Nursing Practice/TeamSTEPPS Flashcards
Communication
A technique for communicating critical information that requires immediate attention and action concerning a patient’s condition.
- written or verbal
SBAR mnemonic
situation
background
assessment
recommendation
SBAR is a
- written or verbal
purpose provide essential, concise information usually during critical situations
Situation
focus on the seriousness of the situation with the exact circumstances explained
Name, Unit, Pt Name, and Room Number
Background
essential info related to only to current situation
age and gender
admitted date and for
presented with
Hx
Assessment
precise statement of data related to the situation, VS and findings
qualified staff
significant labs
clinical concerns
Recommendation
resolving issue based on findings
orders, meds, radiology, lab, therapies, consult, evaluate pt
How to receive a verbal order?
Sender initiates the message
Receiver accepts message and provide feedback
sender reads back order to ensure correct message received
Write Dr’s, NP’s, and RN’s name
Team Goal of Quality Improvement
DESIRED PT OUTCOMES (MAXIMIZE QUALITY OF CARE)
Sentinal event
state reportable incident and includes investigation into hospital neglect
a broken bone or worse
Define “Team”
people working together for a common goal
If a medication is prescribed for pain and you know that it also lowers fever, can you give that medication for fever even though it says PRN for pain?
No, not prescribed for that
Leadership is who
Is anyone seen as a leader because we are all advocating for the pts
Team Stepps Triangle
The center is Pt care team with these skills
-leadership
-situation monitoring
-mutual support
-communication
The 3 corners with arrows in and out are
Knowledge
Attitudes (trust and team orient)
Performance (adapt, accurate, productive, efficiency, and safety
TeamSTEPPS has what 5 key principles?
team structure
communication
leadership
sitaution monitoring
mutual support
Model for Improvement PDSA
Plan - idea for action
Do - make a change
Study - test and collect data
Act - adjust based on results
National Pt Safety Goals 2022
ID Pt correctly
Improve staff communication
Use med safety
Alarms safely
Prevent infections
Id pt safety risk
Improve equity
Multi-Team System for Patient Care Triangle (tip to base)
Pt and family
Core team and Contigency
Coordinating team and ancillary and support
Administration
Magnet
Designation that empowers nurses through shared governance to provide the best nursing care and outcomes
Measures the strength and quality of Nursing
Empowerment
Shared decision-making
Accountability
Magnet Culture
Visionary nursing leadership
Strong nursing representation at the top levels of management
Building an environment that encourages participation
Empowering nurses in patient care
Showing superior patient outcomes
Magnet Culture of Excellence
great leaders
great structures
great nurses
knowledge and innovation
great outcomes
Health Info Technology
Computers, mobile devices, and Telehealth (global help)
Medication administration applications
Computerized provider order entry
Protected health Information (PHI) – document accurate in EHR
Electronic health record (EHR) – direct access to pts chart, decrease Med ERRORS, decreased duplicate orders, decrease errors in handwritten orders
Protect confidentiality of patient’s protected health information
Document appropriately in electronic health records
Use communication technologies to coordinate patient care
Respond correctly to clinical decision-making alerts – LAB VALUES AND CORRECTION
HIPPA
includes your own medical record or friends/family medical records
Tier 1-4 = $100-50000 per violation
What does professional nursing look like to you?
Communication
Punctual
Integrity
Accountable
Team player
Compassionate
Honest
Accurate charting
Bad is the opposite of them
Why does Nursing Practice/Team Stepps Matter question back?
does this support the goals or values of nursing
How can we prevent medical errors
Communication CUS
advocacy and assertion
research
“I am Concerned!”
“I am Uncomfortable!”
“This is a Safety Issue”
Stop the line
How to assert a coorective action in a firm and respectful manner?
Make an opening.
State the concern.
State the problem (real or perceived).
Offer a solution.
Reach agreement on next steps.
Two-Challenge Rule
Empowers all team members to “stop the line” if they sense or discover an essential safety breach.
When an initial assertive statement is ignored:
It is your responsibility to assertively voice concern at least two times to ensure that it has been heard.
The team member being challenged must acknowledge that concern has been heard.
If the safety issue still hasn’t been addressed:
Take a stronger course of action.
Utilize supervisor or chain of command.
The following are responsibilities of effective team leaders:
*Organize the team.
*Identify and articulate clear goals (i.e., the plan).
*Assign tasks and responsibilities.
*Monitor and modify the plan; communicate changes.
*Review the team’s performance; provide feedback when needed.
*Manage and allocate resources.
*Facilitate information sharing.
*Encourage team members to assist one another.
*Facilitate conflict resolution in a learning environment.
*Model effective teamwork.
Brief
Short session prior to start to share the plan, discuss team formation, assign roles and responsibilities, establish expectations and climate, anticipate outcomes and likely contingencies.
Huddle
Ad hoc meetings to re-establish situational awareness, reinforce plans already in place, and assess the need to adjust the plan.
Monitoring and Modifying the Plan
Debrief
Reviewing the Team’s Performance
Informal information exchange session designed to improve team performance and effectiveness through lessons learned and reinforcement of positive behaviors.
Situation monitoring is the process of
continually scanning and assessing a situation to gain and maintain an understanding of what’s going on around you.
Situation awareness is the
state of “knowing what’s going on around you.”
Shared mental model results from
each team member maintaining situation awareness and ensures that all team members are “on the same page.“
STEP means
status of pt
team members
environment
progress toward goal
Status of the Pt
Patient History
__ Vital Signs
__ Medications
__ Physical Exam
__ Plan of Care
__ Psychosocial Issues
Team Members
__ Fatigue
__ Workload
__ Task Performance
__ Skill
__ Stress
Environment
__ Facility Information
__ Administrative Information
__ Human Resources
__ Triage Acuity
__ Equipment
Progress toward goal
__ Status of Team’s Patient(s)?
__ Established Goals of Team?
__ Tasks/Actions of Team?
__ Plan Still Appropriate?
TeamStepps Debriefing AQuestions asked
Was communication clear?
Were roles and responsibilities understood?
Was situation awareness maintained?
Was workload distribution equitable?
Was task assistance requested or offered?
Were errors made or avoided?
Were resources available?
What went well?
What should improve?
