Collaboration and Teamwork
A nurse and an assistive personnel (AP) disagree about how to move a client from the bed to a stretcher. Which of the following statements should the nurse make to promote conflict resolution? "i'm the nurse, you are the AP, so do what I say" "You always need to get your own way" "Let's discuss how we can work together" "if you do not help me, I will report you to the charge nurse"
"Let's discuss how we can work together." This response demonstrates respect by the nurse toward the AP. The nurse recognizes that the AP might have valuable knowledge and experience that could improve client outcomes. Conflict management is a method to settle disagreements peacefully and respectfully, through compromise and accommodation to each other's needs, sharing goals, and avoiding competition with the other party. Negotiations handled with positive approaches can lead to new ideas, strengthen organizational relationships and team performance, promote innovation and creativity, and increase morale.
A charge nurse is providing teaching to a group of nurses about the collaborative teamwork skill of situation monitoring. Which of the following statements by a nurse indicates an understanding of the teaching? "situation monitoring identifies who should be included on the team" "situation monitoring identifies strategies to lead teams effectively" "situation monitoring focuses on the awareness of the team's performance on client outcomes" "situation monitoring supports the team by providing feedback to assist the team to function better"
"Situation monitoring focuses on the awareness of the team's performance on client outcomes." Some of the primary teamwork skills include team structure, communication, leadership, situation monitoring, and mutual support. These skills are used to improve and enhance collaboration and improve client outcomes. Situation monitoring encourages the team to be aware and understand the team's performance and the impact it has on client outcomes.
A newly licensed nurse is talking about their day with another nurse. Which statement by the newly licensed nurse demonstrates incivility? "I hate when I have to ask my preceptor for help with tasks I am unsure about" "The charge nurse called me stupid in front of the team" "My preceptor laughs when I tell a joke" "the charge nurse gave me a difficult assignment"
"The charge nurse called me stupid in front of the team." This statement demonstrates incivility. Incivility is a behavior of unwelcome action(s) intended to harm, humiliate, or distress another. Incivility becomes bullying through the repetition of harmful actions. Even something as simple as body language or tone of voice can be interpreted as uncivil or a bullying tactic.
A nurse is using the introduction, situation, background, assessment, recommendation, and readback (I-SBAR-R) communication tool when contacting a provider about a client who has COPD. Which of the following statements by the nurse should be included in the assessment component? "The client has a history of COPD." "The client has a respiratory rate of 38/min" "I will obtain a sputum culture" "should I increase the client's supplemental oxygen"
"The client has a respiratory rate of 38/min." The nurse should identify that this statement provides information that is included in the assessment component of the I-SBAR-R communication tool. The assessment component includes pertinent data required to provide effective and prompt care. Using a structured handoff tool such as I-SBAR-R provides for a more thorough exchange of information, decreases communication breakdowns, minimizes medical errors, and ensures client safety.
A nurse is using the introduction, situation, background, assessment, recommendation, and readback (I-SBAR-R) communication tool when contacting a provider about a client who has Parkinson's disease. Which of the following statements by the nurse should be included in the situation component? "The client is coughing while eating" "Should I obtain a chest X-ray" "I will request a referral with a speech therapist" "The client has a history of Parkinson's disease"
"The client is coughing while eating." The nurse should identify that this statement provides information that is included in the situation component of the I-SBAR-R communication tool. The situation component includes pertinent data required to provide effective and prompt care. Using a structured handoff tool such as I-SBAR-R provides for a more thorough exchange of information, decreases communication breakdowns, minimizes medical errors, and ensures client safety.
A nurse is teaching a client who has end-stage kidney disease and a new sacral pressure injury. The client's provider has requested a plastic surgery consultation. Which of the following statements by the client indicates an understanding of the consultation? "The plastic surgeon might adjust my renal diet" "The plastic surgeon will assist me with financial counseling" "The plastic surgeon might change my wound care treatment" "The plastic surgeon will coordinate my health care team"
"The plastic surgeon might change my wound care treatment." The nurse should instruct the client that the plastic surgeon is consulted by the provider to treat the client's pressure injury. A consultation is when one provider is delegating responsibility for management of a specific condition to another provider. Though providers make referrals and consultations, nurses' facilitation is essential to reduce gaps and delayed diagnoses or treatment in clients.
A nurse is teaching about change-of-shift report with a newly licensed nurse. Which of the following statements should the nurse make? "Change-of-shift report performed at the client's bedside results in increased overtime by nurses." "Using I-SBAR-R during change-of-shift report decreases the risk of missing information." "Change-of-shift report performed at the client's bedside decreases client satisfaction about their care." "taking notes during change-of-shift report increases the risk for error."
"Using I-SBAR-R during change-of-shift report decreases the risk of missing information." The nurse should include that using a structured handoff tool such as I-SBAR-R reduces the risk for missed or lost information. A structured handoff provides an outline for the newer nurse to use as a communication anchor.
A nurse is caring for a client who asks, "Why do I have to talk to so many people before I can go home? Don't these people communicate?" Which of the following statements should the nurse make? "They are very busy and do not have time to communicate about your health" "Why are you concerned about talking to your health care team" "Your health care team works together so you can safely go home" "The sooner you talk to them, the sooner you can leave"
"Your health care team works together so you can safely go home." This response by the nurse explains the benefits of collaboration and teamwork to provide complete patient-centered care so that the client can be discharged safely to home. The benefits of collaboration and teamwork are improved access to and coordination of health care services; efficiency of client referral and client care services; quality of community health services; as well as decreases in complications, hospital length of stay, sentinel events, mortality, and staff turnover.
A nurse is teaching an in-service about zero-tolerance for bullying and incivility in the health care facility. Which of the following information should the nurse include? Bullying can result in an increase in productivity Incivility can result in improved communication in the workplace Incivility can result in a reduction of medical errors Bulling can result in an increase in nursing turnover
Bullying can result in an increase in nursing turnover. Bullying and incivility can result in decreased teamwork, collaboration, nursing satisfaction, and an increase in nursing turnover. Therefore, over the past several years, health care facilities and their leadership have focused on eliminating this behavior, which is a barrier to collaboration.
A nurse is preparing a discharge plan for a client following a bilateral below-the-knee amputation. Which of the following interventions is the priority? check the availability of transportation to follow-up appointments Request a referral for a home health nurse Provide the client with written material about their medications Determine whether the client's home is wheelchair accessible
Determine whether the client's home is wheelchair accessible. The greatest risk to this client is injury from a fall; therefore, this is the priority intervention. Modifications to the client's home, if needed, must be completed before the client is discharged to reduce the client's risk for injury. Discharge planning is thinking ahead, using a systematic approach, taking into consideration the myriad of individual client factors, coordinating a detailed and thorough plan of care for the client to smoothly transition from admission to either home, another facility, or another level of care.
A nurse is teaching a newly licensed nurse about what to include in a medication reconciliation form for a client who is being transferred to a new facility. Which of the following instructions should the nurse include? Include a list of medications that the client no longer needs Do not include over-the-counter medications the client takes Include medications the client took at home Do not include nutritional supplements the client takes
Include medications the client took at home. The nurse should include medications the client took at home that they will take after discharge to decrease the risk for medication omissions or errors. Medication reconciliation, or medication verification, occurs when a client is being admitted, discharged, or transferred to or from a unit, facility, or home. The nurse must gather a complete list of medications, reconcile, verify accuracy, and then document all medication that the client needs to take while they are in a care setting.
A nurse is teaching a newly licensed nurse about receiving and transcribing verbal prescriptions. Which of the following instructions should the nurse include? Read back the prescription to the provider after transcribing Use symbols when transcribing a verbal prescription Include abbreviations when transcribing a verbal prescription Place a zero after a decimal when transcribing a dosage
Read back the prescription to the provider after transcribing. The nurse should instruct the newly licensed nurse to read back the verbal prescription to the provider after transcribing to reduce the risk for error. Receiving provider's prescriptions, verifying or reading back the information, and then documenting the information correctly is vital to safe client care. Verbal prescriptions are vulnerable to being misunderstood, miswritten, and misinterpreted, especially during initial communication, or when being transcribed into the medication administration record (MAR).
A nurse is caring for a client who has diabetes mellitus and does not adhere to the prescribed diet. Which of the following interventions by the nurse demonstrates collaborative health care? requesting a referral to a dietitian to work with the client instructing the client's family not to bring in snacks for the client asking the client why they are not adhering to the prescribed diet informing the client that they will get used to eating the prescribed diet
Requesting a referral to a dietitian to work with the client The nurse should collaborate with a dietitian to create a menu that includes the client's input. Collaborative health care is a client-centered approach where members of different health care professions come together and work toward a common goal. Including the client's input in the menu should increase compliance and improve outcomes. Client safety, quality of care, and health care outcomes are significantly improved when strong collaborative relationships are in place calling on members of different disciplines, specialties, and practices.
A nurse is assigned to care for a client. The client's provider is known to become angry and yell at the nurse. Which of the following actions by the nurse demonstrates the use of cognitive rehearsal? The nurse asks another nurse to be present as a witness when the provider arrives The nurse confronts the provider outside the client's room The nurse notifies the charge nurse about the provider's actions The nurse mentally practices in advance what to say to the provider
The nurse mentally practices in advance what to say to the provider. The American Psychological Association (2020) defines cognitive rehearsal as an intellectual therapeutic technique where one envisions or visualizes an overwhelming, or an anxiety-producing situation, and then mentally rehearses different reactions, behaviors, or repeats constructive statements to positively effect coping skills. Much like running a game plan or dance steps in one's head before a performance, cognitive rehearsal is playing a difficult scenario in one's head ahead of time to prepare oneself for constructive action if that scenario happens in reality.
A nurse is teaching a class about barriers to interprofessional collaboration between health care professionals. The nurse should include that which of the following is a barrier? Trust in the ability of a team member Unresolved conflicts between team members Effective communication between team members Cultural competency within team members
Unresolved conflicts between team members Unresolved conflicts between team members is a barrier to interprofessional collaboration. This can lead to mistrust, miscommunication, and can result in fragmented care and an increased risk of medical errors.