Patient education and counseling
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To understand healthcare team perceptions of the role of professional interpreters and interpretation modalities during end of life and critical illness discussions with patients and families who have limited English proficiency in the intensive care unit (ICU). ⋯ Patients benefit from having an interpreter, who can function as a cultural broker or literacy guardian during communication in the ICU setting where care is especially complex, good communication is vital, and decision making is challenging.
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Communication about medical errors with patients and families demonstrates respect, compassion, and commitment by providing information, acknowledging harm, and maintaining trust through a process of dialogue that involves multiple conversations. This communication requires knowledge, skills, and attitudes that allow healthcare professionals to discuss facts transparently, take responsibility for what happened, and express regret and (as appropriate) apologize; these abilities also allow professionals to describe what will happen next for the patient and explain what will be done to prevent the error from happening to others in the future. ⋯ Healthcare organizations should promote a systems approach to patient safety and cultivate a culture of transparency and learning in which healthcare professionals are supported as they cope with the distress they experience after an error. Communication about errors should be incorporated into all healthcare practice settings (medical, surgical, in-patient, out-patient), and can be taught to medical students and residents using didactic, role-playing, or simulation methodologies.
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To examine transitions out of prognostic talk in interactions between clinicians and the relatives and friends of imminently dying hospice patients. ⋯ In a context in which there is a great deal of uncertainty, transitioning towards talk on comfort care can emphasise action and the continued care of the patient and their family.