Archive for the ‘Student Guides’ Category

113 – Getting to the Heart of the Matter Student’s Guide

Thursday, September 18th, 2014

113

Student’s GuideGetting to the Heart of the Matter


Overview:
This story is about the importance of recognizing that performance data reports alone may not tell the whole story. Leaders must assess multiple problems and challenges on a unit face-to-face, using walk-rounds and ‘ad hoc’ informal rounding.

 

 

Primary Learning Outcomes
After completing this lesson, you should be able to:

  • Describe the importance of being willing to speak up, question, and clarify abnormalities that could lead to patient harm.
  • Explain the importance of empowering all staff members to create an outstanding patient experience.

 

 

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.

 

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 might this story have been different if Meg had not visited the floor in question? What opportunities might she have missed if she had not visited the floor?
  2. How did Meg’s demeanor empower Nancy to become part of the solution to fixing her floor’s problems?

112 – Trusting Enough to Do the Right Thing Student’s Guide

Thursday, September 18th, 2014

112

Student’s GuideTrusting Enough to Do the Right Thing


Overview:
This story addresses the issue of cross monitoring as it relates to error prevention. A work environment that encourages staff to openly share concerns related to the safety of patients is necessary for optimal patient care and experience.

 

 

Primary Learning Outcomes
After completing this lesson, you should be able to:

  • Describe the importance of reporting concerns to ensure patient safety.
  • Describe the importance of applying reporting principles without fear of retribution or punishment.

 

 

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.

 

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 Allison put Sarah’s health and safety at risk in this story?
  2. What conditions exist in this story that prevented Allison from reporting her concerns about Sarah’s health and safety? How could Colleen address those conditions in the future?

111 – When Shared Mental Models Shatter Student’s Guide

Thursday, September 18th, 2014

111

Student’s GuideWhen Shared Mental Models Shatter


Overview:
This story addresses the impact disruptive behavior has on teamwork, communication, patient safety, and patient satisfaction. Each person involved in patient care, regardless of position, must conduct themselves in a professional manner.

 

Primary Learning Outcomes
After completing this lesson, you should be able to:

  • Describe the importance of adopting standards of professional conduct.
  • Classify individual behaviors as acceptable and unacceptable.

 

 

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.

 

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. What does this story illustrate about the importance of adopting standards of professional conduct?
  2. Describe the behavior in this story that you believe to be unprofessional. What should have been done instead?

110 – Double Check Three Times Student’s Guide

Thursday, September 18th, 2014

110

Student’s GuideDouble Check Three Times


Overview:
This story addresses the issue of double checking and verifying patient identification before administering medication while dealing with fatigue, and simultaneously anticipating family needs when moving a patient to a new room. Adding fatigue to the situation suddenly opens up the possibility for serious error.

 

 

Primary Learning Outcomes

After completing this lesson, you should be able to:

  • Describe strategies to assess and manage the effects of fatigue on individual and team performance
  • Explain the importance of developing and maintaining communications systems for signaling team members, patients, and family members when changes occur in the plan of care.
  • Describe methods for ‘double checking’ high risk patient care practices such as medication administration.

 

 

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 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. What does this story illustrate about the importance of communicating with team members, especially when fatigue becomes an issue at the end of a shift?
  2. What could this team have done to alleviate the stress and safety concerns caused by Mr. Pappas’ move to a new room?
  3. What were some ways that Diane employed “double-checking” during this story? What might the consequences have been if she hadn’t?

109 – Seize the Moment Student’s Guide

Thursday, September 18th, 2014

109

Student’s GuideSeize the Moment


Overview:
This story is about how every staff member’s job is to recognize that what we experience as routine is for the patient a journey that is filled with fear and concern. It emphasizes the positive impact staff members have on patients when they provide reassurance and support.

 

 

Primary Learning Outcomes
After completing this lesson, you should be able to:

  • Describe how going beyond your role to address the emotional needs of patients can positively impact their experience.
  • Describe strategies that can be used by individuals and team members to help deliver an exceptional patient experience regardless of position, role, or status.

 

 

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.

 

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. Explain how this story demonstrates the effect of going beyond your role on the patient’s total experience.
  2. Describe how Terrell and Olivia’s teamwork helped make Mrs. Ferren’s experience more pleasant and safe.

108 – Decision to Indecision Student’s Guide

Thursday, September 18th, 2014

108

Student’s GuideDecision to Indecision


Overview:
This story addresses the importance of effective and consistent forms of team communication. Staff should feel empowered to speak up, assert, and advocate on behalf of the patient and the team regardless of perceived organizational hierarchies.

 

 

Primary Learning Outcomes
After completing this lesson, you should be able to:

  • Describe and apply assertive statements or signal phrases to express safety concerns among team members regardless of hierarchy, using the CUS Technique.
  • Describe the importance of adopting communication methods and strategies for improving team decision-making during emergent situations that include the patient and family.

 

 

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.
  • 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: CUS

  • 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.

 

  • The CUS technique provides a framework for conflict resolution, advocacy, and mutual support. Signal words, such as “danger,” “warning,” and “caution” are common in the medical arena. They catch the reader’s attention. “CUS” and several other signal phrases have a similar effect in verbal communication. When they are spoken, all team members will understand clearly not only the issue, but also the magnitude of the issue.
     
          CUS Technique:
    1. First, state your Concern.
    2. Then state why you are Uncomfortable.
    3. If the conflict is not resolved, state that there is a Safety issue.

 

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. Describe how breaks in Evidence-Based Practice (EBP) put the patient and her baby in danger in this story.
  2. What do you believe Beth did well in the story?
  3. Describe the barriers that Beth faced in her attempt to advocate for her patient with other team members. How could use of the CUS Technique have helped her overcome those barriers?

107 – Anything Else You Want to Tell Us Student’s Guide

Thursday, September 18th, 2014

107

Student’s GuideAnything Else You Want to Tell Us


Overview:
This story is about bedside handoffs and the opportunities they present to share and receive information with the patient and the family. When done well, trust and connections will be established, resulting in staff members meeting the patients’ needs more efficiently.


Primary Learning Outcomes

After completing this lesson, you should be able to:

  • Recall and articulate ways to engage patients and make an emotional connection.
  • Describe the importance of examining the accuracy of patient information across the care continuum by including the patient and family members in the assessment and handoff process.
  • Demonstrate the ability to articulate a patient-centered approach to bedside handoffs to establish personal connections with patients and families, using the I PASS the BATON technique.

 

 

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.
  • 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: I PASS the BATON

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.

I PASS the BATON is a powerful tool that can be used for handoff of care anytime the complete responsibility for the patient from one entity to another, i.e., department to department or facility to facility. I PASS the BATON is a long acronym and usually the caregivers who adopt this tool build a checklist that uses the acronym as its foundation. The letters stand for:

  • I PASS the BATON Technique:
  • I (Introduction) Introduce yourself and your role/job
  • P (Patient) Name, identifiers, age, sex, location
  • A (Assessment) Present vital signs, chief complaint, symptoms and diagnosis
  • S (Situation) Current status/circumstances
  • S (Safety Concerns) Critical lab values/reports, allergies, alerts
  • B (Background) Co-morbidities, previous episodes, current medications, family history
  • A (Actions) What actions were taken or are required
  • T (Timing) Level of urgency and timing/prioritization of actions
  • O (Ownership) Who is responsible for care going forward, including patient and family
  • N (Next) What will happen next? What is the plan?

 

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. What do you believe were the most critical safety concerns revealed in the story? How could they be prevented in the future?
  2. How does this story illustrate the importance of making a personal connection with the patient and family? What were some things that Teresa and Cathy did to ensure that they had the patient’s trust and full attention?
  3. How could a checklist based on the “I PASS the BATON” technique have alleviated some of the issues in this story? What procedures do you think this hospital needs to address and why?

106 – Missed Our Chat Today Student’s Guide

Thursday, September 18th, 2014

106

Student’s GuideMissed Our Chat Today


Overview:

This story is about making a human connection with a patient and how small personal touches and recognizing the needs of others are the key to an exceptional patient experience.


 
Primary Learning Outcomes

After completing this lesson, you should be able to:

  • Recall and describe ways to engage patients to make an emotional connection.
  • Discover and explain techniques for seeing care through the patient’s eyes.

 


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.

 

 
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 might you make an emotional connection with a patient on a regular basis in your role?
  2. What is one thing you could do to see through the patient’s eyes to better anticipate their emotional needs?

105 – The Courage to Make the Call Student’s Guide

Thursday, September 18th, 2014

105

Student’s GuideThe Courage to Make the Call


Overview:

This story is about how a nurse questions a written physician order that doesn’t seem to make sense clinically. The physician is contacted immediately and the order is changed preventing a medication error. It is a prime example of the value of cross monitoring.


Primary Learning Outcomes

After completing this lesson, you should be able to:

  • Describe the importance of comparing written orders in the context of the entire patient care plan to ensure accuracy and patient safety.
  • Explain and apply evidence-based strategies that can limit distractions, interruptions, and multitasking during critical care activities.
  • Recognize the importance of cross monitoring skills across the medical care team, regardless of position, status, or hierarchy to create trust and prevent errors.


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.
  • Evidence-Based Practice (EBP): Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
  • 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 Evidence-Based Practice Enrichment

Evidence Based Practice: Handoffs

  • Handoffs include the transfer of knowledge and information about the degree of uncertainty (or certainty about diagnoses, etc.), response to treatment, recent changes in condition and circumstances, and the plan (including contingencies). In addition, both authority and responsibility are transferred. Lack of clarity about who is responsible for care and for decision-making has often been a major contributor to medical error (as identified in root cause analyses of sentinel events and poor outcomes).

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. What systemic errors or lack of procedures put Mr. Carlson in danger in this story? What individual errors could have caused him harm?
  2. Handoffs are an evidence-based practice (EBP) that help ensure patient safety. What went well in the handoff of Mr. Carlson from Diane to Carol? What could have been improved?
  3. What might have been the consequences for Mr. Carlson had Carol and Diane not called Dr. Jackson? What does this story illustrate about the need to communicate, regardless of hierarchy?

104 – You Tell Me All About It Student’s Guide

Thursday, September 18th, 2014

104

Student’s GuideYou Tell Me All About It

Overview:
This story is about a staff member who goes beyond her role to deliver an excellent patient experience.  Seeing the person, not just the patient, is essential to making personal connections leading to outstanding care from the patient perspective.


Primary Learning Outcomes

After completing this lesson, you should be able to:

  • Describe patient-centered principles that can be applied to routine patient and family interactions, and the importance of valuing all members of the team.
  • Describe patient needs beyond immediate clinical tasks by seeing the person, not just the patient.


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.

 

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. As a member of the housekeeping department, Ernestine might not be considered part of the patient care team by some medical staff. What does this story demonstrate about the need to value all members of the team, regardless of their role?
  2. What do you believe Ernestine did in this story that demonstrated her ability to see the person, not just the patient? How could you apply that thinking to your role?