INTRODUCTION HEALTH CARE TEAM http://www.youtube.com/watch?v=sNSy4DX60vk Quote for the Day: To know what is right and not to do it is the worst cowardice." MEMBER OF HEALTH CARE TEAM D. Ann Currie RN,MSN MEMBER OF HEALTH CARE TEAM Member of the Health Care Team: A licensed nurse who provides patient-centered care by collaborating, coordinating, and/or facilitating comprehensive care with an interdisciplinary/multidisciplinary health care team to determine and implement best practices for the patients and their families. HEALTH CARE TEAM http://www.youtube.com/watch?v=3ad8LJZcnsE http://www.youtube.com/watch?v=i_Psl0nFEzw&feature=relate RNSG 2308 COURSE OBJECTIVES Unit II: Member of the Health Care Team Examine the role and responsibilities of the nurse when collaborating and communicating with the interdisciplinary health care team to provide patient-centered care to the childbearing families and women with selected health issues in various health care settings. (SLO #6) Explore the role of the nurse as an advocate for the rights and quality patient-centered health care of the maternal, newborn, or women’s health care patients and their families. (SLO#3) Describe the nurse’s role in delegating nursing care based upon analysis of the needs of childbearing families and women with selected health issues. (SLO #4, & 6) RNSG 2308 COURSE OBJECTIVES Discuss the nurse’s role as a healthcare advocate with members of the interdisciplinary health care team in the monitoring and promoting patientcentered health care quality and access to health care for the maternal, newborn, or women’s health care patients and their families. (SLO #3 & 6) Explore resources that facilitate continuity of care; health promotion, maintenance and restoration and disease prevention ensure confidentiality of the maternal, newborn, women’s health care patients and their families. (SLO #3 & 6) Explore the use of technology and informatics specific to the patientcentered care of maternal, newborn, and women’s health patients and their families. (SLO #5) TEXAS-DIFFERENTIATED ESSENTIAL COMPETENCIES Member of the Health Care Team: A. Coordinate, collaborate, and communicate with patients, their families, and the interdisciplinary health care team to plan, deliver, and evaluate patient-centered care. B. Serve as a health care advocate in monitoring and promoting quality and access to health care for patients and their families. C. Refer patients and their families to resources that facilitate continuity of care; health promotion, maintenance, and restoration; and ensure confidentiality. TEXAS-DIFFERENTIATED ESSENTIAL COMPETENCIES D. Communicate and collaborate in a timely manner with members of the interdisciplinary health care team to promote and maintain optimal health status of patients and their families. E. Communicate and manage information using technology to support decision making to improve patient care. F. Assign and/ or delegate nursing care to other members of the health care team based upon an KEY POINTS Collaboration Coordination • Delegation Communication Advocate • Patient’ Rights • Quality Patient-Centered Care • Access to health Care Resources and Referrals COLLABORATION Working with an interdisciplinary health care team to provide patient centered health care. Patient care conferences with health care team, patient, and their family. Interdisciplinary health care team rounds at patient’s bedside. NCLEX Collaboration with Interdisciplinary Team ..Identify need for interdisciplinary conferences ..Identify significant information to report to other disciplines (e.g., health care provider, pharmacist, social worker, respiratory therapist) ..Review plan of care to ensure continuity across disciplines ..Collaborate with healthcare members in other disciplines when providing client care* ..Serve as resource person to other staff COORDINATION Coordinates with the health care team patient centered care. Delegation of nursing care activities and tasks to nursing team members. Arranges for Referrals to other Health Care Team Members and or Services. Coordinates health care resources for the patients and their families. DELEGATION The Five Rights of Delegation: • • • • • Right Person Right Task Right Circumstances Right Directions/communication Right Supervision/feedback http://www.bne.state.tx.us/practice/pdfs/delegation-fiverights.pdf ****This website is from Texas BON even though it say BNE DELEGATION http://www.bne.state.tx.us/practice/delegationresources.html http://www.bne.state.tx.us/practice/pdfs/Delegation-Rule224.pdf http://www.bne.state.tx.us/practice/pdfs/Delegation-Rule225.pdf http://www.bne.state.tx.us/practice/pdfs/delegation-donts.pdf Delegation Links http://www.bne.state.tx.us/practice/delegationlinks.html ***** These websites are from the Texas BON even though they say BNE NCLEX Delegation ..Identify tasks for delegation based on client needs ..Ensure appropriate education, skills and experience of personnel performing delegated task ..Communicate task to be completed and client concerns that need to be reported immediately ..Utilize five rights of delegation (e.g., right task, right circumstances, right person, right direction or communication, right supervision or feedback) ..Evaluate delegated tasks to ensure correct completion of activity COMMUNICATION Communication Verbal Handoffs Reports Nurse to Nurse Nurse to Doctors Other Nurse to other Health Care Team Members Written Documentation of communication. GOAL 2 Improve the effectiveness of communication among caregivers. • For verbal or telephone orders or for telephonic reporting of critical test results, verify the complete order or test result by having the person receiving the information record and "read-back" the complete order or test result. • Standardize a list of abbreviations, acronyms, symbols, and dose designations that are not to be used throughout the organization. • Measure and assess, and if appropriate, take action to improve the timeliness of reporting, and the timeliness of receipt by the responsible licensed caregiver, of critical test results and values • Implement a standardized approach to “hand off ” communications, including an opportunity to ask and respond to questions. Clear BRIEF Timely IS THE LISTENER LISTENING COMMUNICATION http://www.youtube.com/watch?v=LNnr5tFkN6g&feature=related Handoff http://www.youtube.com/watch?v=K6Ah8ojVPiQ&feature=related SBAR COMMUNICATION What is SBAR and What is SBAR Communication? A Communication Technique for Today's Healthcare Professional Situation Background Assessment Recommendation (SBAR) is a standardized way of communicating. It promotes patient safety because it helps individuals communicate with each other with a shared set of expectations. Staff and physicians can use SBAR to share patient information in a concise and structured format. It improves efficiency and accuracy. SBAR stands for: Situation Background Assessment Recommendation COMMUNICATION WITH THE PHYSICIAN Communication with physician. “Dr. ________________, This is [state your name], one of the nurses in [state your department]. We have a new patient, [patient’s name], a [age] year-old, [race], [gender]. He came in with complaints of________________________ _____________________________, which started at [time of onset]. His vital signs are [HR], [RR], [BP], [T], and [pulse ox, amount of O2 and type of delivery]. He has a history of ___________________________________________. On assessment, we found______________________________________. So far, we have [tell what interventions you have done so far]. I think he may have ________________________________________. I think he needs some________________________________________. What else you would like for us to do?” Restate what needs to be done, including reading back the orders. Confirm when the health care provider will arrive to assess the patient. SBAR Effective http://www.youtube.com/watch?v=1r31pL1aZDQ Ineffective http://www.youtube.com/watch?v=NBNrYOBFwDs&feature=relmf u Nurse to nurse handoff http://www.youtube.com/watch?v=NOKDrWyYM6I NCLEX Continuity of Care ..Provide and receive report on assigned clients* ..Use documents to record and communicate client information (e.g., medical record, referral/transfer form) ..Use approved abbreviations and standard terminology when documenting care* ..Perform procedures necessary to safely admit, transfer, or discharge a client* ..Maintain continuity of care between/among healthcare agencies* ..Follow up on unresolved issues regarding client care (e.g., laboratory results, client requests) ADVOCATE The nurse is the patient’s advocate. • What does this mean for the maternal, newborn and women’s health care patient? • Give 3 example • http://www.youtube.com/watch?v=Q tFg417oF_A&feature=related NCLEX Advocacy ..Discuss identified treatment options with client and respect their decisions ..Provide information on advocacy to staff members ..Act as a client advocate* ..Utilize advocacy resources appropriately (e.g., social worker, chain of command, interpreter) THE PREGNANT PATIENT’S BILL OF RIGHTS Is it Different ? PREGNANT PATIENT’S BILL OF RIGHTS Same as Patient’s Bill of Rights except for: • Informed consent-Right to know how a procedure, medication, or treatment will effect herself, pregnancy, embryo, fetus, and/or neonate. • Or if she refuses the procedure, medication, and/or treatment how it could effect herself, pregnancy, embryo, fetus, and/or neonate • Can have significant other during labor. Pregnant Patient’s Bill of Rights-website http://www.aimsusa.org/ppbr.htm NCLEX Client Rights ..Recognize client right to refuse treatment/procedures ..Discuss treatment options/decisions with client ..Educate client and staff about client rights and responsibilities (e.g., ethical/legal issues)* ..Evaluate client/staff understanding of client rights QUALITY IMPROVEMENT Solve Patient Care Problem Prevent injuries Improve patient’s outcomes NCLEX Performance Improvement (Quality Improvement) ..Define performance improvement/quality assurance activities ..Participate in performance improvement/quality assurance process (e.g., collect data or participate on a team)* ..Report identified client care issues/problems to appropriate personnel (e.g., nurse manager, risk manager) ..Utilize research and other references for performance improvement actions ..Evaluate the impact of performance improvement measures on client care and resource utilization QUESTIONS THANK YOU http://www.youtube.com/watch?v=ur_ZOXWNag0