Exam 1 WK3 Flashcards
Team STEPPS
To improve safety by improving teamwork and communication
evidence-based framework to help team performance in healthcare
Key components?
team structures, leadership, situation monitoring, mutual support, communication
Team structure:
Everything we do is about the pt - they are at the tip of the pyramid
Administration: foundation of the pyramid - they support the rest of the team
Core team: team members on the floor
Contingency team: rapid response
Leadership
Job responsibilities
○ Must organize the team
○ Articulate clear goals
○ Make decisions through the input of the rest of the team
○ Empower members to speak up + challenge + ask necessary questions
○ promote/facilitate good teamwork
○ Be skillful in conflict resolution
How to promote good teamwork
Brief: occurs prior to the start of the workday
Huddle: creates situational awareness + reinforces plans already in place + assess the need to adjust the plan
(done as needed)
Debrief:follow up
informal information exchange session that occurs after the work is done
a) Situational monitoring?
b) Cross monitoring?
a) process of continually scanning + assessing what is going on around you
b) error reduction strategy that involves monitoring the actions of other team members, provides a safety net within the team + ensures mistakes are caught (watching each other’s backs)
watching each other’s back”
What is the STEP stands for?
S: status of the pt (pt hx, VS, meds, physical exam, POC, psychosocial)
T: team members (fatigue, workload, task performance, skills, stress)
E: environment (facility info, admin info, HR, triage acuity, equipment)
P: progress toward goal (status of pts, established goals of teams, is plan still appropriate?)
IM SAFE/stands for?
self-checklist that needs to be performed
to make sure that you are practicing responsibly
llness,medication, stress, alcohol ,fatigue,emotion
Mutual support:
if you need help, ask for it and provide help to others who are struggling
a) What is the idea about team stepps?
b) What is team work essential for?
a) The idea is that teams will make less mistakes than individuals
b) patient care, quality and safety
A team should…
Collaborate, Cooperate, and Coordinate
b) Task assistance
c) Feedback
b) team members help prevent work overload situations, the focus is patient safety
c) information that helps to improve team performance – should be timely, respectful, specific, directed towards
improvement, considerate
Two-challenge rule?
cEmpowers all team members to “stop the line” if they sense or discover a safety breach.
A person must be assertive with their concern at least 2x to make sure it has been heard
A team member being challenged MUST acknowledge the concern
If the outcome is still not accepted, take a stronger course of action + utilize the chain of command
CUS?
SBAR?
○ Situation: current issues w/ pt
○ Background: clinical background/context
○ Assessment: what do you think the problem is based on findings?
○ Recommendation: what should be done for this pt?
DESC?
used to manage/resolve conflict
D: describe the specific situation/behavior
E: express how the situation makes you feel + what your concerns
S: suggest alternative + seek agreement
C: consequences should be stated in terms of impact on established team goals
Call-out:
informs all team members simultaneously during emergent situations (acknowledging that you heard what someone said)
Check back?
repeating the order to ensure that the information was conveyed correctly + understood
Handoff
Transfer of info during transitions of care – allows for an opportunity for questions, clarification, confirmation (shift changes, pt transfers)
a) Accountability
b) Responsibility
a) RN is legally responsible for their actions + is answerable on legal level
b) e/c person is responsible for + obligated to perform at acceptable level (training, role + setting)
a) Delegation
b) Assignment
a) selected nursing task to a qualified, competent individual able to perform the task.
(Texas:RN to unlicenced person)
b) process of assigning duties + all aspects of care to the pt
5 rights of delegation
1. Right task: task can be delegated safely
2. Right circumstance: appropriate pt setting, available resources, pt is stable, outcome is predictable
3. Right person: person has necessary knowledge + skills + performs the tasks on the right pt
4. Right direction/communication: respectful, clear, concise description of task including limits + expectations – appropriate instructions are given
5. Right supervision: appropriate monitoring, evaluation, intervention is given w/ feedback
What can NOT be delegated?
Assessment(adminition assessment has to done by RN)
Analysis
Nursing DX
Overall plan
Exrtensive teacing,counseling
Evalutation
Unstable patient
a) Barriers in thre delegator
b) Barriers in thre delegatee
a) attitudes
Oraganization skills
uncertainty
comminication skill
b) inexperience,incompetence,disorganization
