Archive for the ‘Student Guides’ Category
Thursday, October 2nd, 2014
155
Student’s Guide – No Shortcuts to Risk Reduction
Overview:
This story is about surgical site infections (SSIs). According to the CDC, SSIs are the second most common healthcare-acquired infection. Following evidence-based perioperative practices such as using precautions to prevent contamination of sterile equipment can prevent the risk of SSI.
Primary Learning Outcomes
After completing this lesson, you will be able to:
- List evidence-based perioperative practices that prevent SSIs.
- Demonstrate awareness of techniques to resolve conflict when team members take shortcuts in perioperative practices.
- Describe a strategy to improve SSI preventative practices, such as implementation of the WHO SSI checklist.
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.
- Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
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.
CUS: 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:
- First, state your Concern.
- Then state why you are Uncomfortable.
- 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:
- What evidence-based perioperative practices were ignored in this story? Why are they important to follow?
- What barriers did Celeste face in addressing the breaks in evidence-based practice that she witnessed? What does this say about the norms of the unit?
- How could the use of the CUS Technique have helped Celeste address her concerns?
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Thursday, October 2nd, 2014
154
Student’s Guide – Patients are People Too
Overview:
This story illustrates how knowing about being patient-centered, and actually doing it, are two different things, and that staff must be intentional and self-aware about engaging the patient.
Primary Learning Outcomes
After completing this lesson, you will be able to:
- Identify the core components of patient-centered behavior.
- Describe the importance of planning for all care providers to demonstrate patient-centered behaviors in all interactions with patients and family members.
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:
- What important elements of patient-centered care did Tiana and Javier miss in this story?
- Why is it important to view events from the patient’s perspective when evaluating the efficacy of patient-centered care?
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Thursday, October 2nd, 2014
153
Student’s Guide – No One Sits Until Everyone Sits
Overview:
This story is about mutual support and task assistance, and how offering assistance to other team members when your workload permits promotes safety, mutual trust, efficiency, productivity, and service excellence.
Primary Learning Outcomes
After completing this lesson, you will be able to:
- Describe the importance of adopting task sharing norms across team members to effectively manage workload.
- Identify high threat practices or protocols requiring increased shared vigilance.
- Generate team norms for engaging non-supportive team members to provide consistent mutual support.
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.
- 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.
QSEN Teamwork & Collaboration Enrichment
TeamSTEPPS® Best Practice: Task Assistance
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.
Task Assistance is guided by situation monitoring because situation awareness allows team members to effectively identify the need for assistance by others on the team. To a certain degree, some of us have been conditioned to avoid asking for help because of the fear of suggesting lack of knowledge or confidence. Many people refuse to seek assistance when overwhelmed by tasks. In support of patient safety, however, task assistance is expected. One of the most important concepts to remember with regard to Task Assistance is that assistance should be actively given and offered whenever there is a concern for patient safety related to workload. Task assistance may involve asking for assistance when overwhelmed or unsure; helping team members to perform their tasks, shifting workload by redistributing tasks to other team members, delaying/rerouting work so the overburdened member can recover, and/or filling in for overburdened team members when necessary.
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:
- What does this story illustrate about the importance of task assistance across the unit and hospital?
- What high threat practices and protocols were occurring in this story?
- What team norms did Jane establish for engaging non-supportive team members to provide consistent mutual support across the unit? Why was this important?
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Thursday, October 2nd, 2014
152
Student’s Guide – Let’s Huddle Up Here
Overview:
This story illustrates the importance of the TeamSTEPPS® “huddle” tool to keep everyone on the same page and allow for brief problem-solving before continuing the treatment plan as a patient’s condition changes.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Identify the types of situations where huddles could be advantageous in coordinating patient care.
- Explain how and when huddles should be conducted.
- Describe how to adopt huddles as a normal problem-solving event for improved patient care.
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: Huddles
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.
Huddles: A huddle is a tool for reinforcing the plans already in place for the treatment of patients and for assessing the need to change plans. It can also help develop a shared understanding between team members of the plan of care and provides team leaders with the opportunity to informally monitor patient and unit-level situations. Huddles are particularly useful because information and patient status change over time, requiring ongoing monitoring and updating of the team. It may just be a matter of a sudden increase in the activity level of an individual or the team needing to reevaluate workload status. Workload distribution may have to be adjusted as a result. Information updates within the team should occur as often as necessary, and can take the form of a huddle at the status board or can occur between individual team members whenever new information needs to be shared.
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:
- How would a huddle have been useful in this story?
- How could the use of huddles help a team better coordinate patient care?
- What were the barriers to using huddles in this story? How could they have been overcome?
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Thursday, October 2nd, 2014
151
Student’s Guide – CUS-sing for Safety’s Sake
Overview:
This story is about CUS, a TeamSTEPPS® tool that helps care providers find the right words to express their concerns when they become aware of something they think will compromise patient safety.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe situations where the TeamSTEPPS® CUS tool would be appropriate to use to advocate for patient safety.
- Generate a plan for and practice using the TeamSTEPPS® CUS tool among providers and staff where there are unexpressed concerns about patient safety.
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.
- 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 Technique
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:
- First, state your Concern.
- Then state why you are Uncomfortable.
- 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:
- Why was the use of CUS so important in this story? What might have happened if it had not been employed?
- Why is it important to express your concerns, regardless of hierarchy?
- What barriers did Marylou have to overcome in order to successfully use the CUS strategy?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
150
Student’s Guide – See You Soon
Overview:
This story illustrates the likelihood of readmission in the absence of a coordinated care plan for the patient. Readmissions are often caused by preventable complications that occur during a transition from one care setting to another and may reflect poor coordination of care.
Primary Learning Outcomes
After completing this lesson, you will be able to:
- List components of a coordinated discharge plan.
- Describe how to modify discharge processes to enhance communication between the hospital and discharge settings.
- Explain the importance of creating opportunities to involve patients and their families in discharge planning.
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:
- What components of a coordinated discharge plan are missing from this story?
- How could Andrea have modified her discharge process to enhance communication between the hospital and Mei Li and her family?
- What could Andrea have done to ensure that Anna was included in the discharge planning process?
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Thursday, October 2nd, 2014
149
Student’s Guide – Room for Improvement
Overview:
This story addresses patient falls. According to reports by the IHI, Robert Wood Johnson Foundation, and several studies, falls are three times more likely in hospitals and nursing homes than in the community. It is every team member’s responsibility to help prevent falls.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe strategies to assess patients at risk for fall or at risk for injury from falls.
- Explain evidence-based fall prevention best practices.
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.
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:
- What evidence-based practices could be used to prevent falls and reduce harm from falls?
- What could have been done in this story to prevent Mrs. Shreaver’s fall?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
148
Student’s Guide – One Big Team
Overview:
This story demonstrates the benefits of a care team functioning as a unified whole where everyone assumes responsibility for every job getting done when it comes to the patient’s safety and satisfaction.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Identify and summarize the problems that are caused by an “it’s not my job” attitude.
- Generate guidelines for how to respond to patients’ requests when the request is outside the staff member’s particular functional responsibilities.
- Describe the importance of the distribution of guidelines to every unit in the hospital.
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.
- 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:
- How did the “it’s not my job” attitude of the staff in the story affect Kathy’s care?
- How could guidelines that help staff members respond to patient requests outside of their responsibilities have helped Kathy?
- Why is it important that all staff members are on the same page regarding policies about patient-centered care?
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Thursday, October 2nd, 2014
147
Student’s Guide – Can You Suggest A Solution?
Overview:
This story is about how you can put the emphasis on respectful problem-solving and building buy-in and responsibility-taking when disruptive or unprofessional behavior affects patients by slowing their care, thereby increasing the risk of error or omission.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Summarize the tools and techniques used in an engagement approach to resolving unprofessional conduct issues.
- Evaluate the appropriateness of an engagement approach versus a disciplinary approach for any given example of unprofessional conduct.
- Plan for an engagement-approach discussion with a peer or subordinate who is exhibiting unprofessional conduct.
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:
- What tools and techniques were used in this story to resolve unprofessional conduct issues?
- Do you think Kim would have had a different reaction from Bob if she had taken a disciplinary approach to the problem? Why?
- What do you think Kim did well in this story to begin building the kind of teamwork she wants to see in her unit?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
146
Student’s Guide – Hidden in Plain Sight
Overview:
This story is about how healthcare as seen through the patient’s eyes is often perceived as serving the staff’s needs instead of the patient’s. The cumulative effect of many small issues can make the care look disjointed and unprofessional.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe what care looks like through a patient’s eyes.
- Describe what needs to be included in the professional code of conduct to make it more patient-centered.
- Explain the importance of integrating patient-centered principles into policies and procedures.
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:
- Imagine you were Sara’s mom. How would you describe the experience at this hospital to your friends and family?
- How could the medical staff in this story have been more patient-centered?
- Why is it important to integrate patient-centered principles into policies and procedures? How could they have improved Sara’s experience?
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