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Instructor’s Guide – I’m Alright, Really
Overview:
It is difficult to be objective about the well-being and fitness to work both about ourselves and our co-workers. The TeamSTEPPS I’M SAFE tool is meant to be a helpful checklist for assessing different dimensions of our own and others ability to deliver safe patient care.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Summarize elements of the TeamSTEPPS “I’M SAFE” resilience self-assessment tool.
- Evaluate team members’ fitness for duty by identifying cues of stress, fatigue, burnout, and the possibility of more serious psychological problems such as PTSD.
- Adopt strategies and methods for open sharing among team members and leaders for early identification of individuals with crippling stress, burnout, and/or more severe psychological problems.
QSEN Pre-Licensure Competencies
The following QSEN competencies are addressed in this lesson:
- Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
- Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
QSEN Teamwork & Collaboration Enrichment
TeamSTEPPS® Best Practice: I’M SAFE
Team Strategies to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among healthcare professionals.
I’M SAFE: Be aware of your own condition to ensure that you are fit and ready to fulfill your duties is essential to delivering safe, quality care. “I’M SAFE” is a simple checklist that should be used daily (or more frequently) to determine both your co-workers’ and your own ability to perform safely.
I’M SAFE stands for:
- Illness: Am I feeling so bad that I cannot perform my duties?
- Medication: Is the medication I am taking affecting my ability to maintain situation awareness and perform my duties?
- Stress: Is there something that is detracting from my ability to focus and perform my duties?
- Alcohol/Drugs: Is my use of alcohol or illicit drugs affecting me so that I cannot focus on the performance of my duties?
- Fatigue: Team members should alert the team regarding their state of fatigue (e.g., watch me a little closer today, I only had three hours of sleep last night).
- Eating and Elimination: Not taking care of our eating and elimination needs affects our ability to concentrate and stresses us physiologically.
Students will answer reflection questions upon completing the story. These questions are aligned with the QSEN competencies and are designed to help the student reflect on both the content of the story and the QSEN competencies addressed by the story.
*Following each question are some potential answers
- How did Amanda’s situation awareness help avoid a possible medical error?
A: Amanda used insight and situational awareness to help avoid the placement of bilateral tourniquets on a patient before it was necessary.
- How can we improve our ability to recognize and manage stress, fatigue, burnout, and the possibility of more serious psychological problems such as PTSD among team members using the TeamSTEPPS I’M SAFE tool?
A: It means being aware of our own situation, but also that of our co-workers. It is not enough to just follow orders, but we must be aware of subtle changes in those around us.
- How can we develop the mutual support necessary to address, and if necessary, confront compromised performance on the part of a team member?
A: One way to develop mutual support is to address the current situation or problem. Amanda did not ask the doctor a series of questions, but she addressed his current state. This should be done in a respectful manner to each person involved.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: It is important to be aware of subtle changes that may occur with our co-workers. It can be awkward at times, but it is important to address these changes. One way to address this issue is to use the I’M SAFE tool.
- How can you self-evaluate using the “I’M SAFE” tool, and why is this an important skill?
A: It is often hard to slow down during high workload periods, but it is necessary for patient safety. It is import to use the I’M SAFE tool if a change is observed in a co-worker or even yourself.
These activities can be tailored for individuals or groups in a face to face or online setting.
- Create a presentation for colleagues on the usefulness of the TeamSTEPPS STEP tool. Describe how it could be used.
- Think of another scenario for using the STEP tool. Describe the scenario and write a story using the STEP tool effectively.
- Brainstorm ways to practice the STEP tool on a regular basis. Share your ideas with the class and come up with a list of the best ways to practice using the tool.
Measuring Student Mastery:
Learning Outcome | Level 1 | Level 2 | Level 3 |
Summarize elements of TeamSTEPPS “I’M SAFE” resilience self-assessment tool. | Student struggles to summarize elements of the TeamSTEPPS “I’M SAFE” resilience self-assessment tool. | Student can summarize elements of the TeamSTEPPS “I’M SAFE” resilience self-assessment tool, but needs further practice. | Student can accurately summarize elements of the TeamSTEPPS “I’M SAFE” resilience self-assessment tool. |
Evaluate team members’ fitness for duty by identifying cues of stress, fatigue, burnout, and the possibility of more serious psychological problems such as PTSD. | Student struggles to evaluate team members’ fitness for duty by identifying cues of stress, fatigue, burnout, and the possibility of more serious psychological problems such as PTSD. | Student can evaluate team members’ fitness for duty by identifying cues of stress, fatigue, burnout, and the possibility of more serious psychological problems such as PTSD, but needs further practice. | Student can accurately evaluate team members’ fitness for duty by identifying cues of stress, fatigue, burnout, and the possibility of more serious psychological problems such as PTSD. |
Adopt strategies and methods for open sharing among team members and leaders for early identification of individuals with crippling stress, burnout, and/or more severe psychological problems. | Student struggles to adopt strategies and methods for open sharing among team members and leaders for early identification of individuals with crippling stress, burnout, and/or more severe psychological problems. | Student can adopt strategies and methods for open sharing among team members and leaders for early identification of individuals with crippling stress, burnout, and/or more severe psychological problems, but needs further practice. | Student can accurately adopt strategies and methods for open sharing among team members and leaders for early identification of individuals with crippling stress, burnout, and/or more severe psychological problems. |
For additional information on improving team communication, please consult the following articles and resources in Further Reading:
Story-Specific Best Practices and Proven Tools:
In addition to the ideas generated by students and mentioned in the activities, there are established best practices that may be appropriate to introduce or reference during this lesson to support communication. Some best practices to consider for improving team communication include:
- I’M SAFE