Archive for the ‘Pro ED Guides’ Category
Thursday, October 2nd, 2014
160
Student’s Guide – Admission of Failure
Overview:
This story is about preventable readmissions. They may result from incomplete treatment or poor care of the underlying problem, or may reflect poor coordination of services at the time of discharge. Every team member is responsible for the discharge process.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe evidence-based strategies that reduce preventable readmissions.
- Explain the importance of arranging for all patients to be encouraged to ask questions about their discharge plans during transitions from hospital to community settings.
- Generate a protocol to coordinate care between hospital and community settings.
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.
- Evidence-Based Practice (EBP): Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health 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:
- How did General Hospital fail to prevent Akiki’s relapse?
- What evidence-based strategies to reduce preventable readmissions did Helen employ? Why were they important?
- What does this story illustrate about the importance of including families and patients in the discharge planning process?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
159
Student’s Guide – Brief to Set the Tone
Overview:
Team leaders must set the tone for service excellence. Without collective decision-making, targeted goal setting and clear roles and responsibilities, team performance suffers. This has a negative impact on patient satisfaction and safety.
Primary Learning Outcomes
After completing this lesson, you will be able to:
- Describe the components of successful team briefing.
- Describe the importance of planning for contingencies related to staffing, resources, and equipment.
- Explain how to integrate safe practices into daily work practices by inviting team accountability and back-up behaviors.
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.
QSEN Teamwork & Collaboration Enrichment
TeamSTEPPS® Best Practice: Team Briefs
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.
Team Briefs: Similar to a pre-flight checklist used in aviation, during a brief the team leader should cover the items on the checklist. As in aviation, the briefings before flights provide the ideal forum for building a team dynamic that allows everyone to work together when carrying out routine tasks and when tackling unexpected problems. Briefs serve the following purposes:
- They clarify who will be leading the team so that others know to whom to look for guidance;
- They open lines of communication among team members, ensuring that everyone can contribute their unique knowledge base to the task, and thereby set the tone for the upcoming procedure. Protocols, responsibilities, and expected behaviors are discussed and reinforced so that possible misunderstandings are avoided;
- They prepare the team for the flow of the procedure, contingency plans, and the means for resolving any unusual circumstances; and,
- By delineating expectations, they reduce disruptive or unexpected behaviors.
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 successful team briefings are demonstrated in this story?
- What do you feel Charlie did well in this story that helped build up his team?
- What does this story illustrate about the importance of integrating safe practices into daily work practices by inviting team accountability and back-up behaviors?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
158
Student’s Guide – The Tiger Gets New Stripes
Overview:
This story is about the deviation from safety protocols. It is a leading cause of patient harm. Executive leaders must hold all providers and staff accountable for safe practices and protocols. Coaching for engagement is a strategy for gaining buy-in and behavior change.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Explain the consequences of not consistently following safety protocols or practices.
- Describe the importance of applying consistent consequences across all disciplines for not following safe 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:
- Why is it important that all team members consistently follow safety protocols and practices?
- Why was it imperative for Mr. Porter to establish the same standard for Dr. Barnes as he expected from the rest of the staff?
- If you were on this surgical team, what could you have done to help ensure that safety protocols were consistently practiced?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
157
Student’s Guide – Improving Medication Safety
Overview:
This story is about how labor nurses are at risk for professional liability when titration results in uterine tachysystole aren’t recognized in a timely manner, and how effective nurse-doctor communication is crucial to provide an outstanding patient experience.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe the roles and responsibilities of team members in reducing patient harm associated with the use of oxytocin.
- Describe evidence-based strategies to enable team members to speak up and intervene in an unsafe situation involving oxytocin.
- Explain and adopt IHI elective induction and augmentation bundles.
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 are the responsibilities of team members in reducing patient harm associated with the use of oxytocin?
- How were those responsibilities fulfilled and neglected in this story?
- What could be done to better empower Francine to speak up and intervene when she sees and unsafe situation involving oxytocin?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, October 2nd, 2014
156
Student’s Guide – Everyone is a Monitor
Overview:
This story is about the impacts of adverse drug events (ADEs). Proper communication protocols between physicians and nursing home staff are essential to prevent patient ADEs.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe evidence-based practices to improve medication safety, and the challenges in ensuring medication safety.
- Identify steps to improve medication safety, including empowering patients to be aware of the medications they are taking.
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 for medication safety were not followed in this story?
- What are some ways this team could ensure better medication safety for their patients?
Posted in Pro ED Guides, Student Guides | No Comments »
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?
Posted in Pro ED Guides, Student Guides | No Comments »
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?
Posted in Pro ED Guides, Student Guides | No Comments »
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?
Posted in Pro ED Guides, Student Guides | No Comments »
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?
Posted in Pro ED Guides, Student Guides | No Comments »
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 »
