TeamSTEPPS Review Questions
This acronym can assist with the hand-off process. A. IPASSTHEBLAME B. IPASSTHEBATON C. STEPPS D. IDONTGIVEAF*CK
B
____ (acronym) is a technique for communicating critical information that requires immediate attention and action concerning a patient's condition.
SBAR
The new resident working in the clinic is having real difficulties interacting with the nurse (who has been working there for a decade). The nurse continually is telling her what to do, but in front of the patients. The best course of action for the resident is to: a. Tell the nurse to stop undercutting her. b. Ask the nurse for a quick meeting to discuss criticisms in front of patients. c. Tell the clinic manager to have a talk with the nurse. d. Complain to the attending that the nurse is hypercritical and ineffective. e. Just let the patients know that the nurse is having a bad day.
b. Ask the nurse for a quick meeting to discuss criticisms in front of patients.
After an unsuccessful effort by the code team, the most helpful pathway toward team performance improvement involves: a. The leader telling everyone what they did wrong. b. Meeting as a team to debrief the events. c. Explaining the protocol deviations. d. Blaming the people who made mistakes. e. Attending the autopsy.
b. Meeting as a team to debrief the events.
A nurse is very concerned about a baby he is taking care of and feels it would be best to have the attending pediatrician come to the bedside immediately to evaluate. Checking around the unit, he locates the pediatrician, but she is busy dictating a consultation. The nurse's best action is to: a. Wait quietly, but tap his foot rhythmically to indicate urgency. b. Quickly explain the infant's worrisome appearance and state, "I need you right now!" c. Walk away, planning to check back in a few minutes. d. Interrupt, shake her shoulder and pull her quickly toward the crib. e. Leave his pager number with the clerk with instructions to have her call.
b. Quickly explain the infant's worrisome appearance and state, "I need you right now!"
The doctor on the procedure team, upon being challenged by the nurse about the potentially dangerous medication dose, and realizing she is right, should respond by: a. Demanding that this nurse be replaced immediately. b. Saying," You're right. Thanks for watching my back; it's been a bad day." c. Saying, "I'm the doctor, do what I say." d. Calling his partner on his cell phone to discuss the case. e. Telling the worried patient, "Sometimes these dosages are confusing."
b. Saying," You're right. Thanks for watching my back; it's been a bad day."
In the ambulatory clinic, the primary care team is evaluating a patient who likely will need an urgent referral to a specialist. Continuity of care and patient safety are usually enhanced by all of the following except: a. Considering the specialist to be part of the treatment team and sharing information. b. Withholding the reason for referral from the patient to decrease fear. c. Using a structured and detailed handoff document. d. Creating a reminder for seeking the lab and consultation results. e. Instructing the patient to call if he hasn't yet been seen in a certain timeframe.
b. Withholding the reason for referral from the patient to decrease fear.
SBAR - B - ____ - i.e. what is the clinical background or context?
background
A surgeon, anesthesiologist, nurse and technologist are in the OR for a complicated case, which will start shortly. The surgeon, as team leader, should: a. Go scrub and tell the circulating nurse to "get the ball rolling." b. Reassure the new team that she had plenty of experience with tough cases like this one and not to worry, and say, "I'll tell you what you need to know." c. Introduce herself, briefly describe the situation, plan, and potential pitfalls and ask for input from the team members. d. Explain the need for extra speed during this complicated case and set expectations for rapid turnover between cases. e. Pull out the x-rays and textbook and explain the details of the surgery to the rest of the crew, emphasizing the strict need for following protocols.
c. Introduce herself, briefly describe the situation, plan, and potential pitfalls and ask for input from the team members.
DESC script - C - ____ should be stated in terms of impact on established team goals; strive for consensus
consequences
____-monitoring is a harm error reduction strategy that involves monitoring actions of other team members, providing a safety net within the team, and ensuring that mistakes or oversights are caught quickly and easily.
cross (i.e. watch eachother's back)
If the doctor, in fact, is correct in his dosage and the nurse was incorrect in her memory of the proper medication dosage, when this is suspected, the doctor's best action would be to: a. Call the pharmacist and ask her to send a package insert to review. b. Let the nurse know, in no uncertain terms, how it is inappropriate to challenge a senior physician. c. Request that the nurse be sent for retraining and put a notation in her file. d. Stop action, verify the correct dose and thank the nurse for her concern regarding patient safety. e. Call the team together afterwards and have the nurse explain her mistake.
d. Stop action, verify the correct dose and thank the nurse for her concern regarding patient safety.
DESC script - D - ____ the specific situation/behavior with concrete data
describe
The technologist is setting up for a procedure and notices that the doctor seems to be on the wrong side of the patient and may be making a mistake. The doctor has often been short tempered around the nurses and techs and doesn't take suggestions very well. The best action for the technologist is to: a. Call for a supervisor to come into the room. b. Quietly observe and hope that the doctor notices. c. Let the patient and doctor figure it out. d. Ask the doctor if he knows what he is doing. e. Call for a "time-out" to verify the procedure.
e. Call for a "time-out" to verify the procedure.
A nurse is called to the phone to receive a telephone order from the doctor about a patient she is taking care of today. After clearly establishing the patient and physician identities, the best procedure for the nurse would be: a. Listening to the order, calling the pharmacist, writing the details on the order sheet, and bringing the drug to the bedside. b. Refusing to take this telephone order and indicating that she can't be sure of the physician's thought process. c. Listening to the order, repeating back what the doctor said, and then writing it down in the patient's medical record. d. Listening to the order, asking the charge nurse how to spell the drug's name, asking the family member if that was in the plan for today, and carrying out the order. e. Listening to the order, writing it on the order page, reading the order back to the physician, and seeking his verification of the order's accuracy.
e. Listening to the order, writing it on the order page, reading the order back to the physician, and seeking his verification of the order's accuracy.
The team is making great progress with the procedure until the nurse recognizes that the doctor is clearly making a dangerous mistake in asking for a dose that is ten times the usual dose! Very concerned, she asks the doctor if he's sure that is what's wanted. Giving her a nasty look, he growls, "Well, that's what I asked for, isn't it?.." Confident that the dose is way off base, her next action should be to: a. Walk away and indicate discouragement at being treated so rudely. b. Say loudly, "That's a huge mistake, doctor; nobody uses a dose like that!" c. Not say anything for fear of making the doctor even more angry. d. Ask the secretary to put in a stat page to the nursing supervisor. e. Say, "I'm very concerned about the safety of that dose, Doctor; it's much higher than I've ever seen given."
e. Say, "I'm very concerned about the safety of that dose, Doctor; it's much higher than I've ever seen given."
A big focus of a brief and TeamSTEPPS in general is to develop a shared ___ ____.
mental model (i.e. errrbody on the same page)
_____ mental model results from each team member maintaining situation awareness and ensure that all team members are "on the same page"
shared
SBAR - S - _____ - i.e. what is going on with the patient?
situation
Components of situation monitoring: STEP S - ____ of the patient T - ____ members E - ____ P - ____ towards goal
status, team, environment, progress
DESC script - S - ____ other alternatives and seek agreement
suggest
It is a called the Two Challenge Rule because team members must voice their concern at least ___ times to ensure it has been heard - the person being challenged is required to acknowledge it as well.
2
TeamSTEPPS have __ key principles: team structure and four teachable skills.
5
A ___ is sharing session prior to starting activities used to share the plan, discuss team formation, assigns roles and responsibilities, establish expectations and climate, and anticipate outcomes. A. brief B. huddle C. debrief D. colloquium E. symposium
A
A ____ is a strategy used to communicate important or critical information that informs all team members simultaneously during emergent situations, helps team members anticipate next steps, and is important to direct responsibility to a specific individual responsible for carrying out the task. A. call-out B. check-back C. reach-back D. send-off E. pull-out F. hand-off
A
Information provided to team members for the purpose of improving team performance is called ______. A. feedback B. evaluation C. wall-to-wall counseling D. beat down
A
SBAR, call-0ut, check-back, and hand-0ff are all tools/strategies for improving ______. A. communication B. leading teams C. situation monitoring D. mutual support
A
The following are all sub-components of which area of STEP (components of situation monitoring)? - patient history - vital signs - medications - physical exam - plan of care - psychosocial issues A. status of patient B. team members C. environment D. progress towards goal
A
The following describes which key principle of TeamSTEPPS? identification of the components of a multi-team system that must work together effectively to ensure patient safety A. team structure B. communication C. leadership D. situation monitoring E. mutual support
A
Which of the following are the teachable-learnable skills of TeamSTEPPS (choose all that apply)? A. communication B. situation monitoring C. mutual support D. shared governance E. leadership
A, B, C, E
A ___ is an ad hoc meeting to re-establish situational awareness, reinforce plans already in place, and assess the need to adjust the plan. A. brief B. huddle C. debrief D. colloquium E. symposium
B
A ___ uses closed-loop communication to ensure that information conveyed by the sender is understood by the receiver as intended. A. call-out B. check-back C. reach-back D. send-off E. pull-out F. hand-off
B
Briefs, huddles, and debriefs are all tools/strategies for improving ______. A. communication B. leading teams C. situation monitoring D. mutual support
B
Situation ____ (individual skill) is the process of continually scanning and assessing a situation to gain and maintain an understanding of what's going on around you. A. perceiving B. monitoring C. development D. awareness
B
The following are all sub-components of which area of STEP (components of situation monitoring)? - fatigue - workload - task performance - skill - stress A. status of patient B. team members C. environment D. progress towards goal
B
The following describes which key principle of TeamSTEPPS? structured process by which information is clearly and accurately exchanged among team members A. team structure B. communication C. leadership D. situation monitoring E. mutual support
B
A ___ is informal information exchange designed to review team performance and improve future performance and effectiveness via lessons learned and reinforcing positive behaviors. A. brief B. huddle C. debrief D. colloquium E. symposium
C
STEP and IMSAFE are tools/strategies for improving ______. A. communication B. leading teams C. situation monitoring D. mutual support
C
The acronym ____ can be used to assess one's own safety status. A. IMHERE B. IMAWAKE C. IMSAFE D. URSAFE
C
The following are all sub-components of which area of STEP (components of situation monitoring)? - facility information - admin information - human resources - triage acuity - equipment A. status of patient B. team members C. environment D. progress towards goal
C
The following describes which key principle of TeamSTEPPS? ability to maximize the activities of team members by ensuring that team actions are understood, change in information are shared, and team members have the necessary resources A. team structure B. communication C. leadership D. situation monitoring E. mutual support
C
The acronym ____ is a model for assertive statements. - I am concerned! - I am uncomfortable! - This is a safety issue!
CUS
Situation ____ (individual outcome) is the state of "knowing what's going on around you" A. perceiving B. monitoring C. development D. awareness
D
Task assistance, feedback, assertive statements, two-challenge rule, CUS, and DESC script are all tools/strategies for improving ______. A. communication B. leading teams C. situation monitoring D. mutual support
D
The following are all sub-components of which area of STEP (components of situation monitoring)? - status of team's patient(s) - established goals of team - tasks/actions of team - plan still appropriate? A. status of patient B. team members C. environment D. progress towards goal
D
The following describes which key principle of TeamSTEPPS? process of actively scanning assessing situational elements to gain information or understanding, or to maintain awareness to support team functioning A. team structure B. communication C. leadership D. situation monitoring E. mutual support
D
The _____ script is a constructive approach for managing and resolving conflict.
DESC (a.k.a. the hurt feelings report, a.k.a. the butt-hurt report).
The following describes which key principle of TeamSTEPPS? ability to anticipate and support team members' needs through accurate knowledge about their responsibilities and workload A. team structure B. communication C. leadership D. situation monitoring E. mutual support
E
____ is the transfer of information (along with authority and responsibility) during transitions in care across the continuum that includes an opportunity to ask questions, clarify, and confirm. A. call-out B. check-back C. reach-back D. send-off E. pull-out F. hand-off
F
During closure of a complex surgical case, the sponge count comes up one short after two careful counts. The surgeon ignores the request by the circulating nurse to help find a solution and continues the closure. The best action for the concerned circulating nurse would be to: a. Explain the current hospital policy and required actions. b. Page the medical director. c. Call the operating room supervisor. d. Scream at the doctor to stop the closure. e. Convince the anesthesiologist to make the surgeon respond.
a. Explain the current hospital policy and required actions.
A night nurse is concerned about the changing circumstances for an inpatient and knows it will be necessary to call and awaken the covering physician. Getting his thoughts and information together, he plans to structure the phone call using a proven structured communication technique, SBAR. He plans to introduce himself, identify the patient and describe: a. Situation, Background, Assessment, Recommendations. b. Sleep, Bathroom Activities, Results. c. Systems, Background, Alimentary, Respiratory. d. His pleasant memories of summer vacation at the S-BAR Ranch. e. Social Background, Assurance, Reassurance.
a. Situation, Background, Assessment, Recommendations.
SBAR - A - ____ - i.e. what do I think the problem is?
assessment
A nurse working in the Emergency Department overhears the doctor on the team make a misstatement about a sick patient, a comment that could result in a medical error and poor outcome. The nurse's correction of the misstatement is best interpreted as: a. A breach of etiquette in the Emergency Department. b. An interference in the doctor's business. c. An action of cross monitoring that makes teamwork safer. d. An action the doctor will likely get defensive about. e. A wrong-headed approach to teamwork.
c. An action of cross monitoring that makes teamwork safer.
In the interest of patient care quality and safety, it is expected and mandatory that: a. Conflict is avoided at all cost. b. People always do the right thing. c. Members speak up if they are concerned. d. Leaders not make mistakes. e. Everyone will agree with the plan.
c. Members speak up if they are concerned.
The team is making great progress with the procedure until the nurse recognizes that the doctor is clearly making a dangerous mistake in asking for a dose that is ten times the usual dose! Very concerned, she asks the doctor if he's sure that is what's wanted. Giving her a nasty look, he growls, "Well, that's what I asked for, isn't it?.." NOT confident and NOT positive that the dose is too high, but still very concerned about the patient's safety, should take the following course of action: a. Walk away and indicate discouragement at being treated so rudely. b. Say loudly, "That's a huge mistake, doctor; nobody uses a dose like that!" c. Not say anything for fear of making the doctor even more angry. d. Ask the secretary to put in a stat page to the nursing supervisor. e. Say, "I'm very concerned about the safety of that dose, Doctor; it's much higher than I've ever seen given."
e. Say, "I'm very concerned about the safety of that dose, Doctor; it's much higher than I've ever seen given."
The following are responsibilities of ____ ___ _____: - organize the team - ID and articulate clear goals (i.e. the plan) - assign tasks and responsibilities - monitor and modify plan - communicate plan changes - manage and allocate resource - facilitate conflict resolution - provide team feedback
effective team leaders
DESC script - E - ____ how the situation make you feel/what are your concerns
express (https://i.imgur.com/DqIJ5Ex.jpg)
Timely, respectful, specific, directed, and considerate are all important characteristics describing proper _____ to team members.
feedback
SBAR - R - ____ - i.e. what would I do to correct it?
recommendation (or request)
___ _____ involves helping others build a strong team with key strategies including: - team members protect each other from work overload situations - effective teams place all offers and requests for assistance in the context of patient safety - team members foster a climate where it is expected that assistance will be actively sough and offered
task assistance
The __ ____ Rule allows all team members to "stop the line" if they sense or discover an essential safety breach.
two challenge
Advocacy and assertion are used when team member' _____ don't coincide with that of the decision maker.
viewpoints
