TeamSTEPPS Fundamentals Course: Module 4. Situation Monitoring: Classroom Slides
TeamsTEPPS Fundamentals Course
- Slide 1. Situation Monitoring
- Slide 2. Objectives
- Slide 3. Scenario
- Slide 4. TeamSTEPPS
- Slide 5. A Continuous Process
- Slide 6. Situation Monitoring (Individual Skill)
- Slide 7. Cross Monitoring Is...
- Slide 8. Cross Monitoring Example
- Slide 9. Step
- Slide 10. Status of the Patient
- Slide 11. Team Members
- Slide 12. I'm Safe Checklist
- Slide 13. Environment
- Slide 14. Progress Toward Goal
- Slide 15. Situation Monitoring
- Slide 16. Situation Awareness Is...
- Slide 17. Conditions that Undermine Situation Awareness (SA)
- Slide 18. A Shared Mental Model Is...
- Slide 19. Shared Mental Model?
- Slide 20. Practical Exercise
- Slide 21. How Shared Mental Models Help Teams
- Slide 22. What Do You See?
- Slide 23. When To Share?
- Slide 24. Situation Monitoring
- Slide 25. Teamwork Actions
Slide 1: Situation Monitoring
"Attention to detail is one of the most important details ..."
Slide 2: Objectives
- Define situation monitoring
- Define cross monitoring
- Discuss the components of the STEP process
- Define situation awareness (SA), and identify conditions that undermine SA
- Discuss the importance of a shared mental model
- Discuss when to share information
- Recognize the barriers, tools, strategies, and outcomes of situation monitoring
Slide 3: Scenario
A patient in the ICU has coded, and CPR is in progress. The Resuscitation Team is busy ensuring that intravenous 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 5: A Continuous Process
Slide 6: Situation Monitoring (Individual Skill)
Process of actively scanning behaviors and actions to assess elements of the situation or environment
- Fosters mutual respect and team accountability
- Provides safety net for team and patient
- Includes cross monitoring
Remember, engage the patient whenever possible.
Slide 7: Cross Monitoring Is...
Process of monitoring the actions of other team members for the purpose of sharing the workload and reducing or avoiding errors
- Mechanism to help maintain accurate situation awareness
- Way of "watching each other's back"
- Ability of team members to monitor each other's task execution and give feedback during task execution
Mutual performance monitoring has been shown to be an important team competency.
(McIntyre and Salas 1995)
Slide 8: Cross Monitoring
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Cross Monitoring (Flash video, 18 sec.; 1.9 MB) (Download Flash)
Slide 9: STEP
Components of Situation Monitoring: Status of the Patient, Team Members, Environment and Progress Toward Goal
Slide 10: Status of the Patient
Status of the Patient
- Patient History
- Vital Signs
- Physical Exam
- Plan of Care
- Psychosocial Condition
Select the penguin director icon below to access the video.
STEP (Flash video, 38 sec.; 3.9 MB)
Slide 11: Team Members
- Task Performance
- Skill Level
- Stress Level
Slide 12: I'M SAFE Checklist
I = Illness
M = Medication
S = Stress
A = Alcohol and Drugs
F = Fatigue
E = Eating and Elimination
An individual team member's responsibility.
Slide 13: Environment
- Facility Information
- Administrative Information
- Human Resources
- Triage Acuity
Slide 14: Progress Toward Goal
Progress Toward Goal
- Status of team's patient(s)?
- Goal of team?
- Tasks/actions that are completed or that need to be done?
- Plan still appropriate?
Slide 15: Situation Monitoring
- Recollect examples of situation monitoring, in which you needed to:
- Be aware of what was going on
- Prioritize and focus on different elements of the situation
- Share this information with others
- Select one or two that best represent the concept of situation monitoring
Slide 16: Situation Awareness Is...
The state of knowing the current conditions affecting the team's work
- Knowing the status of a particular event
- Knowing the status of the team's patients
- Understanding the operational issues affecting the team
- Maintaining mindfulness
Slide 17: Conditions that Undermine Situation Awareness (SA)
- 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)
Slide 18: 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.
"Teams that perform well hold shared mental models."
(Rouse, Cannon-Bowers, and Salas 1992)
Slide 19: Shared Mental Model?
Slide 20: Practical Exercise
|1||Jackson||EKG, O2, Cardiac Enzymes||HR 115 R 24 B/P 174/98|
|2||Simmons||CBC, U/A, 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 21: How Shared Mental Models Help Teams
- Help ensure that teams know what to expect, so if necessary, can regroup to get on the "same page"
- Foster communication to ensure care is synchronized
- Ensure that everyone on the team has a picture of what it should look like
- Enable team members to predict and anticipate better
- Create commonality of effort and purpose
"Shared mental models help teams avoid errors that place patients at risk."
Slide 22: What Do You See?
Slide 23: When to Share?
- Transitions in Care
... Share information as soon as possible when a change occurs in the patient's status.
Slide 24: Situation Monitoring
|BARRIERS||TOOLS and STRATEGIES||OUTCOMES|
Slide 25: Teamwork Actions
- Conduct team exercises to increase situation monitoring skills
- Share information in a timely fashion
- Include patient and/or family in communication
- Use cross monitoring
- Apply the STEP process when monitoring the situation
- Foster communication to ensure that all members of the team have a shared mental model
- Share information during briefs, team huddles, debriefs, and transitions in care
"Teams do not seek consensus; they seek the best answer."
—Katzenbach and Smith