Week 7: Managing patient Care, teamwork and collaboration

Clinical care coordination consists of

Clinical decisions Priority setting Organizational skills Use of resources Time management Evaluation

Theory of collaborative decision making

-Collaboration between the patient and the nurse -Could extend to other family members or health professionals -Continuum with joint decision making as the highest level of collaboration

Low priority

Actual potential problems may or may not be directly related to patients illness or disease

When making clinical decisions____

Apply the nursing process Know your patient Use clinical decision making practices Accurate, clinical decision making keeps you focused on the proper course of action

Collaboration exist at each level of the nursing process, which includes

Assessment Diagnosis Outcomes identification Planning Implementation Evaluation

Interprofessional education collaborative model

Attributes are equally distributed in a fluid circle surrounded by patient- and family-centered care

Examples of interprofessional education

Clinical care coordination Team communication Delegation Knowledge building

Case management

Collaborative process of assessing, planning, facilitating, and advocating for options and services to meet an individuals health needs Clinicians oversee management of patients with specific complex health problems Case manager is often an APN, who helps via specific interventions

CEUs

Continuing Education Units, credits required for many certified professionals

Decentralized management

Decision making occurs at the level of the staff

The complexity of healthcare delivery systems requires and interprofessional approach. This includes:

Educators Researchers Administrators

Nursing manager support staff through:

Establishing nursing practice through problem-solving committees or professional, shared governance councils Staff communication, staff education

To determine which patient's needs should be addressed first they should be categorized by priority setting, which include

High priority Intermediate priority Low priority

QSEN initiative anticipates that collaboration will have a huge impact on positive patient outcomes and _____

Improve quality of care for the best outcomes for patients

Interorganizational collaboration

Includes pooling resources between organizations to benefit patients and communities from all different departments

The _______ identifies effectively working together as an important, professional competency

Institute of Medicine (IOM)

high priority

Intermediate threat to patient survival or safety

Collaboration

Is a development of partnerships to achieve the best possible outcomes that reflect the particular needs of the patient, Family, or community

Intermediate priority

Nonemergent, non-life threatening

First principle of delegation

Nurses must have knowledge of the nurse practice act in the state where they are license

Today's models of Nursing care delivery methods

Patient centered care Total patient care Case management

What goes into collaboration?

Professional identity, ethics, communication, safety, healthcare, quality, care, coordination

Total patient care

Registered nurse works directly with patient, family, and health care team members. RN is responsible for patients during shift of care, although care can be delegated. Approach may not be cost-effective owing to high number of registered nurses needed. Patient satisfaction is high.

Time management is important in clinical care coordination, this means

Remain goal oriented Identify priorities Establish personal goals

Effective team development

Requires team building and training, trust, communication, and a workplace that facilitates collaboration

Patient and family centered care focuses on

Respect and dignity Information sharing Participation Collaboration

The five rights of delegation

Right task Right circumstance Right person Right direction Right supervision

___________ has cited the breakdown in communication among team members as the primary factor in sentinel events

The Joint Commission (TJC)

Second principle of delegation

The RN cannot delegate assessment, planning, evaluation, or accountability for the assigned task

Third principle of delegation

The person to whom the assignment was delegated, cannot delegate that assignment to someone else

Models of interprofessional, collaborative practice

Theory of collaborative decision making Interprofessional education collaborative model

Delegation by NCSBN

Transfer of ahthority

Delegation by ANA

Transfer of responsibility

Delegation means

Transferring responsibility while remaining accountable for outcomes Requires knowing which skills are transferable Results and improved quality, safe, patient care, improve deficiency, increase, productivity, and empower stuff, and skill development of others

Staff involvement in decision making

Transformational leadership All staff benefit from knowledge and skills of entire work group Requires skilled communication

For attributes necessary for effective interprofessional collaboration

Values and ethics Roles and responsibilities Communication Teams and teamwork

Nurse-Nurse Collaboration

mentoring, shared governance (both making decisions), happens in all levels of nursing, and in various types of practice

Traditional models of nursing care delivery methods

team nursing (ER setting) and primary nursing (main care)