What nursing strategies can be used when caring for a client with a hearing impairment?

There are simple steps you can take to help you to identify hearing loss, communicate with your patients better, and maintain their hearing aids so that they get the best out of them.

Inhaltsverzeichnis Show

Using a hearing loss support kit
How you should record a patient’s hearing loss
Providing hearing aid storage boxes
Using a hearing loss champion
More information
Three examples of poor access impacting health and wasting resources
Booking an appointment
Remote Consultations
12 Tips for communicating with Deaf patients
Review of the NHS Accessible Information Standard
Related reading:
Why does SignHealth provide specialist services?
What are the common nursing interventions for a client with hearing impairment?
What are the strategies of hearing impairment?
What would be the best way for a nurse to communicate with a hearing impaired client?
How would a nurse adapt care for a patient with hearing loss?

Using a hearing loss support kit

If a hearing loss support kit is available on the ward, it can help you to recognise when a patient has hearing loss and to support them so that their care isn’t affected by communication difficulties. You can use the kit to help you with:

hearing loss screening
communication
hearing aid maintenance.

Depending on what your Trust provides, a hearing loss support kit usually contains:

A hearing check screener to be used as part of the admissions process, or when hearing loss is suspected. If the screening result indicates that the patient has hearing loss, they can be referred for further assessment.
A personal listener that comes with headphones, a neckloop and a user guide for the listener. A personal listener can help patients with hearing aids if they set them to the loop setting and use the neckloop. If the patient doesn’t have hearing aids, the listener can be used on its own, with the headphones.
A hearing aid maintenance kit with hearing aid components and cleaning materials that staff trained in hearing aid maintenance can use to make sure that patients get the best out of their hearing aids.

Some hearing loss support kits will also have screening and hearing aid maintenance logbooks, GP referral letters and other useful resources to help you.

How you should record a patient’s hearing loss

When you’re caring for a person with hearing loss, it’s important to record their hearing difficulties in their handwritten or electronic patient notes, and in their communication care plan, if available. Where information about patients is recorded on whiteboards, hearing loss should be included.

If a personal listener is used to make it easier to communicate with a patient, or a patient has been screened for hearing loss, this should also be recorded in their notes, particularly if a referral to hearing services or an ear, nose and throat specialist has been made. You can also record when hearing aid maintenance is carried out.

Providing hearing aid storage boxes

Hearing aids can easily be lost on busy hospital wards. If your Trust provides hearing aid storage boxes to help keep hearing aids safe, you should use the following standard operating procedure for cleaning them:

The storage box (and laminated card) should be cleaned as required and every time a new patient uses the box, using Clinell sanitising wipes.
In exceptional cases, where infection is suspected, Chlorclean, which is made up in cold water, is to be used, or the box disposed of.

Using a hearing loss champion

Some Trusts have a policy of having staff who are ‘champions’ in different disciplines – for example, dementia, dignity, diversity. Find out if your Trust has a hearing loss champion (sometimes called a ‘link worker’) and seek them out if you feel you need guidance or support around hearing loss.

If there isn’t currently a hearing loss champion in your Trust, could someone step into this role?

More information

If you have more questions about caring for patients with hearing loss, see our good nursing practice Q&A.

Communication barriers are the number one reason Deaf people have had poorer health compared to hearing people.

Three examples of poor access impacting health and wasting resources

Booking an appointment

It actually starts with making an appointment. In some places, Deaf patients still have to walk into their surgery to book time with their doctor, because of the lack of SMS, email or online appointment systems.

Remote Consultations

An ordinary phone call is not an accessible medium for communicating with a Deaf patient. This includes holding consultations, sharing test results or confirming appointment details. According to the Accessible Information Standard, alternative communication channels must be arranged that meet the communication preferences of your patient.

Alternative methods might include text message or email for notifications, or booking a BSL interpreter for remote consultations using a Video Relay Service (VRS).

Reception

Have a system to call people into the consulting room which doesn’t rely on shouting out their name.

12 Tips for communicating with Deaf patients

Book an interpreter. A patient should not use a friend or family member to interpret for them. They will not know medical jargon or be trained to interpret health information, but most importantly, your patient will have no independence or privacy if a friend or family member accompanies them.
Talk directly to your patient, not the person interpreting for them.
Make sure you have your patient’s attention before talking. The patient will need to be able to see the interpreter.
Maintain eye contact whilst communicating. Don’t talk to your patient whilst looking at your computer screen, filling out paperwork or turning around. Avoid covering your mouth with your hands or paper.
Use normal lip movement. You don’t need to over exaggerate each word, and don’t mumble, because this can make it difficult to lip-read.
Speak at a normal volume. Shouting can be uncomfortable for a patient wearing hearing aids.
Make sure the room is well lit so that the patient can see your face clearly.
Speak in plain English at a normal speed.
Use written notes or diagrams to assist if you are having difficulty explaining something. But remember that Deaf people have different communication needs, so writing information down won’t be helpful for everyone. If your patient doesn’t understand you, try and think of a different way to explain yourself rather than repeating the same words again.
Use gestures and facial expressions to help explain yourself. Show with your face if something is painful, scary, or nothing to worry about.
Point to parts of your body if necessary.
Keep checking to make sure your patient understands you. If your patient doesn’t understand you, try and think of a different way to explain yourself.

It’s vital that the surgery/hospital (not the patient) book an interpreter in advance of the patient’s appointment. This is a basic right for Deaf people and one that will ensure your patient has a clear understanding of their health and the information you are telling them.

To book an interpreter, visit the NRCPD website.

Review of the NHS Accessible Information Standard

Urgent priorities for change, informed by patients’ lived experience and NHS professionals.

Report

Why does SignHealth provide specialist services?

There are a number of gaps in service provisions that can significantly impact the health and wellbeing of Deaf people. We provide psychological therapy, domestic abuse support, advocacy, outreach and residential services to support Deaf people who would otherwise struggle due to communication barriers.

We are working to improve the health and wellbeing of Deaf people. Please consider donating today.

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What are the common nursing interventions for a client with hearing impairment?

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What would be the best way for a nurse to communicate with a hearing impaired client?

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Book an interpreter. ... .

Talk directly to your patient, not the person interpreting for them..

Make sure you have your patient's attention before talking. ... .

Maintain eye contact whilst communicating. ... .

Use normal lip movement. ... .

Speak at a normal volume..

How would a nurse adapt care for a patient with hearing loss?

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