ContentsTeamSTEPPS® Show
TeamSTEPPS®Framework and CompetenciesTeam Competency Outcomes [D] Select for Text Description Knowledge
Attitudes
Performance
TeamSTEPPS has five key principles. It is based on team structure and four teachable-learnable skills: Communication, Leadership, Situation Monitoring, and Mutual Support. The arrows depict a two-way dynamic interplay between the four skills and the team-related outcomes. Interaction between the outcomes and skills is the basis of a team striving to deliver safe, quality care and support quality improvement. Encircling the four skills is the team structure of the patient care team, which represents not only the patient and direct caregivers, but also those who play a supportive role within the health care delivery system. ...TeamSTEPPS is an evidence-based framework to optimize team performance across the health care delivery system. Key PrinciplesTeam StructureIdentification of the components of a multi-team system that must work together effectively to ensure patient safety. CommunicationStructured process by which information is clearly and accurately exchanged among team members. LeadershipAbility to maximize the activities of team members by ensuring that team actions are understood, changes in information are shared, and team members have the necessary resources. Situation MonitoringProcess of actively scanning and assessing situational elements to gain information or understanding, or to maintain awareness to support team functioning. Mutual SupportAbility to anticipate and support team members' needs through accurate knowledge about their responsibilities and workload. Return to Contents Team Structure[D] Select for Text Description Multi-Team System For Patient CareSafe and efficient care involves the coordinated activities of a multi-team system. Return to Contents Communication[D] Select for Text Description SBARA technique for communicating critical information that requires immediate attention and action concerning a patient's condition Situation—What is going on with the patient? "I am calling about Mrs. Joseph in room 251. Chief complaint is shortness of breath of new onset." Background—What is the clinical background or context? "Patient is a 62 year old female post-op day one from abdominal surgery. No prior history of cardiac or lung disease." Assessment—What do I think the problem is? "Breath sounds are decreased on the right side with acknowledgement of pain. Would like to rule-out pneumothorax." Recommendation and Request—What would I do to correct it? "I feel strongly the patient should be assessed now. Can you come to room 251 now?" Call-OutStrategy used to communicate important or critical information
Example during an incoming trauma: Leader: "Airway status?" Check-BackUsing closed-loop communication to ensure that information conveyed by the sender is understood by the receiver as intended. The steps include the following:
Example: Doctor: "Give 25 mg Benadryl IV push" HandoffThe transfer of information (along with authority and responsibility) during transitions in care across the continuum. It includes an opportunity to ask questions, clarify, and confirm. Examples of transitions in care include shift changes; transfer of responsibility between and among nursing assistants, nurses, nurse practitioners, physician assistants, and physicians; and patient transfers. HandoffStrategy designed to enhance information exchange during transitions in care
Return to Contents Leadership[D] Select for Text Description Effective Team LeadersThe following are responsibilities of effective team leaders:
Team EventsSharing the Plan
Monitoring and Modifying the Plan
Reviewing the Team's Performance
Brief ChecklistDuring the brief, the team should address the following questions: ___ Who is on the team? ___ Do all members understand and agree upon goals? ___ Are roles and responsibilities understood? ___ What is our plan of care? ___ What is staff and provider's availability throughout the shift? ___ How is workload shared among team members? ___ What resources are available? Debrief ChecklistThe team should address the following questions during a debrief: ___ Was communication clear? ___ Were roles and responsibilities understood? ___ Was situation awareness maintained? ___ Was workload distribution equitable? ___ Was task assistance requested or offered? ___ Were errors made or avoided? ___ Were resources available? ___ What went well? ___ What should improve? Return to Contents Situation Monitoring[D] Select for Text Description Situation Monitoring ProcessSituation monitoring is the process of continually scanning and assessing a situation to gain and maintain an understanding of what's going on around you. Situation awareness is the state of "knowing what's going on around you." A shared mental model results from each team member maintaining situation awareness and ensures that all team members are "on the same page." STEPA tool for monitoring situations in the delivery of health care Components of Situation Monitoring: Status of the Patient Team Members Environment Progress Toward Goal Tool to help assess health care situations STEPStatus of Patient Team Members Environment Progress Towards Goal Cross-MonitoringA harm error reduction strategy that involves:
Situation MonitoringEach team member is responsible for assessing his or her own safety status. I'M SAFE Checklist__ I = Illness Return to Contents Mutual Support[D] Select for Text Description Task AssistanceHelping others with tasks builds a strong team. Key strategies include:
FeedbackInformation provided to team members for the purpose of improving team performance. Feedback should be:
Return to Contents Advocacy and AssertionAdvocate for the patient
Assert a corrective action in a firm and respectful manner
Two-Challenge RuleEmpowers all team members to "stop the line" if they sense or discover an essential safety breach. When an initial assertive statement is ignored:
CUSAssertive statements: DESC ScriptA constructive approach for managing and resolving conflict D—Describe the specific situation or behavior; provide concrete data. E—Express how the situation makes you feel/what your concerns are. S—Suggest other alternatives and seek agreement. C—Consequences should be stated in terms of impact on established team goals; strive for consensus. Return to Contents Team Performance Observation Tool
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Return to Contents Contact InformationTo learn more about TeamSTEPPS, refer to the Agency for Healthcare Research and Quality (AHRQ) Web site: Developed for the Department of Defense Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality. TeamSTEPPS™ Pocket Guide—2.0 ISBN 1-58763-191-1 Return to Contents Which tool would help the nurse to understand a family's structure and relationships?The genogram is a tool that helps the nurse outlines the family's structure.
Which of the following is the first step a nurse must do when conducting a home visit?Greet the patient and introduce yourself.. State the purpose of the visit.. Observe the patient and determine the health needs.. Put the bag in a convenient place and then proceed to perform the bag technique.. Perform the nursing care needed and give health teachings.. Which of the following should be given priority in the beginning of her family assessment?Adequate identification and collection of information about the client's response to these actual or potential health problems is the first priority in family assessment.
Which will the nurse anticipate when conducting a home visit?Which will the nurse anticipate when conducting a home visit? Spend between 30 and 60 minutes at the family's home for the visit. Which nursing action during the termination phase of home visits would require correction? Complete recording of interaction with the family.
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Which of the following would be better understood by the nurse after using a family map
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