. Talk directly to resident. Do not move items. Put anything you move back where it was found.

77. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs Guidelines for communicating with residents with vision impairment (cont’d): Tell resident where the call light is. Leave door completely open or closed. When assisting resident with walking, walk slightly ahead, letting resident grasp your arm. Encourage use of other senses. Use large clocks or clocks that chime. Offer large-print books, audio books, digital books, and Braille books if necessary. Do not play with guide dogs.

78. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs The following guidelines are important when communicating with residents who have experienced CVA/stroke: Keep questions and directions simple. Phrase questions that can be answered with a “yes” or “no.” Agree on signals. Give residents plenty of time to respond. Use a pencil and paper if possible.

79. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs Guidelines for communicating with residents who have experienced CVA/stroke (cont’d): Use terms weaker or involved to refer to affected side. Keep call light within reach. Use verbal and nonverbal communication. Use communication boards or special cards.

80. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs REMEMBER: Even if residents are not able to speak, it is important that care team members not talk about them as if they are not there.

81. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs The following guidelines are important when communicating with residents who are demonstrating combative behavior: Block blows or step out of way. Allow the resident time to calm down before the next interaction. Ensure resident is safe and give him space. Remain calm. Lower tone of voice. Be flexible and patient. Stay neutral. Do not respond to verbal attacks or argue. Do not use gestures that could frighten or startle resident. Be reassuring and supportive. Consider what provoked the resident.

82. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs The following guidelines are important when communicating with residents who are demonstrating angry behavior: Stay calm. Do not respond to verbal attacks or argue. Empathize. Try to find out cause. Be respectful. Explain what you are going to do. Answer call lights promptly. Stay at a safe distance.

83. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs There is a difference between assertive and aggressive behavior. A person is behaving assertively when he Expresses thoughts, feelings, and beliefs in a direct and honest way. Respects his own needs and feelings and those of other people. A person is behaving aggressively when he Expresses thoughts, feelings, and beliefs in ways that humiliate, disgrace, or overpower the other person. Shows little or no respect for the needs or feelings of others.

84. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs REMEMBER: NAs should report aggressive behavior from residents.

85. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs The following guidelines are important when communicating with residents who are demonstrating inappropriate behavior: Report behavior. Be professional and do not overreact. Try distraction. Gently direct resident to private area.

86. 4 Communication and Cultural Diversity 16. List guidelines for communicating with residents with special needs REMEMBER: An NA must never hit a resident, no matter how the resident behaves. Hitting is considered abuse and may result in termination and/or legal action.