Talk about the strange phenomena during nursing quality control interviews

Many nursing quality assessments, such as health education, high-quality nursing, graded care, and pressure ulcer follow-up, all need to be completed by interviewing patients or family members. The above situation is not uncommon in clinical nursing quality control interviews, so why does the same interviewee give inconsistent answers to this strange phenomenon? How should nursing staff deal with strange phenomena when they occur?

1. The influence of questioning methods

Commonly used words in open-ended questions are "what", "where", "how", "why", "talk about", etc. The interview subjects have a wider range of answers and are generally used to ask the other party to talk. Ideas, suggestions, questions, the purpose is to expand the topic. Using open-ended questions to conduct interviews can prompt interviewees to self-analyze and obtain deeper information about their needs. Commonly used words in closed-ended questions are "is it", "can it", "will it", etc., and are generally used to collect information in a targeted manner.

Using closed-ended questions to conduct interviews is relatively simple and easy for the other party to answer, but the narrow range of answers may result in one-sided and inaccurate feedback results. In clinical quality control interviews, open-ended questions should be used as much as possible to obtain comprehensive and true information. Inappropriate closed-ended questions will interfere with the results of the interview.

Clinical example:

Nurse A (open-ended question): Are you feeling okay? What's wrong?

Patient H: Fortunately, nothing uncomfortable.

Nurse B (closed question): Do you feel chest tightness and shortness of breath?

Patient: It seems a little bit.

Life examples

Waiter A (open-ended question): Do you need something to eat?

Guest K: No, thank you.

Waiter B (closed question): Do you want one egg or two eggs?

Guest K: Then have an egg.

2. The influence of the interviewer’s mentality

If the other party does not fully understand the interview content during the interview, the interviewer will use language, demeanor, and actions to further explain, and this Whether the explanation is explanatory or inductive is related to the interviewer's mentality. Explanatory explanation is to describe the problem in a way that the other party can understand. This process is impersonal and the explainer has no expectations for the interview results. Inductive explanation is to explain the problem in a way that the other party can understand the questioner's intention. This process has the subjective intention of the explainer, who intends to make the interview results develop in the direction of induction.

Nursing quality control interview is a process of interviewing patients or family members to understand the working conditions of nurses. Therefore, the patient's answers determine the results of the quality control assessment. If the interviewer conducts the interview with a mentality of avoiding the emergence of questions or the questions raised already have clear answers, the interview will be meaningless.

Clinical example:

Nurse A (explanation): Do you know who your responsible nurse is? The responsible nurse is the nurse in charge of this ward. She is usually responsible for your main treatment and nursing work.

Patient H: I don’t know who is my responsible nurse. The treatment these days has been performed by several nurses, and no one told me who is my responsible nurse.

Nurse B (induction instructions): Don’t you remember who your responsible nurse is? (Pointing to the responsibility sign under the TV with both hands and eyes at the same time)

Patient H: Oh, the sign says, Nurse Li**.

Lifestyle Example

Customer (question with clear answer): Waiter, is today’s dish fresh?

Waiter: It’s fresh, how could it not be fresh? (The answer "not new" is impossible)

3. The impact of information reception

Interviews use language as a carrier, and the information expressed and the information received are conveyed through language. confirm. Due to different cultural levels, language environment, personality characteristics, etc., the language used to express information may not necessarily allow the other party to receive the same information. At this time, the conversation may deviate from the topic, and words such as misunderstanding and misunderstanding may arise. .

The interviewer should conduct the conversation in a way that can be understood by the other party according to the different characteristics of the target. The feedback information needs to be confirmed again. When "That's not what I meant" appears, the interviewer should promptly adjust and organize his or her language. , otherwise the results of the interview may not necessarily reflect the real situation.

Clinical Case

Nurse A: Kid, do you want me to put the needle in your left hand or your right hand?

Patient: I don’t even want to. (The message received is "I feel pain on both sides")

Nurse B: Children, do you need to use your right hand to pick up toys?

Patient: Yes.

Nurse B: Can we give the injection to the left hand? (The message received is "I can play with my right hand")

Patient: Okay.

Life examples

Junior: Can I smoke while praying?

Elder: No. (The message received is "It is ungodly to want to smoke while praying")

Junior: Can I smoke and pray at the same time?

Elder: Yes. (The information received is "thinking about praying while smoking is a sign of piety")

1. Quality control personnel should start from the interview process to find their own problems.

When strange things happen, When this phenomenon occurs, quality control personnel need to ask themselves: Is the selection of interviewees reasonable? Were there any problems during the interview?

Clinical nursing quality control interview is a sample survey to judge the quality of department nurses’ work. Although the sampling is random, in order to more accurately reflect the quality of department nurses' work, some interview subjects must be considered to be excluded from the sampling, such as those who are unwilling to be interviewed due to illness or psychology, those with hearing or expression impairments, those who have been admitted to hospital or have recovered consciousness. The normal patients and family members who have been with the nurse for a short period of time are not suitable for interviews because they cannot truly and comprehensively reflect the work situation of the nurse.

The nursing quality control interview process revolves around the steps of asking, answering, checking, and confirming. The interviewer should first eliminate the other party’s doubts and unfamiliarity before jumping into the topic. If necessary, the topic should be explained. You should confirm again after listening to the other party's reply.

2 Responsible nurses should discover their own problems from the interview results

When strange phenomena occur, responsible nurses need to ask themselves: Have I done a good job? Am I doing it to cope with the examination or to meet the patient's needs? .

There is a difference between doing something well and doing it well, saying something and saying it well. The nursing quality control assessment is to check the quality of the nurses' work rather than to check whether they have "done it". There was once a senior intellectual who had suffered from diabetes for many years who was hospitalized. When the responsible nurse gave him an education, he always refused to listen because the nurse said repetitive things. During the quality control interview, his answer was: "The nurse didn't say that." What’s useful”. The responsible nurse was very angry after hearing the result. During the second hospitalization, another responsible nurse taught this way: "You do have a lot of knowledge about diabetes, but only healthy behaviors can promote recovery from the disease. Let's establish this behavior together, okay?" The patient came immediately. Interested, the nurse then discussed the patient's problems with the patient. During this quality control interview, his answer was: "I thought I knew a lot, but I discovered my mistake under the guidance of the nurse. This nurse Very good explanation. ”

3. The head nurse needs to find out his own problems from the role change.

When strange phenomena occur, the head nurse needs to ask himself: the quality control work of the department. How to improve? How to improve the quality of nurses' work? .

The head nurse is the quality controller in the daily work of the department, and is also the person being controlled when undergoing inspections. No matter what role the head nurse is in, he should understand that "problems are discovered" is not necessarily a bad thing. , if the head nurse cannot calm down when she is the person under quality control, then she will not be able to make the nurses in the department have a correct attitude when conducting quality control in the department.

Whether a nurse does a good job or not, the patient has the most say. Interviews are one of many methods of nursing quality control assessment. In order to avoid distortion of results during interviews, attention should be paid to the impact of questioning methods, interviewer's mentality and information transmission on the interviewees.

When the same interviewee gives inconsistent answers, the quality control personnel, responsible nurses and head nurses should all look for the reasons based on their respective jobs. They should not look for reasons from colleagues, let alone excuses from patients or family members. Otherwise, the quality control assessment will fail. Not only does it fail to improve the quality of nursing care, it may also cause conflicts between nurses and nurses and between nurses and patients.