Archive for the ‘Pro ED Guides’ Category
Thursday, September 18th, 2014
120
Instructor’s Guide – Doctor, I’m Concerned…
Overview:
This story is about what happens when a patient is allowed to leave a cardiac clinic without critical test results being examined and resolved because the protocols for allowing a patient to leave were either non-existent or not followed by the staff.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Demonstrate and apply critical language to advocate for patient safety.
- Demonstrate the ability to explain the “why” to patients related to safe practices and protocols.
- Describe the use of a team huddle for problem-solving related to all patient safety concerns.
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.
- 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: Team 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.
- A team huddle is an ad hoc meeting to discuss issues, realign resources, and modify the plan.
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
- What critical language could Caroline have used with Dr. Feldman? With Harry?
A: Caroline could have told Dr. Feldman that Harry was intending on leaving and the lab results were not back. She could have told Harry the seriousness of his situation and the potential adverse effects if he were to leave the office.
- Describe how Caroline could have better explained the “why” to Harry in this story.
A: Caroline needed to remember that as an educator she is responsible to inform Harry of the seriousness of his situation. He may be feeling fine, but his heart was at increased risk of a heart attack.
- How could a team huddle have prevented the problem in this story?
A: A team huddle would have informed the cardiologist and nurses of the current situation. Although this may have turned out differently, every situation should be treated in a serious manner. A team huddle would have allowed the team to hear Caroline’s concerns and provide her with support or feedback.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: The patient has the right to leave or sign out against medical advice (AMA), however the nurse is responsible to provide the patient with accurate information. The patient can then make a sound decision based on knowing the information.
- What’s one thing you could do to advocate, assert, and ‘explain the why’ to ensure your patients are safe?
A: It is important to provide each patient with accurate and precise information. The nurse should not provide information to scare the patient, but to provide them with the information in order to make an educated decision.
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Write a script that demonstrates how Caroline could have used critical language to ‘explain the why’ to Harry, about why he should stay to wait for his results. Act out the script or share with the class for discussion.
- Write a dialogue between Caroline and Dr. Feldman demonstrating how she could have used critical language to advocate for Harry, successfully countering Dr. Feldman’s objections.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| Demonstrate and apply critical language to advocate for patient safety. |
Student struggles to demonstrate and apply critical language to advocate for patient safety. |
Student can demonstrate and apply some aspects of critical language to advocate for patient safety, but needs more practice. |
Student can demonstrate and apply critical language to advocate for patient safety. |
| Demonstrate the ability to explain the “why” to patients related to safe practices and protocols. |
Student struggles to demonstrate the ability to explain the ‘why’ to patients related to safe practices and protocols. |
Student can demonstrate some ability to explain the ‘why’ to patients related to safe practices and protocols, but needs more practice. |
Student can accurately demonstrate the ability to explain the ‘why’ to patients related to safe practices and protocols. |
| Describe the use of a team huddle for problem-solving related to all patient safety concerns. |
Student struggles to describe the use of a team huddle for problem-solving related to all patient safety concerns. |
Student can describe some of the use of a team huddle for problem-solving related to all patient safety concerns, but needs more practice. |
Student can accurately describe the use of a team huddle for problem-solving related to all patient safety concerns. |
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
- Two-Challenge Rule
- STEP
- Feedback
- Advocacy and Assertion
- 3Ws- Who I Am, What I am Doing, and Why I Care
Posted in Pro ED Guides, Teacher Guides | No Comments »
Thursday, September 18th, 2014
119
Instructor’s Guide – Organizational Antibodies
Overview:
This story is about how one IT director learned through trial and error to gain the support of medical staff through carefully orchestrated EMR implementation planning, a must for any change initiative to succeed.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe the importance of creating understanding and buy-in related to change
- Analyze and explain the risks and benefits of the change at the frontline.
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.
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
- Why is the use of EMR and other technologies important for quality patient care?
A: Clinical decision support tools and enhanced communications between disciplines will enhance patient care and ultimately improve patient outcomes.
A: Improved efficiencies included with fully implemented effective EMRs are associated with reducing in unnecessary redundancies.
A: Standardized reporting allows for enhanced query capabilities and tracking of quality metrics.
- Describe the actions in the story that helped create buy-in amongst the ED doctors. Why do you think they were so effective?
A: Actively listen.
A: Provide a reminder that the previous system was at the end of life functionally, the change was not embarked upon just for the sake of change, but to improve patient care.
A: Empowerment of the end users, in this case, physicians, demonstrate that stakeholder engagement will lead to more effective implementations.
- What things could you do to promote understanding and buy-in related to change initiatives?
A: Plan ahead, and plan well.
A: Engage all the stakeholders and develop a communication and deployment strategy that involves representatives from the various groups.
A: Listen for learning opportunities as the new system experience issues and delays.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: The importance of planning for large-scale change or implementation of new technologies.
A: The importance of effective communication with all aspects of healthcare to include interprofessional relationships.
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Describe why it is important that people on all levels of the organization are involved in the implementation of important changes.
- Dissect Jim’s directions to Connie. Make a To Do/Not To Do guide for implementing a change like the one in the story.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| Describe the importance of creating understanding and buy-in related to change |
Student struggles to describe the importance of creating understanding and buy-in related to change. |
Student can describe some aspects of the importance of creating understanding and buy-in related to change, but needs more practice with the topic. |
Student can accurately describe the importance of creating understanding and buy-in related to change. |
| Analyze and explain the risks and benefits of the change at the frontline. |
Student struggles to analyze and explain the risks and benefits of the change at the frontline. |
Student can analyze and explain some aspects of the risks and benefits of the change at the frontline, but needs more practice. |
Student can accurately analyze and explain the risks and benefits of the change at the frontline. |
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:
Posted in Pro ED Guides, Teacher Guides | No Comments »
Thursday, September 18th, 2014
118
Instructor’s Guide – The Perfect Storm
Overview:
This story is about how handoffs are the single most error-prone event in the patient continuum of care. Ineffective communication, coupled with distractions and an incomplete patient assessment, can often lead to a sentinel event.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe and demonstrate a structured patient handoff, including a verbal check back from the team member receiving the patient.
- Describe the importance of designing a team structure that ensures the team leader is not pulled away from coordinating care across the unit.
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: Check-Backs
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.
-
- A check-back is a closed-loop communication strategy used to verify and validate information exchanged. The strategy involves the sender initiating a message, the receiver accepting the message and confirming what was communicate, and the sender verifying that the message was received. Typically, information is called out anticipating a response on any order which must be checked.
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.
- What do you feel was Juan’s biggest error in the story? What should he have done instead?
- How could the use of check-backs helped to avoid the problem in this story?
- How could Chelsea ensure that this problem never occurs in her unit again?
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.
- What can we learn from this story?
- What is one thing you can do to ensure you provide a thorough report and safe handoff for every patient?
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Write a script for the patient handoff that should have occurred with Mrs. Schulte. Be sure to include check-backs in your dialogue. If time permits, have students perform their scripts with a partner.
- Think about Chelsea’s role in the unit. Design a team structure that ensures that she is not pulled away from coordinating care in the unit, and delineates each team member’s responsibilities in assessing and managing patient care.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| Describe safe practices during all surgical procedures related to post-operative counts ensuring that no retained foreign objects remain. |
Student struggles to describe safe practices during surgical procedures related to post-operative counts ensuring that no RFOs remain. |
Student can describe some safe practices during surgical procedures related to post-operative counts ensuring that no RFOs remain, but needs more practice. |
Student can accurately describe safe practices during surgical procedures related to post-operative counts ensuring that no RFOs remain. |
| Recall and describe methods and strategies to ‘stop the line’ when surgical counts are questioned for accuracy. |
Student struggles to recall and describe methods and strategies to ‘stop the line’ when surgical counts are questioned for accuracy. |
Student can recall and describe some methods and strategies to ‘stop the line’ when surgical counts are questioned for accuracy, but needs more practice. |
Student can accurately recall and describe methods and strategies to ‘stop the line’ when surgical counts are questioned for accuracy. |
| Describe and adopt team-based behaviors to successfully manage information conflict between team members. |
Student struggles to describe team-based behaviors to successfully manage information conflict between team members. |
Student can describe and demonstrates some adoption of team-based behaviors to successfully manage information conflict between team members, but needs more practice. |
Student accurately describes and adopts team-based behaviors to successfully manage information conflict between team members. |
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
- Check-backs
- Cross Monitoring
- SBAR
- Call-Out
- Handoff
- Task Assistance
- I PASS the BATON
- “Speak Up”
- 3Ws – Who I Am, What I am Doing, and Why I Care
Posted in Pro ED Guides, Teacher Guides | No Comments »
Thursday, September 18th, 2014
117
Instructor’s Guide – Empowered to Challenge
Overview:
This story is about how retained foreign objects (RFOs) during surgery can result in significant harm due to infection and other complications, and speaking up is crucial when the instrument count is inaccurate. Protocols must be followed during surgical counts to ensure an RFO is not left behind that could be deadly to a patient.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Describe safe practices during all surgical procedures related to post-operative counts ensuring that no retained foreign objects remain.
- Recall and describe methods and strategies to ‘stop the line’ when surgical counts are questioned for accuracy.
- Describe and adopt team-based behaviors to successfully manage information conflict between team members.
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
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 healthcare 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.
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.
- Describe safe practices during all surgical procedures related to post-operative counts ensuring that no retained foreign objects remain.
- What does this story illustrate about the importance of using Evidence-Based Practices, like the rules for accounting for all surgical instruments, at all times? Under what circumstances do you feel they can be ignored or altered?
- Describe how Juanita’s use of the CUS technique prevented a larger issue for Mrs. Gatlin. Why was this important?
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.
- What can we learn from this story?
- How can you manage information conflict more effectively when working with your team?
- What is one thing you could do to ‘stop the line’ for patient safety?
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Read the article “The Prevention of Retained Foreign Bodies After Surgery”. Create a short presentation or poster describing the most important reminders or steps a team should take to prevent RFOs in surgery.
- Imagine Juanita had not advocated for the patient and stood up to Dr. Charles. Research what might have happened to Mrs. Gatlin if the sponge had been left after the surgery. Present your findings.
- Think of another scenario in which “stopping the line” or stopping a procedure or action is necessary for patient safety. Describe your scenario, and how you could use the CUS technique to ensure patient safety. Present your scenario to the class for discussion.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| Describe and demonstrate a structured patient handoff, including a verbal check back from the team member receiving the patient. |
Student struggles to describe and demonstrate a structured patient handoff, including a verbal check back from the team member receiving the patient. |
Student can describe and demonstrate some aspects of a structured patient handoff, including a verbal check back from the team member receiving the patient. |
Student can accurately describe and demonstrate a structured patient handoff, including a verbal check back from the team member receiving the patient. |
| Describe the importance of designing a team structure that ensures the team leader is not pulled away from coordinating care across the unit. |
Student struggles to describe the importance of designing a team structure that ensures the team leader is not pulled away from coordinating care across the unit. |
Student can describe some aspects of the importance of designing a team structure that ensures the team leader is not pulled away from coordinating care across the unit, but needs more practice. |
Student can accurately describe the importance of designing a team structure that ensures the team leader is not pulled away from coordinating care across the unit. |
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
- Two-Challenge Rule
- Huddles
- STEP
- Debriefs
- Cross-monitoring
- Feedback
- Advocacy and assertion
- DESC Script
- Collaboration
- Call-Out
- 3 Ws – Who I Am, What I Am Doing, and Why I Care
- PEARLA
Posted in Pro ED Guides, Teacher Guides | No Comments »
Thursday, September 18th, 2014
116
Instructor’s Guide – Why Not
Overview:
This story is about how patient choice can improve the patient experience by better meeting patients’ emotional needs. To do this, healthcare professionals must see exceptional care from the patient’s perspective and act as a navigator of the system of care.
Primary Learning Outcomes
After completing this lesson, the student will be able to:
- Generate strategies and methods to meet the emotional needs of the patient.
- Examine patient and family policies and practices to ensure they provide choice and are patient-centered.
- Describe and adopt strategies to act as a system navigator for patients, not a system enforcer.
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.
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
- How were Charlie’s emotional needs met in this story?
A: A patient centered approach required active listening.
A: A patient centered approach requires considering the patient’s requests are unique and may require changes to the workflow.
A: Patient’s emotional needs were considered and addressed by the Anethesiologist and surgical nurse.
- Who in this story acted as a system navigator for Charlie? Who acted as a system enforcer?
A: The surgical nurse was the system navigator
A: The Anesthesiologist was the enforcer, encouraging the doubting CRNA to support this patient’s request.
- What do you believe are the characteristics of someone who acts as a system navigator for patients?
A: A system navigator is the healthcare professional that has institutional knowledge and functions with a patient centered focus to advocate for the patient in order to enhance their experience of care.
Discussion Questions:
Use discussion questions for face to face or online discussion boards to get students to further reflect on the content of the story together.
*Following each question are some potential answers
- What can we learn from this story?
A: People, including healthcare providers, are change averse.
A: Having a patient centered approach to care requires acceptance of other view points and consideration of cultural, spiritual and emotional needs.
A: A patient centered approach is enhanced by communication and teamwork.
- What is one thing you could do to meet both the clinical and emotional needs of your patients?
A: Actively listen to each patient’s needs. Being fully present and allowing patients to communicate what is important to them, is therapeutic in and of itself.
Suggested Classroom Mastery Activities:
These activities can be tailored for individuals or groups in a face to face or online setting.
- Read the article “What Patient-Centered Should Mean: Confessions of an Extremist”
How do Berman’s views on patient-centered care correspond with your own? Describe three “A-HA” moments or points of interest that you took from the article.
- Make a list of strategies and methods that you believe could help meet the emotional needs of patients in a variety of situations you might encounter. Work with a partner or small group to create a presentation of your Top Ten Ways to Deliver Patient-Centered Care.
Measuring Student Mastery:
| Learning Outcome |
Level 1 |
Level 2 |
Level 3 |
| Generate strategies and methods to meet the emotional needs of the patient. |
Student struggles to generate strategies and methods to meet the emotional needs of the patient. |
Student can generate some strategies and methods to meet the emotional needs of the patient, but needs more practice. |
Student can generate strategies and methods to meet the emotional needs of the patient. |
| Examine patient and family policies and practices to ensure they provide choice and are patient-centered. |
Student struggles to examine patient and family policies and practices to ensure they provide choice and are patient-centered. |
Student can examine patient and family policies and practices to ensure they provide choice and are patient-centered, but needs more practice in classification. |
Student can examine patient and family policies and practices to ensure they provide choice and are patient-centered. |
| Describe and adopt strategies to act as a system navigator for patients, not a system enforcer. |
Student struggles to describe and adopt strategies to act as a system navigator for patients, not a system enforcer. |
Student can describe and adopt some strategies to act as a system navigator for patients, not a system enforcer, but needs more practice in application of the skill. |
Student can describe and adopt strategies to act as a system navigator for patients, not a system enforcer.
|
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
- 3Ws – Who I Am, What Am I Doing, and Why I Care
- Speak Up
Posted in Pro ED Guides, Teacher Guides | No Comments »
Thursday, September 18th, 2014
120
Student’s Guide – Doctor, I’m Concerned…
Overview:
This story is about what happens when a patient is allowed to leave a cardiac clinic without critical test results being examined and resolved because the protocols for allowing a patient to leave were either non-existent or not followed by the staff.
Primary Learning Outcomes
After completing this lesson, you should be able to:
- Demonstrate and apply critical language to advocate for patient safety.
- Demonstrate the ability to explain the “why” to patients related to safe practices and protocols.
- Describe the use of a team huddle for problem-solving related to all patient safety concerns.
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.
- 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: Team 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.
- A team huddle is an ad hoc meeting to discuss issues, realign resources, and modify 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:
- What critical language could Caroline have used with Dr. Feldman? With Harry?
- Describe how Caroline could have better explained the “why” to Harry in this story.
- How could a team huddle have prevented the problem in this story?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, September 18th, 2014
119
Student’s Guide – Organizational Antibodies
Overview:
This story is about how one IT director learned through trial and error to gain the support of medical staff through carefully orchestrated EMR implementation planning, a must for any change initiative to succeed.
Primary Learning Outcomes
After completing this lesson, you should be able to:
- Describe the importance of creating understanding and buy-in related to change.
- Analyze and explain the risks and benefits of the change at the frontline.
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:
- Why is the use of EMR and other technologies important for quality patient care?
- Describe the actions in the story that helped create buy-in amongst the ED doctors. Why do you think they were so effective?
- What things could you do to promote understanding and buy-in related to change initiatives?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, September 18th, 2014
118
Student’s Guide – The Perfect Storm
Overview:
This story is about how handoffs are the single most error-prone event in the patient continuum of care. Ineffective communication, coupled with distractions and an incomplete patient assessment, can often lead to a sentinel event.
Primary Learning Outcomes
After completing this lesson, you should be able to:
- Describe and demonstrate a structured patient handoff, including a verbal check back from the team member receiving the patient.
- Describe the importance of designing a team structure that ensures the team leader is not pulled away from coordinating care across the unit.
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 healthcare professionals.
- A check-back is a closed-loop communication strategy used to verify and validate information exchanged. The strategy involves the sender initiating a message, the receiver accepting the message and confirming what was communicate, and the sender verifying that the message was received. Typically, information is called out anticipating a response on any order which must be checked.
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 do you feel was Juan’s biggest error in the story? What should he have done instead?
- How could the use of check-backs helped to avoid the problem in this story?
- How could Chelsea ensure that this problem never occurs in her unit again?
Posted in Pro ED Guides, Student Guides | No Comments »
Thursday, September 18th, 2014
117
Student’s Guide – Empowered to Challenge
Overview:
This story is about how retained foreign objects (RFOs) during surgery can result in significant harm due to infection and other complications, and speaking up is crucial when the instrument count is inaccurate. Protocols must be followed during surgical counts to ensure an RFO is not left behind that could be deadly to a patient.
Primary Learning Outcomes
After completing this lesson, you should be able to:
- Describe safe practices during all surgical procedures related to post-operative counts ensuring that no retained foreign objects remain.
- Recall and describe methods and strategies to ‘stop the line’ when surgical counts are questioned for accuracy.
- Describe and adopt team-based behaviors to successfully manage information conflict between team members.
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 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:
- 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:
- Describe safe practices during all surgical procedures related to post-operative counts ensuring that no retained foreign objects remain.
- What does this story illustrate about the importance of using Evidence-Based Practices, like the rules for accounting for all surgical instruments, at all times? Under what circumstances do you feel they can be ignored or altered?
- Describe how Juanita’s use of the CUS technique prevented a larger issue for Mrs. Gatlin. Why was this important?
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Thursday, September 18th, 2014
116
Student’s Guide – Why Not?
Overview:
This story is about how patient choice can improve the patient experience by better meeting patients’ emotional needs. To do this, healthcare professionals must see exceptional care from the patient’s perspective and act as a navigator of the system of care.
Primary Learning Outcomes
After completing this lesson, you should be able to:
- Generate strategies and methods to meet the emotional needs of the patient.
- Examine patient and family policies and practices to ensure they provide choice and are patient-centered.
- Describe and adopt strategies to act as a system navigator for patients, not a system enforcer.
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:
- How were Charlie’s emotional needs met in this story?
- Who in this story acted as a system navigator for Charlie? Who acted as a system enforcer?
- What do you believe are the characteristics of someone who acts as a system navigator for patients?
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