Module 5D Collaboration PowerPoint PDF

Collaboration NUR 211 Unit 5 Module 5D Jill Huffman, MSNed, RN Learning Outcomes ● Describe the nurse’s role as a collaborative member of the healthcare team. ● Summarize the benefits and nature of interprofessional collaborative practice. ● Analyze aspects...

Collaboration NUR 211 Unit 5 Module 5D Jill Huffman, MSNed, RN Learning Outcomes ● Describe the nurse’s role as a collaborative member of the healthcare team. ● Summarize the benefits and nature of interprofessional collaborative practice. ● Analyze aspects of conflict prevention and management. Learning Resources ● Ignatavicius, D. (2021). pp. 6-7 ● ATI Engage Fundamentals: (Review) ○ Foundational Concepts of Nursing PRactice - Collaboration and Teamwork ● Evidence-Based Practice Articles as posted in Open LMS Teamwork and Collaboration ● The nurse functions effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care. ● Communication is an essential process for evaluating patient care together using an interprofessional plan of care. ● Interprofessional team includes the patient, family, primary health care providers, nurses, assistive personnel, and other health care professionals and their assistants Teamwork and Collaboration ● When working with an interprofessional team it is important to demonstrate the following qualities for safe and effective patient care: ○ Asks other disciplines about patient progress in their area on a regular basis ○ When planning patient discharge home safety is coordinated among all team members ○ Participate in comprehensive patient rounding ○ Delegate tasks appropriately ○ Consult with other disciplines on patient care Communication ● All interactions consist of both verbal and nonverbal communication ● 10% of communication is verbal whereas 70-90% is nonverbal ● Verbal communication is how we express our beliefs, values, perceptions, meanings, ideas, desires, feelings, and understanding. It is the primary means of expression. ● Nonverbal communication includes tone, pitch, inflection, and intensity of how we speak. It also includes posture, body movements, facial expressions, personal appearance, eye contact, eye cast, physical characteristics, how we listen, and how we use silence, touch and space. Communication ● Therapeutic communication - establishment of a therapeutic relationship through the use of empathy, genuineness, positive regard, and self-awareness. ● Communication Facilitators - factors that enhance effective communication . By projecting warmth, acceptance, friendliness, openness, empathy, and respect in all interactions with the patient and family it fosters open communication. ● Active Listening - being attentive to the patient’s verbal and nonverbal communication and helps the patient to feel as if they were heard, and establishes trust. Requires an open mind and full concentration to hear what the patient is saying and requires clarification and verification of messages. Communication Blockers and Facilitators Blockers ● Making value judgements ● Excessive questioning ● Giving approval or disapproval ● Advising ● Minimizing feelings ● Environmental factors ● Blurring boundaries ● Making irrelevant comments ● Making ambiguous comments ● Not responding to questions ● Using too familiar language ● Changing the subject from patient concerns ● Turning away from the patient ● Being distracted ● Inappropriate kidding and joking ● Displaying annoying tics or habits, such as tapping a foot Facilitators ● Responding directly to the patient’s statements ● nodding one’s head or leading toward the patient ● Staying on the topic at hand or directing the topic toward the major concerns ● Showing verbal and nonverbal interest ● Expressing understanding ● Seeking clarification ● Elaborate on the content ● Making eye contact ● Using silence ● Being non judgemental ● Giving unconditional positive regard ● being genuine ● Demonstrate empathy ● Being self-aware ● Showing cultural awareness Collaborative Communication ● Refers to the interactions and functioning among the patient and members of the health care team to provide safe, patient-centered, quality care. ● Poor communication between professional caregivers and health care agencies causes many medical errors and patient safety risks. ● Handoff Communication - communication when co-workers need to pass information on to another co-worker ● SBAR has been adopted by many agencies as an effective way to improve communication between the healthcare team and health care agencies. ● TeamSTEPPS is a systematic communication approach for interprofessional teams that was designed to improve safety and quality. SBAR ● S ituation - Describe what is happening at the time to require this communication ● B ackground - Explain any relevant background information that relates to the situation ● A ssessment - Provide an analysis of the problem or patient need based on assessment data ● R ecommendation / R equest - State what is needed or what the desired outcome is ● Several modification of SBAR include I-SBAR, I-SBAR-R, and SBARQ ○ I dentify ○ R esponse ○ Additional Q uestions TeamSTEPPS ● Team - includes all members of the interprofessional team involved in the care of the patient. ● S trategies and T ools to E nhance P erformance and P atient S afety ● Common communication tools as part of TeamSTEPPS used to promote patient safety, communication, and teamwork: ○ CUS words : State “ I am C oncerned; I’m U ncomfortable; I don’t feel like this is S afe” ○ Check backs : Restate what a person a person said to verify understanding by all team members ○ Call outs : Shout out important information (such as vital signs) for all team members to hear at one time ○ Two-challenge rule : State a concern twice as needed: if ignored, follow the chain of command to get the concern addressed Delegation and Supervision ● Delegated responsibility is a nursing activity, skill, or procedure that is transferred from a licensed nurse to a delegatee, usually a LPN or assistive personnel. ● Requires precise and accurate communication ● Make sure that it is within the scope of practice for the delegatee to perform the task ● The nurse is always accountable for what is delegated! ● Supervision is guidance or direction, evaluation, and follow-up by the nurse to ensure that they are performed appropriately and safely. Five Rights of Delegation and Supervision ● Right Task : The task is within the delegatee’s scope of practice and competence. ● Right Circumstance : The patient care setting and resources are appropriate for the delegation. ● Right Person: The delegatee is competent to perform the delegated activity, skill, or procedure. ● Right Communication: The nurse provides a clear and concise explanation of the task or activity, including limits and expectations. ● Right Supervision: The nurse appropriately monitors, evaluates, intervenes, and provides feedback on the delegated process as needed. Documentation ● Documentation is written communication that becomes part of the legal record. It is used to measure outcomes and determine costs and may serve to defend the care given if litigation occurs. ● Establishes that standards of practice, policies, and procedures were followed and that standards of care were met. ● Must be accurate account of the patient’s response to the illness and treatment. ● Must reflect the total nursing process - assessment, nursing diagnosis, planning, implementation, and evaluation - as well as any revisions to the plan of care. Conflict Management ● Conflict is an opposition of feelings, beliefs, desires, or goals. ● Generally considered to be a negative occurrence or state. ● Can be: ○ intrapersonal - within one individual ○ Interpersonal - between two or more individuals ○ Intragroup - within one group ○ Intergroup - between one or more groups ● Conflict has a preceding causative event that sets up a perceived or felt antagonism. ● Can interfere with patient care and safety Conflict Management ● Any discussion regarding the conflict should be done in an area that gives as much privacy as possible, especially away from patient care areas where patients and their families may hear. ● Focus must be on patient care and safety. ● Both parties must be willing to talk calmly and rationally. ● If either party becomes angry and out of control then you must stop and take up the discussion at a later time. ● If you cannot resolve the conflict, you must know when to stop and recruit a manager to assist. Conflict Resolution ● Recognize that those involved each have points of view worth considering. ● Think through each point of view in a logical manner. ● Ask the parties to assist in helping to clarify issues. ● Be assertive, logical, and reasoned with assessing the situation. ● Do not act with emotions ● Stay focused on the facts of the issue. ● Be aware of potential consequences for patient safety if resolution were not to occur. ● Be clear and rational when presenting your point of view. Steps to Collaborative Conflict Resolution 1. Open a dialogue that brings forth and is respectful of each individual’s point of view. 2. Determine a group or shared goal. 3. Identify the expertise and contribution of each individual 4. Review the gaol and move to honestly accept or reject it. 5. Design a plan to meet the new goal, using the expertise of the group to design interventions tho meet the goals. 6. Determine the roles of the members in carrying out of the interventions. 7. Set an evaluation point and include all individuals in the evaluation process. Maintain respect for everyone’s input or contribution, focus on interventions and actions rather than personalities, feelings, or prejudices. Types of Conflict Resolution ● Sacrifice Resolution - One party may strongly want to avoid or end the conflict and will therefore accommodate the other part by essentially sacrificing his or her position. ● Competition Resolution - One or both parties work competitively, instead of cooperatively, toward a resolution. ● Win-Win Resolution - The two opposing parties come together to decide on mutual goals, design interventions to meet these goals, and work together to evaluate the outcome. Case Study J.E. is a 70 yr-old female who was admitted to the ICU with a report of increasing shortness of breath, fatigue, and weight gain. She has a history of HTN for 20 years and a MI at 58 yrs of age. She reports increasing shortness of breath, fatigue, and unexplained 11-lb weight gain during the past 2 wks. She had a respiratory tract infection 2 wks ago. She is noted to have a persistent cough and edema in BLE. She cannot climb stairs without getting short of breath and sleeps with her head elevated on 3 pillows. She lives alone and does not always remember to take her medication. Case Study Currently J.E is noted to have moderate respiratory distress, using accessory muscles, resp rate 36 bpm, audible systolic heart murmur, bilateral crackles in all lung fields, cyanotic lips and extremities, skin is cool and diaphoretic. Chest X-ray results: cardiomegaly with right and left ventricle hypertrophy; fluid in lower lung fields Echocardiogram results: ejection fraction 20% Current Orders: Furosemide (Lasix) 40 mg IV twice daily Potassium 40 mEq PO twice daily Enalapril (Vasotec) 5mg/day PO Continuous ECG monitoring Diet: 2-gram sodium diet Titrate O2 to keep O2 sat >93% Monitor intake and output; Daily weights Serum electrolytes; cardiac biomarkers q 8hr X 3