Supporting effective provider communication: from communication trainings to next steps
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In June 2016, training for doctors and nurses was held in the Kyzylorda and Mangistau regions. This presentation is a brief on the training outcomes and the reasons why we believe they were successful.
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Basics of Electrocardiogram
CONTENTS
●Conduction System of the Heart
●What is ECG or EKG?
●ECG Leads
●Normal waves of ECG.
●Dimensions of ECG.
● Abnormalities of ECG
CONDUCTION SYSTEM OF THE HEART
ECG:
●ECG is a graphic record of the electrical activity of the heart.
●Electrical activity precedes the mechanical activity of the heart.
●Electrical activity has two phases:
Depolarization- contraction of muscle
Repolarization- relaxation of muscle
ECG Leads:
●6 Chest leads
●6 Limb leads
1. Bipolar Limb Leads:
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Lead 2- Between right arm(-ve) and left leg(+ve)
Lead 3- Between left arm(-ve)
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2. Augmented unipolar Limb Leads:
AvR- Right arm
AvL- Left arm
AvF- Left leg
3.Chest Leads:
V1 : Over 4th intercostal
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V2: Over 4th intercostal space near left sternal margin
V3:In between V2 and V4
V4:Over left 5th intercostal space on the mid
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V6:Over left 5th intercostal space on the mid
axillary line.
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Waves of ECG:
P Wave
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Duration: 0.1 sec
QRS Complex:
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‘R’ wave is followed by a small negative wave, the ‘S’ wave.
Cause:Ventricular depolarization and atrial repolarization
Duration: 0.08- 0.10 sec
T Wave:
•‘T’ wave is the final ventricular complex and is a positive wave.
Cause:Ventricular repolarization Duration: 0.2 sec
Intervals and Segments of ECG:
P-R Interval:
•‘P-R’ interval is the interval
between the onset of ‘P’wave and onset of ‘Q’ wave.
•‘P-R’ interval cause atrial depolarization and conduction of impulses through AV node.
Duration:0.18 (0.12 to 0.2) sec
Q-T Interval:
•‘Q-T’ interval is the interval between the onset of ‘Q’
wave and the end of ‘T’ wave.
•‘Q-T’ interval indicates the ventricular depolarization
and ventricular repolarization,
i.e. it signifies the
electrical activity in ventricles.
Duration:0.4-0.42sec
S-T Segment:
•‘S-T’ segment is the time interval between the end of ‘S’ wave and the onset of ‘T’ wave.
Duration: 0.08 sec
R-R Interval:
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•It signifies the duration of one cardiac cycle.
Duration: 0.8 sec
Dimension of ECG:
How to find heart rhytm of the heart?
Regular rhytm:
Irregular rhytm:
More than or less than 4
How to find heart rate using ECG?
If heart Rhytm is Regular :
Heart rate =
300/No.of large b/w 2 QRS complex
= 300/4
=75 beats/mins
How to find heart rate using ECG?
If heart Rhytm is irregular:
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5×6=30
10×7 = 70 Beats/min
Abnormalities of ECG:
Cardiac Arrythmias:
1.Tachycardia
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Test bank clinical nursing skills a concept based approach 4e pearson educati...
Test bank clinical nursing skills a concept based approach 4e pearson educati...
Supporting effective provider communication: from communication trainings to next steps
- 1. Supporting effective provider communication: from communication trainings to next steps Brett Craig, PhD Assistant Professor, Health Communication, St Louis College of Pharmacy St Louis, MO, USA Aizhan Kapysheva MPA Candidate, Columbia University New York, NY, USA
- 2. Findings from training A statistically significant increase in attitude towards patient-centeredness Qualitative responses: Provider-Patient Orientation Scale (PPOS)* Pre and Post Test 3.29 to 3.4, p < .05 Subscales: Perceived the need for training and its practical relevance Strong requests for more training • interprofessional training • training for management Caring: 3.59 to 3.72, p <.05 Sharing: 2.98 to 3.08, p >.05 *Krupat E, Bell RA, Kravitz RL, Thom D, Azari R. When physicians and patients think alike: Patient-centered beliefs and their impact on satisfaction and trust. J Fam Practice. 2001; 50:1-8.
- 3. Reasons for success • Listened to providers, so they listened to us • Framed training as a support to their profession needs • Made training understandable and relevant • Customized training based on problems identified by providers and patients
- 4. Reasons for success However, … • Listened to providers, so they listened to us • Framed training as a support to their profession needs • Made training understandable and relevant • Customized training based on problems identified by providers and patients • Could not demonstrate improved skills • Resistance to practice in training • More training needed, especially follow up • On-site small-scale training and visits needed to improve skills in practical contexts
- 5. Moving forward Educating and engaging patients on healthcare roles and responsibilities Strengthening current healthcare professionals to meet patient needs Preparing medical students for communication needs of the healthcare profession
- 6. Educating and engaging patients on healthcare roles and responsibilities Models of appropriate, patient-centered communication in polyclinics Transparency and public awareness of processes, queues, expectations, etc. Signs explaining expected behaviors for both patients and providers in highly visible areas of polyclinic Announcements by polyclinic staff to avoid uncertainty
- 7. Strengthening current healthcare professionals to meet patient needs Training trainers to hold frequent, short trainings on-site Trainings to focus on: building trust, conflict resolution, health behavior change Preparing written and video resources for reference and continued support (online and in print)
- 8. Preparing medical students for communication needs of the healthcare profession Strengthening communication knowledge and practice in existing curriculum Integrating communication strategies with clinical practice Increasing focus on communication needs specific to population of Kazakhstan