ATI Fundamentals (Ch. 2: Interprofessional Team)

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Physical therapist

- Assesses and plans for clients to increase musculoskeletal function, especially of the lower extremities, to maintain mobility Example of when to refer: following his arthroplasty, a client requires assistance learning to ambulate and regain strength

Occupational therapists

- Assesses and plans for clients to regain ADLs, especially motor skills of the upper extremities. Example of when to refer: A client has difficulties using an eating utensil with their dominant hand following a stroke.

Provider

- Assesses, diagnosis, ad treats disease and injury. - include medical doctors (MDs), doctors of osteopathy (DOs), advanced practice nurses (APNs), and physician assistants (PAs). - State regulations vary in their requirements for supervision of APNs and PAs by a physician (MDs or DOs) Example of when to refer: A client has a temperature of 39 C (102.2 F), is achy and shaking, and reports feeling cold

Registered dietitian

- Assesses, plans for m and educate regarding nutritional needs. - Designs special diets, and supervises meal prep Example of when to refer: A client has a low albumin level and recently had an unexplained weight loss

Speech-language pathologist

- Evaluates and makes recommendations regarding the impact of disorders or injuries on speech, language, and swallowing. - Teaches techniques and exercises to improve function Example of when to refer: A client is having difficulty swallowing a regular diet after trauma to the head and neck

Certified registered nurse anesthetist (CRNA)

- administers anesthesia and provides care during procedures under supervision of an anesthesiologist

Certified nurse-midwife (CMW)

- collaborates with one or more providers to deliver care to maternal-newborn clients and their families

Nurse practitioner (NP)

- collaborates with one or more providers to deliver nonemergency primary health care in a variety of settings

Nurse researcher

- conduct research primarily to improve the quality of client care

Respiratory therapist

- evaluates respiratory status and provides respiratory treatments including oxygen therapy, chest physiotherapy, inhalation therapy, and mechanical ventilation. Example of when to refer: A client who has respiratory disease is short of breath and requests a nebulizer treatment

Advanced practice nurse (APN)

- has a great deal of autonomy. - APNs usually have a minimum of a master's degree in nursing ( or related field), advanced education in pharmacology and physical assessment, and certification in a specialized area of practice. - included in this role are followings: 1. Clinical nurse specialist (CNS) 2. Nurse practitioner (NP) 3. Certified registered nurse anesthetist (CRNA) 4. Certified nurse-midwife (CNM)

Assistive personnel (AP)

- includes certified nursing assistants (CNAs) and certified medical assistants (CMAs), and non-nursing personnel (dialysis technicians, monitor technicians, and phlebotomists). Educational preparation: - must meet the state's formal or informal training requirements - requirement by most states for training and examination to attain CNA status Roles and responsibilities: - work under the direct supervision of an RN or PN - position description in the employing facility outlines specific tasks - tasks can include feeding clients, preparing nutritional supplements, lifting, basic care (grooming, bathing, transferring, toileting, positioning), measuring and recording vital signs, and ambulating clients.

Laboratory technician

- obtains specimens of body fluids, and perform diagnostic tests. Example of when to refer: A provider needs to see a client's complete blood count results immediately

Radiologic technologist

- positions clients and performs x-rays and other imaging procedures to review for diagnosis of disorders of various body parts Example of when to refer: A client reports severe pain in their hip after a fall, and the provider prescribes an x-ray of the client's hip

Nurse administrator

- provides leadership to nursing departments within a health care facility

Spiritual support staff

- provides spiritual care (pastors, rabbis, priests) Example of when to refer: A client requests communion, or the family asks for prayer prior to the client undergoing a procedure

Pharmacist

- provides, monitors, and evaluates medication - supervises pharmacy technicians in states that allow this practice Example of when to refer: A client is concerned about a new medication's interactions with any of their other medications

Nurse educator

- teaches in schools of nursing, staff developments in health care facilities, or client education departments

Registered nurse (RNs)

- the RN is the lead team member, soliciting input from all nursing team members and setting priorities for the coordination of client care Education preparation: - must meet the state board of nursing's requirements for licensure - requires completion of a diploma program, an associate degree, o a baccalaureate degree in nursing prior to taking the licensure exam Roles and responsibilities: - function legally under state nurse practice acts - perform assessments, establish nursing diagnoses, goals, and interventions, and conduct ongoing client evaluation - develop inter professional plans for client care - share appropriate information among team members, initiate refusals for client assistance, including health education, and identify community resources

Clinical nurse specialist (CNS)

- typically specializes in a practice setting or clinical field

Social worker

- works with clients and families by coordinating inpatient and community resources to meet psychological and environmental needs that are necessary for recovery and discharge Example of when to refer: A client who has terminal cancer wishes to go home but is no longer able to perform many ADLs. The client's partner needs medical equipment in the home to care for the client

Nursing Personnel

1. Registered nurse (RNs) 2. Practical nurse (PN) 3. Assistive personnel (AP)

Interprofessional Personnel (Non-nursing)

1. Spiritual support staff 2. Registered dietitian 3. Laboratory technician 4. Occupational therapist 5. Pharmacist 6. Physical therapist 7. Provider 8. Radiologic technologist 9. Respiratory therapist 10. Social worker 11. Speech-language pathologist

5. A nurse is acquiring a group of newly licensed nurses with the roles of the various members of the health care team they will encounter on the types of tasks certified nursing assistants can perform, which of the following client activities should the nurse include? (Select all that apply) A. Bathing B. Ambulating C. Toileting D. Determining pain level E. Measuring vital signs

Answer: A, B, C, E

1. A nurse is caring for a group of clients on a medical-surgical unit. For which of the following client care needs should the nurse initiate a referral for a social worker? A. A client who has terminal cancer requests hospice care in the home B. A client asks about community resources available for older adults C. A client states, "I would like to have my child baptized before surgery." D. A client requests an elastic wheelchair for use after discharge E. A client states, " I do not understand how to use a nebulizer."

Answer: A, B, D

3. A client who is PO following knee arthroplasty is concerned about the adverse effects of the medication prescribed for pain management. Which of the following members of the inter professional care team can assist the client in understanding of the medication's effects? (Select all that apply) A. Provider B. Certified nursing assistant C. Pharmacist D. Registered nurse E. Respiratory therapist

Answer: A, C, D

2. A goal for a client who has difficulty with self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral to which of the following members of the interprofessional care team? A. Social worker B. Certified nursing assistant C. Registered dietitian D. Occupational therapist

Answer: D

4. A client who has a cerebrovascular accident ha persistent problems wth dysphagia. The nurse caring for the client should initiate a referral with which of the following members of the inter professional care team? A. Social worker B. Certified nursing assistant C. Occupational therapist D. Speech-language pathologist

Answer: D

Practical nurse (PN)

Educational preparation: - must meet the state board of nursing's requirements - requires vocational or community college education prior to taking the licensure exam Roles and responsibilities: - work under the supervision of the RN. - Collaborate within the nursing process, assist with the plan of care, consult with other team members, and recognize the need for referrals to assist with actual or potential problems - possess technical knowledge and skills - participate in the delivery of nursing care, using nursing process as a framework


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