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133 – They Come and Go Student’s Guide

Thursday, September 25th, 2014

133

Student’s Guide – They Come and Go


Overview:
This story is about the patient experience as seen through the eyes of the patient. Patients view their care as competent, yet disjointed, especially at shift changes. Bedside handoffs are one technique to make the transitions of care both satisfying and safer for the patient.

 

 

Primary Learning Outcomes

After completing this lesson, the student will be able to:

  • Evaluate and explain team opportunities to consistently involve patients and family members during transitions of care, especially at shift changes.
  • Describe the importance of integrating bedside handoffs into daily practice to promote safer care and improve patient experience.

 

 

QSEN Pre-Licensure Competencies

The following QSEN competencies are addressed in this lesson:

  • Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
  • 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: Bedside Handoffs

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 health care professionals.

 

Bedside Handoffs – Change of shift report occurring at the patient’s bedside with these essential components:

  • A standardized nursing report handoff tool.
  • Bedside shift-to-shift report.
  • Inclusion of the patient and family in the discussion of plans and goals of care, including introductions.
  • Two-person medical record check.

 

Story Directions: 

As you listen to and read the story, think about the things that you think the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.

 

Reflection Questions:

  1. How did the team’s inability to consistently involve Daryl and Ed during transitions of care affect their experiences?
  2. What does this story illustrate about the importance of bedside handoffs?

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132 – Debrief or Perish Student’s Guide

Thursday, September 25th, 2014

132

Student’s Guide – Debrief or Perish


Overview:
This story is about the importance of team debriefs. Teams often fail to learn as much as they can from critical incidents by not taking adequate time to report, discuss, and examine errors in patient care. Teams are destined to repeat the same mistakes if they fail to debrief.

 

 

Primary Learning Outcomes

After completing this lesson, you will be able to:

  • Describe the importance of integrating team debriefs into regular practice to promote team learning, error management, continuous improvement, and self-correction.
  • Explain the importance of integrating family members as a critical source of patient information and medical history, especially if the patient is incapacitated or impaired.
  • Generate and summarize strategies for recording and sharing lessons learns from debriefs with other team members and across the organization.

 

 

QSEN Pre-Licensure Competencies

The following QSEN competencies are addressed in this lesson:

  • 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.
  • Evidence-Based Practice (EBP): Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
  • Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.
  • Quality Improvement (QI): Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.

 

 

QSEN Teamwork & Collaboration Enrichment
TeamSTEPPS Best Practice: 

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.

Debriefs: To conduct a debrief:

  • Facilitate the discussion as a leader by asking questions related to team performance. What did we do well?
  • Recap the situation, background, and key events that occurred.
  • As a team, assess how the following played a role in the performance of the team:
    • Team Leadership
    • Situation Awareness
    • Mutual Support
    • Communication
  • Then summarize lessons learned and set goals for improvement.
  • This checklist can be used by the team during a debriefing to ensure that all information is discussed.

 

Story Directions: 

As you listen to and read the story, think about the things that you think the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.

 

Reflection Questions:

  1. How does this story illustrate the importance of integrating team debriefs into regular practice to promote team learning, error management, continuous improvement, and self-correction?
  2. Why is it important to actively seek out family members to participate as a full partner in a patient’s care?
  3. What are some ways this team could record and share lessons learned from debriefs with other team members and across the organization, considering their time constraints?

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131 – Between the Cracks Student’s Guide

Thursday, September 25th, 2014

131

Student’s Guide – Between the Cracks


Overview:
This story demonstrates the importance of improving team communication, developing effective cues, re-engineering processes, and promoting coordination between units to reduce Emergency Department length of stay (LOS) to improve patient safety, efficiency, and satisfaction.

 

 

Primary Learning Outcomes

After completing this lesson, you will be able to:

  • Identify and describe strategies and methods to improve team monitoring of patient flow status related to discharge or admitting.

 

 

QSEN Pre-Licensure Competencies

The following QSEN competencies are addressed in this lesson:

  • 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.
  • Quality Improvement (QI): Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.

 

Story Directions: 

As you listen to and read the story, think about the things that the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.

 

Reflection Questions:

  1. Who do you believe is most at fault for the breakdown in Mrs. Harris’ care in the story? Explain your reasoning.
  2. What strategies and methods for monitoring patient flow could this team use to achieve better quality patient care?

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130 – Sound the Alarm Instructor’s Guide

Thursday, September 25th, 2014

130

Instructor’s Guide – Sound the Alarm


Overview:
This story is about how staff response to safety alarms and patient call lights is essential to ensure patient safety. Preventing patient harm due to falls requires effective strategies and protocols in addition to team vigilance.

 


Primary Learning Outcomes

After completing this lesson, the student will be able to:

  • Explain the factors that affect team response to bed alarms or call signals.
  • Describe team strategies to reduce patient falls through improved response to alarms or call signals.

 

 

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.

 

 

Reflection Questions:

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

  1. What are some reasons that no one responded to Cecil’s alarm? Explain those in the story, as well as others you might infer from the story and your experience.
    A: People often do not respond to alarms because they assume “someone else” is going to respond. Healthcare professionals often do not want to be interrupted from their work, to answer an alarm.
  2. Describe strategies that the team on this floor might be able to use to reduce patient falls and improve their response to alarms and call signals. Identify your top three priorities for improvement based on what you learned in the story.
    A: Patients who are at risk for falls can be placed closer to the nurse’s station or closer together, so they are easier to watch. Also, all staff should be informed of the importance of responding to alarms. It is not just the job of the nurse, but every health care professional is responsible.

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

  1. What can we learn from this story?
    A: That we should not assume that someone else is responding to an alarm. Every healthcare professional is responsible to help deter a patient from falling.
  2. What can you do to influence others on your team to better respond to patient needs?
    A: One way is to acknowledge when other nurses help with your own patients. If healthcare professionals work as a team and keep the patient the focus of care then the responsibility does not fall on only one person.

 

Suggested Classroom Mastery Activities:

These activities can be tailored for individuals or groups in a face to face or online setting. 

  • Create a poster for the staff areas on this floor that reminds the entire medical team of the importance of working together to prevent patient falls and improve their response to alarms and calls.
  • Research other reasons that nurses, doctors, and other medical professionals fail to respond to alarms and calls, and the consequences of their inaction. Share your findings with the class.

 



Measuring Student Mastery: 

Learning Outcome Level 1 Level 2 Level 3
Explain the factors that affect team response to bed alarms or call signals. Student struggles to explain the factors that affect team response to bed alarms or call signals. Student can explain some factors that affect team response to bed alarms or call signals, but needs more practice. Student can explain some factors that affect team response to bed alarms or call signals, but needs more practice.
Describe team strategies to reduce patient falls through improved response to alarms or call signals.  Student struggles to describe team strategies to reduce patient falls through improved response to alarms or call signals. Student can describe some team strategies to reduce patient falls through improved response to alarms or call signals, but needs more instruction. Student can accurately describe team strategies to reduce patient falls through improved response to alarms or call signals.


Additional Story-Specific Resources:

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:

  • Huddles
  • STEP
  • Cross Monitoring
  • Collaboration
  • Call-Out
  • Task Assistance
  • Patient Rounding

Posted in Pro ED Guides, Teacher Guides | No Comments »

129 – The Floor’s Open Instructor’s Guide

Thursday, September 25th, 2014

129

Instructor’s Guide – The Floor’s Open


Overview:
This story is about the importance of patience, flexibility, adaptability, and prior planning during the ‘learning curve’ to manage the changes related to team processes, workflows, and practices when any new technology or information system is introduced.

 


Primary Learning Outcomes

After completing this lesson, the student will be able to:

  • Analyze the impact of new technology on established team processes, practices, and workflows.
  • Describe team strategies to balance workload and prioritize the use of technology or automation against established safe care practices.
  • Explain the importance of demonstrating civility among team members to manage conflict, build trust, and establish open channels of team communication.

 

 

QSEN Pre-Licensure Competencies

The following QSEN competencies are addressed in this lesson:

  • Quality Improvement (QI): Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.
  • 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: PEARLA

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 health care professionals.

    • PEARLA is a technique used for connecting strongly with someone in order to establish their trust when delivering suggestions for correcting unprofessional or disruptive behavior. The letters stand for:

 

    • P (Presence) – Look and see if you are fully present for the discussion or if you are distracted by other concerns or are overly emotional about the situation.
    • E (Empathy) – Use empathic listening skills to actively express your understanding.
    • A (Acknowledge) – Acknowledge the importance to them and to everyone concerned of finding a solution to the problem.
    • R (Reflect/Reframe) – The goal is to reflect back what may be important to the person who is making the statement and provide an alternative way to view the situation that captures what matters most to that person.
    • L (Listen Openly) – Listening openly requires that you listen to the facts, listen to the emotions, notice the body language, and listen for the meaning behind words.
    • A (Ask Clarifying Questions) – Ask open-ended questions to more fully understand the situation from the other’s point of view.

 

Reflection Questions:

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

  1. Why is it important to consider the impact of new technology on established team processes and practices? Use examples from the story to support your answer.
    A: Workflow and processes should be mapped out to allow for evaluation of how new documentation systems can be integrated.
    A: New technology should be beta tested in the environment before deploying in a live patient scenario, to identify unforeseen challenges and evaluated added time needed during the “learning curve”.
    A: Patterns of practice may need alternation when new technologies are introduced. Preemptively expressing that reality, while engaging all the stakeholders, will help to diffuse the early frustrations seen with any change management situation.
  2. Describe how Cindy used PEARLA to address Nancy’s concerns. What else do you think she could have done?
    A: Cindy called Nancy and asked her to meet her in person. This allowed for her to be fully present, but an in person discussion allowed for the opportunity of assessing non-verbal communication.
    A: Pre-emptively, having an opportunity for OR champions of the change with advanced training and beta testing the system deployment, may have helped to thwart the early failure and engage the staff in a more positive, yet difficulty implementation process.
  3. Why is civility in the workplace so important, especially during high stress situations? What consequences could have resulted from Dr. Kaymer’s anger?
    A: Professionalism in the workplace, particularly in the healthcare environment is paramount. High stress situations, such as new technology deployment, needs to well thought out, tested and have identified local champions that have advanced training before the “go live” first case.
    A: The patient’s care and ultimately the procedure itself could have been negatively impacted as well the team morale.
    A: The OR staff stability could have been negatively and permanently impacted had the situation not been quickly diffused.

 

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

  1. What can we learn from this story?
    A: Implementation of a new process requires thoughtful and intentional planning.
    A: Organizational leadership is required for effective implementation of change, to ensure that adequate resources are deployed for the new program or technology.
    A: Relationship management requires thoughtful attention.
  2. What one thing could you do to show other team members that you support them, respect them, and understand their challenges?
    A: The PEARLA technique can be used in professional interactions that are challenging.

 

Suggested Classroom Mastery Activities:

These activities can be tailored for individuals or groups in a face to face or online setting. 

  • Think about some ways you could help team members adjust to the implementation of new technology in your department. What are your strengths and weaknesses in facilitating the implementation of new technology?
  • Describe another scenario in which PEARLA could be useful. Explain how you would use this technique to better communicate with a colleague.
  • Develop a plan for Cindy to implement the next time a new technology or procedure is implemented to better prepare her team.

 



Measuring Student Mastery: 

Learning Outcome Level 1 Level 2 Level 3
Describe the impact of new technology on established team processes, practices, and workflows. Student struggles to describe the impact of new technology on established team processes, practices, and workflows. Student can describe some impacts of new technology on established team processes, practices, and workflows. Student can accurately describe the impact of new technology on established team processes, practices, and workflows.
Describe team strategies to balance workload and prioritize the use of technology or automation against established safe care practices. Student struggles to describe team strategies to balance workload and prioritize the use of technology or automation against established safe care practices. Student can describe some team strategies to balance workload and prioritize the use of technology or automation against established safe care practices. Student can accurately describe team strategies to balance workload and prioritize the use of technology or automation against established safe care practices.
Explain the importance of demonstrating civility among team members to manage conflict, build trust, and establish open channels of team communication.  Student struggles to explain the importance of demonstrating civility among team members to manage conflict, build trust, and establish open channels of team communication. Student can explain some of the importance of demonstrating civility among team members to manage conflict, build trust, and establish open channels of team communication. Student can explain the importance of demonstrating civility among team members to manage conflict, build trust, and establish open channels of team communication.

 


Additional Story-Specific Resources:

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:

  • PEARLA

Posted in Pro ED Guides, Teacher Guides | No Comments »

128 – Welcome to the Team Instructor’s Guide

Thursday, September 25th, 2014

128

Instructor’s Guide – Welcome to the Team


Overview:
This story is about how bullying, hazing, and lateral violence are frequently part of a healthcare professional’s indoctrination. These practices cause both unnecessary stress and premature abandonment of the field, and often compromise both the satisfaction and safety of patients.

 


Primary Learning Outcomes

After completing this lesson, the student will be able to:

  • Explain and evaluate on-boarding practices to ensure proper supervision for safe, competent, and quality patient care.
  • Describe the importance of adopting “no bullying, no hazing” policies and protocols.
  • Clarify and explain the responsibility of team members in creating a climate of respect and professionalism for new team members.

 

 

QSEN Pre-Licensure Competencies

The following QSEN competencies are addressed in this lesson:

  • 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.
  • Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.

 

 

Reflection Questions:

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

  1. What does this story illustrate about the importance of shared on-boarding practices?
    A: Susie was not put in a position to succeed. This not only put her in danger, but also the hospital and Trey.
  2. Explain how Karen and Alice failed to create a climate of respect and professionalism in this story.
    A: Karen and Alice spoke negatively about having nursing students on the floor and that attitude continued to Susie. She was not included in the report or welcomed to the department.
  3. How did Karen and Alice, and the procedures in place at the hospital, fail to minimize the risk of harm to Susie and Trey in this story? What should have been done instead?
    A: Alice should have learned more about Susie’s clinical skills, strengths and weaknesses. Alice is responsible for the care that Susie provides to each of the patients and needs to know the scope of Alice’s training.
    A: It is not sufficient for a preceptor to ask if a trainee knows something, she needs to also assess that skill.

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

  1. What can we learn from this story?
    A: That bullying and hazing can come in different forms and does not always look the same. Alice might not think she is being a bully, but she needs to know her behavior is not acceptable.
  2. What one thing can you do to ensure all team members are treated with respect, regardless of rank, position, or role?
    A: One way is to “talk up” a colleague. Karen could have discussed how nice it is to have a new member to their team. Susie may be able to contribute in ways Karen and Alice did not realize.
  3. Have you witnessed or been a victim of hazing or bullying from other colleagues, classmates, or staff members? How did it make you feel?
    A: It becomes a negative environment when nurses speak negatively about each other. Lateral violence, bullying, and hazing are all too common in the healthcare field. One way to stop this is to use open communication and learn to collaborate with all healthcare team members.

 

Suggested Classroom Mastery Activities:

These activities can be tailored for individuals or groups in a face to face or online setting. 

  • Continue this story from Susie’s perspective. How do you think Karen and Alice’s actions and words in this story might affect her future in the profession?
  • Create a presentation to educate others on the effects of bullying and hazing in the medical profession. Use the Professional Conduct Survey to learn more about issues in the medical workplace, and do other research on your own.

 



Measuring Student Mastery: 

Learning Outcome Level 1 Level 2 Level 3
Explain and evaluate on-boarding practices to ensure proper supervision for safe, competent, and quality patient care.  Student struggles to explain and evaluate on-boarding practices to ensure proper supervision for safe, competent, and quality patient care. Student can explain and evaluate some on-boarding practices to ensure proper supervision for safe, competent, and quality patient care, but needs more practice. Student can accurately explain and evaluate on-boarding practices to ensure proper supervision for safe, competent, and quality patient care.
Describe the importance of adopting “no bullying, no hazing” policies and protocols. 
 Student struggles to describe the importance of adopting “no bullying, no hazing” policies and protocols. Student can describe some of the importance of adopting “no bullying, no hazing” policies and protocols, but needs further instruction. Student can accurately describe the importance of adopting “no bullying, no hazing” policies and protocols.
Clarify and explain the responsibility of team members in creating a climate of respect and professionalism for new team members.  Student struggles to clarify and explain the responsibility of team members in creating a climate of respect and professionalism for new team members. Student can clarify and explain some of the responsibility of team members in creating a climate of respect and professionalism for new team members, but needs further practice. Student can accurately clarify and explain the responsibility of team members in creating a climate of respect and professionalism for new team members.

 
 

Additional Story-Specific Resources:

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:

  • CUS
  • STEP
  • I’M SAFE
  • Feedback
  • DESC Script
  • Collaboration
  • Task Assistance
  • 3Ws – Who I Am, What I am Doing, and Why I Care
  • “Speak Up”
  • 4 Step Process
  • PEARLA

Posted in Pro ED Guides, Teacher Guides | No Comments »

127 – Caution for CAUTI Instructor’s Guide

Thursday, September 25th, 2014

127

Instructor’s Guide – These Things Happen


Overview:
This story describes the importance of following best practice protocols, such as the IHI bundle, to prevent urinary catheter associated infections. Use of a daily checklist ensures appropriate practices and guidelines are followed to decrease potential for infection.

 


Primary Learning Outcomes

After completing this lesson, the student will be able to:

  • Describe and apply safe guidelines for placement, care, and removal of urinary tract catheters.
  • Generate strategies to ensure urinary tract catheter safe practices are strictly followed.
  • Explain and adopt methods for challenging team members when safety protocols are not followed for any reason.

 

 

QSEN Pre-Licensure Competencies

The following QSEN competencies are addressed in this lesson:

  • Evidence-Based Practice (EBP): Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
  • Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.

 

 

Reflection Questions:

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

  1. Describe commonly accepted safe guidelines for the placement, care, and removal of urinary tract catheters. How were these Evidence-Based Practices not utilized in this story?
    A: This facility did not have protocol or evidence based practice standards regarding the use and removal of urinary tract catheters. Many facilities have protocol and standing orders to guide the healthcare team on urinary tract catheter removal times.
  2. What strategies could be used in this hospital to ensure that preventable CAUTIs do not continue to occur?
    A: One way is to established guidelines and standing orders so that nurses can follow the protocol and are not reliant on their own personal judgement. This also allows doctors to use their time to do other things and will not be called as often to answer questions about urinary catheter removal.
  3. How does this story demonstrate the importance of teamwork and communication that is focused on patient safety?
    A: The hospital staff did not acknowledge Sue Ella’s concerns regarding the urinary tract infection. They could have communicated with her in a more empathetic and informative way.

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

  1. What can we learn from this story?
    A: The nurses could have asked the doctor, within the first day after surgery, to remove the catheter, but they did not.
    A: We have also learned the importance of having a catheter checklist or protocol.
  2. What is one thing you could do to prevent CAUTIs with your patients?
    A: Be proactive and remove the catheter as soon as medically possible. The patient should not suffer more because a checklist is not currently in place.

 

Suggested Classroom Mastery Activities:

These activities can be tailored for individuals or groups in a face to face or online setting. 

  • Develop a safe catheter practices checklist for this hospital to use to avoid a situation like this one in the future.
  • Brainstorm a list of strategies to ensure that preventable CAUTIs are avoided at this hospital. Share your list with a classmate, and develop a top ten list of reminders for medical professionals to prevent CAUTIs.
  • Describe the possible consequences for both the patient and the hospital when situations like the one in this story occur. Why is it important for all team members to understand the consequences of their action or inaction for both patients, themselves, and the hospital?

 



Measuring Student Mastery: 

Learning Outcome Level 1 Level 2 Level 3
Describe and apply safe guidelines for placement, care, and removal of urinary tract catheters. Student struggles to describe and apply safe guidelines for placement, care, and removal of urinary tract catheters. Student can describe and apply some safe guidelines for placement, care, and removal of urinary tract catheters, but needs more practice. Student can accurately describe and apply safe guidelines for placement, care, and removal of urinary tract catheters.
Generate strategies to ensure urinary tract catheter safe practices are strictly followed. Student struggles to generate strategies to ensure urinary tract catheter safe practices are strictly followed. Student can generate some strategies to ensure urinary tract catheter safe practices are strictly followed, but needs more practice. Student can generate strategies to ensure urinary tract catheter safe practices are strictly followed.
Explain and adopt methods for challenging team members when safety protocols are not followed for any reason. Student struggles to explain and adopt methods for challenging team members when safety protocols are not followed for any reason. Student can explain and adopt some methods for challenging team members when safety protocols are not followed for any reason, but needs more practice. Student can explain and adopts methods for challenging team members when safety protocols are not followed for any reason.
Additional Story-Specific Resources:

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:

  • CUS
  • Huddles
  • Cross Monitoring
  • Collaboration
  • Two-Challenge Rule
  • Advocacy and Assertion
  • “Speak Up”
  • STEP

Posted in Pro ED Guides, Teacher Guides | No Comments »

130 – Sound the Alarm Student’s Guide

Thursday, September 25th, 2014

130

Student’s Guide – Sound the Alarm


Overview:
This story is about how staff response to safety alarms and patient call lights is essential to ensure patient safety. Preventing patient harm due to falls requires effective strategies and protocols in addition to team vigilance.

 

 

Primary Learning Outcomes

After completing this lesson, you will be able to:

  • Explain the factors that affect team response to bed alarms or call signals.
  • Describe team strategies to reduce patient falls through improved response to alarms or call signals.

 

 

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.

 

 

Story Directions: 

As you listen to and read the story, think about the things that the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.

 

Reflection Questions:

  1. What are some reasons that no one responded to Cecil’s alarm? Explain those in the story, as well as others you might infer from the story and your experience.
  2. Describe strategies that the team on this floor might be able to use to reduce patient falls and improve their response to alarms and call signals. Identify your top three priorities for improvement based on what you learned in the story.

Posted in Pro ED Guides, Student Guides | No Comments »

129 – The Floor’s Open Student’s Guide

Thursday, September 25th, 2014

129

Student’s Guide – The Floor’s Open


Overview:
This story is about the importance of patience, flexibility, adaptability, and prior planning during the ‘learning curve’ to manage the changes related to team processes, workflows, and practices when any new technology or information system is introduced.

 

 

Primary Learning Outcomes

After completing this lesson, you will be able to:

  • Analyze the impact of new technology on established team processes, practices, and workflows.
  • Describe team strategies to balance workload and prioritize the use of technology or automation against established safe care practices.
  • Explain the importance of demonstrating civility among team members to manage conflict, build trust, and establish open channels of team communication.

 

 

QSEN Pre-Licensure Competencies

The following QSEN competencies are addressed in this lesson:

  • Quality Improvement (QI): Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.
  • 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: PEARLA

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 health care professionals.

  • PEARLA is a technique used for connecting strongly with someone in order to establish their trust when delivering suggestions for correcting unprofessional or disruptive behavior. The letters stand for:

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    • P (Presence) – Look and see if you are fully present for the discussion or if you are distracted by other concerns or are overly emotional about the situation.
    • E (Empathy) – Use empathic listening skills to actively express your understanding.
    • A (Acknowledge) – Acknowledge the importance to them and to everyone concerned of finding a solution to the problem.
    • R (Reflect/Reframe) – The goal is to reflect back what may be important to the person who is making the statement and provide an alternative way to view the situation that captures what matters most to that person.
    • L (Listen Openly) – Listening openly requires that you listen to the facts, listen to the emotions, notice the body language, and listen for the meaning behind words.
    • A (Ask Clarifying Questions) – Ask open-ended questions to more fully understand the situation from the other’s point of view.

 

Story Directions: 

As you listen to and read the story, think about what you think the team members did well, and the things you think that could lead to errors. Also, keep the questions below in mind as you listen.

 

Reflection Questions:

  1. What safety protocols that can help prevent the risk of CLABSI were violated in this scenario?
  2. QSEN requires you to discriminate between valid and invalid reasons for modifying evidence-based clinical practice based on clinical expertise or patient/family preferences. Do you think Dr. Long’s deviations from EBP in this scenario were valid or invalid? Explain your reasoning.
  3. Thinking about the TeamSTEPPS best practice “CUS” described earlier, when and how could Carly have employed this technique to better advocate for her patient’s safety?

 

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128 – Welcome to the Team Student’s Guide

Thursday, September 25th, 2014

128

Student’s Guide – Welcome to the Team


Overview:
This story is about how bullying, hazing, and lateral violence are frequently part of a healthcare professional’s indoctrination. These practices cause both unnecessary stress and premature abandonment of the field, and often compromise both the satisfaction and safety of patients.

 

 

Primary Learning Outcomes

After completing this lesson, you will be able to:

  • Explain and evaluate on-boarding practices to ensure proper supervision for safe, competent, and quality patient care.
  • Describe the importance of adopting “no bullying, no hazing” policies and protocols.
  • Clarify and explain the responsibility of team members in creating a climate of respect and professionalism for new team members.

 

 

QSEN Pre-Licensure Competencies

The following QSEN competencies are addressed in this lesson:

  • 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.
  • Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.

 

 

Story Directions: 

As you listen to and read the story, think about the things that the team members did well, and the things you think could lead to errors. Also, consider the questions below as you listen.

 

Reflection Questions:

  1. What does this story illustrate about the importance of shared on-boarding practices?
  2. Explain how Karen and Alice failed to create a climate of respect and professionalism in this story.
  3. How did Karen and Alice, and the procedures in place at the hospital, fail to minimize the risk of harm to Susie and Trey in this story? What should have been done instead?

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