Table 6.2 Skills to enhance information gathering.
| NEED | SKILLS |
|---|---|
| Get to know the patient | Introduce yourself and explain your role in the delivery of their careRefer to #hellomynameis campaignUtilise documentation including healthcare recordsObserving the patient both physically and psychologicallyRemember this is a continuous processDemonstrate self and emotional awarenessBe attentive to every sign or signal from the patientTransform the information gathered |
| Gather clues | Talk to the healthcare team members and observe the patientBe careful not to make assumptionsTalk to the patientObserve the patient’s actionsTuning into and picking up on patient cuesTake care not to misinterpret patients’ reactionRead and interrupt the patient’s non‐verbal cues |
| Establish a rapport | Make eye contact when appropriate, helping the patient to feel comfortable with you Notice and acknowledge the patient Actively listen to the patient’s thoughts, feelings and concerns (and their families)Undertake a comprehensive assessmentRecall something the patient has already told you about himself/herself Talk to the patient little and often depending on their need Demonstrate empathyEvaluate and review progress of the nurse–patient relationshipRemain attentiveAppropriate use of physical touch |
| Gain trust | Show respect and treat each patient with compassion Remain non‐judgemental Offer explanations using terminology that the patient understandsParaphrase what the patient has told so that you acknowledge what has been saidBe receptive and responsive to patients’ non‐verbal communication Display high standard of professional knowledge, self‐confidence and concern to gain the patients’ trust Show concern Act as the patients’ advocate |
| Determine the patient’s readiness to learn | Ask the patient about their goals, attitudes and motivations |
| Learn the patient's perspective | Talk to the patient about worries, fears and possible misconceptions |
| Ask the right questions | Use open‐ended questions that require the patient to reveal more detailsListen carefullyThe patient’s answers will help you learn their core beliefs |
| Learn about the patient’s skills | Find out what the patient already knows and build on this knowledge |
| Involve others | Identify the significant people in the patients’ life Identify what support they have and what they might need Collaborate with other healthcare professionals as needed |
Gathering Credible Literature
Evidenced‐based practice is reflected in and underpins the proficiencies for nursing associates (Nursing & Midwifery Council 2018). Within this chapter, it has previously been acknowledged that research in clinical practice allows the nursing associate to acquire both objective and subjective information regarding the patients’ condition and their experiences of living with it. Gathering this type of information will guide and enhance what is gathered through the therapeutic nurse–patient relationship. While research plays an important factor in supporting the decision‐making process without acknowledging the credibility of the research, the question of whether the findings can be trusted needs to be addressed. Two ways to determine this refer to critical appraisal and hierarchy of evidence.
Poorly conducted research seriously compromises the integrity of the research process; therefore, critical appraisal of the quality of clinical research is central to inform decision‐making in healthcare. Critical appraisal is the process of carefully and systematically examining research evidence to judge its trustworthiness, its value and relevance in a particular context (Caldwell et al. 2011). It allows clinicians to use research evidence reliably and efficiently. Critical appraisal is intended to enhance the healthcare professionals’ skill to determine whether the research evidence is true and relevant to their patients (Burls 2009). Critiquing tools such as Caldwell et al.’s (2011) Critical Appraisal Skills Programme (2011) and Joanna Briggs Institute’s Critical appraisal tools (2017) are commonly used within nursing to critically appraise research.
Figure 6.1 Hierarchy of evidence.
Source: Based on Evans (2003).
Particularly, in medicine, there is a requirement to seek the best available evidence, and in order to understand this, knowledge of the hierarchy of evidence is required. Figure 6.1 illustrates how the hierarchy of evidence refers to a ranking system whereby a range of different methodologies are graded according to the validity of their findings (Evans 2003).
A number of hierarchies of evidence have been developed to enable different research methods to be ranked according to the validity of their findings. However, most have focused on the evaluation of the effectiveness of interventions.
Conclusion
This chapter has considered the importance of gathering relevant information so as to ensure the delivery of evidence‐based patient‐centred care. The therapeutic nurse–patient relationship has been acknowledged, indicating this is pivotal to patient‐centred care. It has been acknowledged that the nursing associate will gather information to inform nursing practice from a variety of sources; however, it would seem that the effectiveness of this information gathering is somewhat reliant on the emotional intelligence skills of the nursing associate as well as underpinning an appreciation of the research process. Previous experience and expertise appear to develop these skills, as the less experienced nursing associate may not be as in tune with the patient in order to pick up the non‐verbal cues of the patient, having not been exposed to similar clinical situations previously.
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