Question 1
What were the examples of teamwork skills demonstrated in this scenario?
Please use the following example but do not forget to write it in your own word and change the sentence structure.
In this scenario, there was evident leadership, effective communication and proper support from team members. For effective leadership, Doctor Matthews was able to delegate proper roles and responsibilities to his members by giving orders for the medications, xrays and procedures. The Resus team was also keen as to their role in the team by making sure that an IV line was available. Support and communication was also evident with Natalie and Judy because Judy was able to realise that Natalie did not get what the doctor ordered her to do.
Question 2
Can you think of an experience you have had when on placement when this has occurred? Give an example of this, or if you have not experienced this, give an example of where this might occur.
When you answered the questions , please provide reference with the page number.
Question 3
Have you used or seen situation monitoring during any of your placements? How did the information that you observed from the environment affect how the staff/you approached or responded to the situation?
Explain what situation monitoring is and then link it to the example you provided.
When you answered the questions, please provide reference with the page number.
Question 4
What are some of the ways you might monitor the situation on the ward, unit or department during your clinical placement?
When you answered the questions , please provide reference with the page number.
Question 5
What is an example of a situation in which cross monitoring was successful on a ward or unit where you have had a clinical placement on, and one in which cross monitoring should have been used but was not. If you have not experienced this, give an example of what you think might be examples of these on a ward or unit.
When you answered the questions , please provide reference with the page number.
Question 7
• What were the examples of teamwork skills demonstrated in this scenario?
• What actions by the intern Dr Pham were a result of cross monitoring?
Please use the following example but do not forget to write it in your won words and change the sentence structure.
The skill demonstrated in the video is effective communication, mutual support and efficient cross-monitoring skills. By cross-monitoring, Dr. Pham was able to correct the doctor about the dose to be given to the patient. If cross-monitoring was not done, the patient would have had overdose on Misoprostol.
Question 6
In the cartoon below, how might this team member’s cross monitoring be beneficial to the patient and the team as a whole?
Please use the following example but do not forget to write it in your own word and change the sentence structure.
The individual on the cartoon could save the life of the patient by telling the team leader about the patient’s condition. In this case, the blood pressure and the heart of the patient need to be monitored and given an appropriate action. With his quick thinking, his team would be able to save the patient’s life and prevent any form of complication.
Question 8
Even though the patient’s vital signs were normal, why did Greg have reason for concern?
• Patient was not lucid.
• Patient did not ‘seem’ herself.
• Patient’s stress level was elevated.
Please use the following example but do not forget to write it in your own word and change the sentence structure.
Greg had a reason for concern because the patient was lucid. Even though the patient seems to look normal with normal vital signs, she looked stressed out and was not giving out appropriate answers for the question Greg was asking her. These changes in behaviour may not have been noted before and it could possibly serve as a basis to a new diagnosis or as something to watch out for in the hand over. With Greg showing his concern, the team just helped in making the patient become better.
Question 9
• In your current situation as a nursing student would you feel able to express that you’re not safe?
• What are the factors that inhibit you from doing so and/or that contribute to your inability to do so?
• If you feel inhibited, what can you and your team do to change the culture?
Please use the following example but do not forget to write it in your own word and change the sentence structure.
Yes, there are many times that I do not feel safe in practicing nursing. I often find it hard to balance my time for my family, the workload, the overwhelming assignments and the language itself. With communication, I often am not comfortable speaking and understanding English because there are lots of Australian slangs. Sometimes I just pretend that I understand something even if I don’t. With the workload and assignments, I find it hard to manage and organise my time.
I often try to manage my time and study every time I have some free time. With language, I try to practice my English all the time and ask about the slangs if I do not understand it. I also try to engage with the patients so I am able to practice communicating with them.
Question 10
What are some real-life examples (if you have experienced these, or ones you may think might occur) of situation monitoring in which you needed to:
• Be aware of what was going on.
• Prioritise and focus on different elements of the situation.
• Share that information with others.
When you answered the question, please provide reference with the page number.
Question 11
What are some instances in which you have been on the ‘same page’ with others on their team.
Answer this question based on clinical experience.
Question 12
How can lack of a shared mental model affect safety?
Use the following example but do not forget to write it in your own words and provide reference.
If there is a lack of shared mental model then the team would not be able to provide proper care for the patient. One member might be thinking of one way to manage a patient, while another might have a different way of managing it. Opposing management ideas might not be beneficial for the patient. It might harm the patient and usually, health care workers who don’t work well would usually not provide proper care for the patient. One study even showed that people with shared similar mental models and knowledge after collaborative learning relates to a greater amount of learning (Jeong & Chi, 1997).
Question 15
What actions will you take to improve your and your team’s situation monitoring skills when you are on placement?
When you answered the question, please provide reference with the page number.
Appropriate for: ICU/Paediatric
Question
Describe what the issues were in this scenario regarding communication. Based on TeamSTEPPS® that you have learned about so far, what could have been done in this situation?
Use the following example but do not forget to write it in your own words and provide reference.
There was no team leader. They should have proper delegation of roles and responsibilities. Their scope of management should have been clear and cross-monitoring should have been done like in the case of giving out Lorazepam to the patient. If cross-monitoring was done, they would have known that the patient was not given the right dose of the medication. They also did not communicate properly. Even with telephone referrals, they should have asked and checked if the orders were right and appropriate. The nurses should also asked or communicated with the different departments to confirm the appropriate actions for the patients like with the administration of phenytoin and monitoring the case of the patient when he has a seizure.
For effective communication, clear and precise messages deeply rely on verification, collaboration, a calm demeanour, mutual respect and understanding one’s roles in the case (Robinson et al, 2010, p 206). Teamwork is also needed because it leads to a better job satisfaction, increased patient safety, quality care and increase satisfaction for the patient (Kalisch et al 2007, p 77).
Question 1
Watch the following videos and list all the possible negative issues with using an electronic health system (EPIC is an American version of an electronic record system).
Use the following example but do not forget to write it in your own words and provide reference.
There are many possible negative issues with the electronic health system first, you always need computers, software and electricity to access the records and data. In emergency cases, time to access information would be too long and it could possibly compromise the condition of the patient. It is also prone to have defective hardware, viruses and bugs. There is also a question in keeping the privacy and confidentiality of the patient’s records.
Question 2
Watch the following videos and list all the possible positive issues with using an electronic health system.
Use the following example but do not forget to write it in your own words and provide reference.
There are also positive things that we could gain in using an electronic health system. First, it would help us integrate health care data which was previously on paper to promote quality care. It could also help health workers track their patient’s records quickly. It could also streamline the patient’s data flow and accessing data and sharing insights would be much easier for health care practitioners.
Study suggests that nurses found electronic health systems improved the quality of their documentation and majority of them believed that it lead to a more safe and quality patient care (Moody et al, 2004, p 337).
SCOPE OF PRACTICE
Question 1:
When you answered the following the question, please provide reference with the page number.
• Explain in your own words what scope of practice is.
• How can you determine if an activity or task is within your scope of practice?
• What advice would you give a first year nursing student on their first clinical placement regarding their scope of practice?
Question 2
• Based on the Registered Nurses Competency Standards, develop five (5) multiple choice questions on scope of practice.
There needs to be two (2) answer options with only one correct answer. There cannot be an option ‘all of the above’ or ‘none of the above’ or similar responses. Each answer must be structured as you would find in an exam. The correct answer must be referenced with as much detail as possible on where there correct answer can be found. For example, author, date, page number, paragraph number, line number.
Use the following example but do not forget to write it in your own words and provide reference.
1 The following is an example of integrating organisational policies and guidelines with professional standards?
A Refuses to incorporate the policies of the pharmacists into the nursing practice because they are not connected
B Maintains current knowledge of and incorporates organisational policies and guidelines into practice .
(NMBA 2016, National Competency Standards for the Registered Nurse, page 3)
1 As a nurse, which is essential to provide safe and effective nursing care?
A Disclosing information to all the people who are asking about the patient
B considers ethical responsibilities in all aspects of practice
(NMBA 2016, National Competency Standards for the Registered Nurse, page 4)
1 How do you delegate aspects of care to others according to their competence and scope of practice?
A Delegates aspects of care according to role, functions, capabilities and learning needs
B Blaming the student nurse for taking the wrong vital signs in a cardiac patient.
(NMBA 2016, National Competency Standards for the Registered Nurse, page 7)
1 Which is an example of agreed priorities for resolving the health need of patients?
A Incorporates relevant assessment data in developing a plan for care
B Nurse does not prioritise patient X because he is already on palliative care
(NMBA 2016, National Competency Standards for the Registered Nurse, page 6)
1 How do you practice the nurses’ professional codes of ethics and conduct?
A Recognising the rights of patients**
Declining service to a homosexual man because he is a sinner.
(NMBA 2016, National Competency Standards for the Registered Nurse, page 3)
ISBAR HANDOVER
Questions:
1 List the ways in which the nurses identified the patient.
Use the following example but do not forget to write it in your own words.
There were 2 nurses in the video. Nurse 1 was reading the details of the patient like the name, birthday and MRN while nurse 2 confirmed the details on the wrist band.
2 List the features of the situation that the nurses shared.
Use the following example but do not forget to write it in your own words.
Patient Sapphire Black was brought to the hospital with a complaint of shortness of breath and wheezing. The doctors diagnosed her with Asthma. During her first stay, upon waking up, shortness of breath, coughing and a worsening wheeze were observed.
3 State the features of the child’s background that the nurses described.
Use the following example but do not forget to write it in your own words.
Patient Sapphire Black has been diagnosed since she was 3 years old as having infrequent intermittent asthma. The current admission is her third with prior admission on 2011 for the same complaints. Initial management done at home was the attempt to administer Ventolin through a puffer and spacer but showed no relief so she came to ER by ambulance. She was given 3\20-minutes interval Ventolin inhalation with puffer and spacer, Prednisolone and oxygen at 2 litres. Chest Xray was done.
4 What were the findings of the child’s assessment?
Use the following example but do not forget to write it in your own words.
The findings of the assessment conform to the improvement of Sapphire Black’s case.
Her respiratory rate improved to 20-30’s from 50’s. She was also noted to have a mild to moderate rib recession, decreased breath sounds in the left lower lobe and scattered wheezing. Her oxygen saturation was noted to be at 98% where she was already weaned off the oxygen and her x-ray results showed mild consolidation.
5 What recommendations were made for the child's care?
Use the following example but do not forget to write it in your own words.
The recommendations mentioned in the video were: (1) the need to encourage Sapphire to get up and walk around, (2) make sure her oxygen is okay, (3) Her medications, specifically Ventolin was given every three hours and that the attending physician wanted to check for the breath sounds before administering it at 3 pm and (4) the mother should be educated on how to use the puffer and spacer when Sapphire gets an Asthma attack at home.
6 What infection control strategies did the nurses use?
Use the following example but do not forget to write it in your own words.
One very important strategy they used was hand hygiene at the beginning and end of the handover.
7 What good communication strategies did the nurses demonstrate?
Use the following example but do not forget to write it in your own words .
The nurses established good rapport between the two of them as well as with the patient and her mother. Their manner of speaking and tone of voice were clear. They also followed ISBAR and that alone helped them communicate by not missing an important detail to help in managing the case of the patient. They also followed their ethical obligation to confidentiality where they complied to the request of the parents to not disclose the information on the family moving interstate so as not to upset the children.