Readiness for enhanced communication

Domain 5. Perception-cognition
Class 5. Communication
Diagnostic Code: 00157
Nanda label: Readiness for enhanced communication
Diagnostic focus: Communication

Introduction to Nursing Diagnosis Readiness for Enhanced Communication

Communication is an essential component of nursing practice. For any healthcare-related activity to be successful, effective communication between nurses and patients is necessary. The NANDA Nursing Diagnosis Readiness for Enhanced Communication provides an evaluation of the patient's ability to engage in conversations with and to understand instructions given by the nurse. The purpose of this assessment is to ensure that nurses understand the patient's communication needs so that they can try to improve the patient's communication skills and overall care.

NANDA Nursing Diagnosis Definition

The NANDA Nursing Diagnosis Readiness for Enhanced Communication, often referred to as NIC-R, is a type of assessment used to evaluate the patient's ability to communicate. This includes the ability to comprehend verbal and non-verbal forms of communication, engage in relationships with others, and communicate feelings of anxiety or stress. By assessing NIC-R, nurses can better understand the patient's medical needs and provide tailored care.

Defining Characteristics

• Subjectives: Patient expresses difficulty understanding spoken or written words, shows reluctance to participate in conversation, displays disinterest in discussing feelings or express emotions, lacks trust with nurses or other healthcare personnel, has difficulty initiating or engaging in conversations, leaves details out when providing information on medical history.
• Objectives: Patient speaks slowly and does not complete sentences, does not accurately answer questions about medical history or care, speaks in monosyllables, avoids eye contact, struggles with interpreting verbal and non-verbal cues, displays signs of poor self-esteem or low confidence.

Suggestions for Use

Given the importance of communication in the nursing profession, assess the NIC-R among all newly admitted patients and on an ongoing basis. This helps to provide nurses with an understanding of the patient's communication abilities and needs. Such an assessment should also be included as part of any individualized plan of care or medication teaching by nurses.

Suggested Alternative NANDA Nursing Diagnoses

In certain cases, where the patient does not display any readiness for enhanced communication, alternative NANDA nursing diagnoses may be more suitable. These include:

• Ineffective verbal communication: This diagnosis is appropriate when the patient finds it difficult to verbally communicate their feelings, needs, or concerns. It is important to recognize that the inability to communicate verbally can lead to further psychological and physical challenges during a healthcare journey.
• Ineffective interpersonal relationships: This is useful when a patient is displaying signs of reluctance to engage in conversations, fear of disapproval, or a lack of trust with nurses. These difficulties can also inhibit open dialogue which can further lead to interruptions in care.

Usage Tips

In order to properly assess NANDA Nursing Diagnosis Readiness for Enhanced Communication, nurses should consider the following factors:

• What is the patient's current level of communication? Is there a disparity between their verbal and non-verbal communication?
• During conversations, are the patient's responses adequate and appropriate?
• Are there any identified discrepancies between the patient's verbal and non-verbal communication, such as a lack of eye contact?
• Does the patient respond to verbal and/or non-verbal instruction appropriately?

NOC Outcomes

For nurses to adequately assess the patient's level of Readiness for Enhanced Communication, they must have a clear sense of the patient's current abilities. The NOC outcomes will help nurses in measuring the patient's progress and efforts. The NOC outcomes include:

• Effective verbal and non-verbal communication: This refers to the patient's ability to accurately interpret and comprehend verbal and non-verbal communication.
• Confidence in speaking and communicating: This refers to the patient's ability to share and exchange information with others without hesitation or fear.
• Interpersonal relationships: This refers to the patient's ability to interact with healthcare personnel, establish and maintain caring relationships, and handle conflicts effectively.
• Adaptive verbal and non-verbal communication: This refers to the patient's ability to adjust communication style to various conversations and social situations.

Evaluation Objectives and Criteria

It is important for nurses to evaluate the patient's success in meeting the NOC outcomes listed above. This evaluation should be patient-centric and focus on the following objectives and criteria:

• Can the patient interpret and comprehend verbal and non-verbal communication accurately?
• Does the patient feel comfortable sharing medical information and discussing feelings?
• Can the patient demonstrate respectful behaviour towards healthcare personnel?
• Does the patient feel confident in speaking with others and successfully handling conflicts?
• Can the patient adjust their communication style depending on the conversations and social scenarios?

NIC Interventions

Once the evaluation is completed and the objectives and criteria are met, nurses must take action in order to enhance the patient's communication. The NIC interventions for improving communication include:

• Assessment of verbal and non-verbal communication strategies: The nurse must assess how the patient communicates in practical settings and suggest strategies to improve communication abilities.
• Verbal and non-verbal communication training: During one-on-one or group sessions, the nurse will guide the patient's development in their ability to interpret and comprehend verbal and non-verbal cues.
• Positive reinforcement techniques: The nurse should reward the patient for responding to verbal and non-verbal cues. This can be done through use of positive reinforcement such as praise or recognition.
• Group discussions: In group settings, the nurse must facilitate conversations so that the patient can develop a better understanding of how to communicate effectively.
• Role play activities: This activity allows the patient to practice their communication skills in different situations. The nurse will provide suggestions and guidance where necessary.

Nursing Activities

When the patient displays readiness for enhanced communication, the nurse can then implement a comprehensive plan of action. This includes:

• Regularly assessing the patient's verbal and non-verbal communication.
• Encouraging the patient to participate in group discussions and role play activities.
• Using positive reinforcement to motivate and reward the patient for making progress.
• Providing guidance and advice to the patient in areas where communication is lacking.
• Ensuring the patient understands instructions and communicating expectations clearly.

Conclusion

Nursing diagnosis Readiness for Enhanced Communication is an important aspect of the nursing profession and essential in developing a quality care plan. Nurses must assess the patient's ability to communicate and provide tailored interventions to enhance communication. Through regular assessment and well-rounded intervention, nurses can provide excellent care and improve the patient's quality of life.

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