TeamSTEPPS Fundamentals Course: Module 5. Situation Monitoring
Classroom Slides
Contents
- Slide 1. Situation Monitoring
- Slide 2. Teamwork Exercise #2
- Slide 3. Objectives
- Slide 4. Situation Monitoring
- Slide 5. A Continuous Process
- Slide 6. STEP
- Slide 7. Status of the Patient
- Slide 8. Team Members
- Slide 9. I'm SAFE Checklist
- Slide 10. Environment
- Slide 11. Progress Toward Goal
- Slide 12. Situation Monitoring Exercise
- Slide 13. Situation Awareness is...
- Slide 14. Conditions That Undermine Situation Awareness
- Slide 15. A Shared Mental Model is...
- Slide 16. Shared Mental Model?
- Slide 17. When and How to Share?
- Slide 18. Practical Exercise
- Slide 19. What Do You See?
- Slide 20. How Shared Mental Models Help Teams
- Slide 21. Tools & Strategies Summary
- Slide 22. Applying TeamSTEPPS Exercise
Slide 1: Situation Monitoring
Slide 2: Teamwork Exercise #2
Slide 3: Objectives
- Discuss how situation monitoring affects team processes and outcomes.
- List components of the STEP mnemonic.
- Explain situation awareness and identify undermining conditions.
- Define a shared mental model and how it is cultivated within a team.
Slide 4: Situation Monitoring
- Ensures new or changing information is identified for communication and decisionmaking.
- Leads to effective support of fellow team members.
Image: The TeamSTEPPS logo. [D] Select for Text Description.
Slide 5: A Continuous Process
- Situation monitoring (an individual skill).
- Situation awareness (an individual outcome).
- Shared mental models (a team outcome).
Slide 6: STEP
The components of Situation Monitoring:
- Status of the patient.
- Team members.
- Environment.
- Progress toward the goal.
Slide 7: Status of the Patient
- Patient history.
- Vital signs.
- Medications.
- Physical exam.
- Plan of care.
- Psychosocial condition.
Select the link below to access the video.
STEP (38 sec.)
Slide 8: Team Members
- Fatigue level.
- Workload.
- Task performance.
- Skill level.
- Stress level.
Select the link below to access the video.
Cross-Monitoring (18 sec.)
Slide 9: I'M SAFE Checklist
- I = Illness.
- M = Medication.
- S = Stress.
- A = Alcohol and Drugs.
- F = Fatigue.
- E = Eating and Elimination.
Slide 10: Environment
- Facility information.
- Administrative information.
- Human resources.
- Triage acuity.
- Equipment status.
Slide 11: Progress Toward Goal
- Call a huddle.
- Status of the team's patients.
- Goal of the team.
- Tasks/actions completed or that need to be completed.
- Continued appropriateness of the plan.
Slide 12: Situation Monitoring Exercise
A patient in the ICU has coded, and CPR is in progress. The Resuscitation Team is busy ensuring that IV access is available and the ET tube is inserted correctly. Dr. Matthews, the Team Leader, is calling out orders for drugs, X-rays, and labs. Judy, a nurse at the bedside, is inserting an IV. Nancy, another nurse, is drawing up meds. Judy can tell by Nancy's expression that she didn't get the last order called out by Dr. Matthews. Judy calls out while continuing to place the IV, "Nancy, he wants the high-dose epinephrine from the vial in the top drawer."
Slide 13: Situation Awareness is...
The state of knowing the current conditions affecting one's work.
Includes knowing...
- Status of the patient.
- Status of other team members.
- Environmental conditions.
- Current progress toward the goal.
Image: A seal is trying to catch a penguin using fish as bait. The seal is thinking about eating the penguin, and the penguin is thinking about eating the fish.
Slide 14: Conditions That Undermine Situation Awareness
Failure to—
- Share information with the team.
- Request information from others.
- Direct information to specific team members.
- Include patient or family in communication.
- Utilize resources fully (e.g., status board, automation).
- Maintain documentation.
- Know and understand where to focus attention.
- Know and understand the plan.
- Inform team members the plan has changed.
Slide 15: A Shared Mental Model is...
The perception of, understanding of, or knowledge about a situation or process that is shared among team members through communication.
Image: Four penguins all thinking about the same fish.
Slide 16: Shared Mental Model?
Image: Four people in a group are wearing hazard suits and masks and searching the ground. A fifth person in shorts and polo shirt stands by apparently unconcerned.
Slide 17: When and How to Share?
When:
- Briefs.
- Huddles.
- Debriefs.
- Transitions in Care.
How:
- SBAR.
- Call-outs.
- Check-backs.
Slide 18: Practical Exercise
Room # | Patient | Orders | VS |
---|---|---|---|
1 | Jackson | EKG, O2, Cardiac Enzymes | HR 115 R 24 B/P 174/98 |
2 | Simmons | CBC, UA, HCG, IV | HR 132 R 22 B/P 92/76 |
3 | Bailey | CXR, neb Rx, CBC, UA, O2 | HR 120 R 32 B/P 132/86 |
Slide 19: What Do You See?
Images: Three images of optical illusions with multiple interpretations are shown: American Indian and Alaska Native, old woman/young girl, and duck/rabbit.
Slide 20: How Shared Mental Models Help Teams
- Lead to mutual understanding of situation.
- Lead to more effective communication.
- Enable back-up behaviors.
- Help ensure understanding of each other's roles and how they interplay.
- Enable better prediction and anticipation of team needs.
- Create commonality of effort and purpose.
Slide 21: Tools & Strategies Summary
Barriers | Tools and Strategies | Outcomes |
---|---|---|
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Slide 22: Applying TeamSTEPPS Exercise
- Is your teamwork issue related to the team's or individuals' skill at monitoring the situation?
- If yes, what is the situation monitoring issue?
- Which situation monitoring tools and/or strategies might you consider implementing to address the issue?