Summary Role Play: Exercise Sheet

TeamSTEPPS® Long-Term Care Version: Module 7

The Long-Term Care version of TeamSTEPPS adapts the core concepts of the TeamSTEPPS program to reflect the environment of nursing homes and other other long-term care settings such as assisted living and continuing care retirement communities. The examples, discussions, and exercises below are tailored to the long-term care environment.

 

Disclaimer: This is a fictitious case used only for training purposes.

Instructions:

  1. Break into four small groups. Each group will receive one of four teamwork skills to focus on.
  2. Read the role play scenario below.
  3. Identify the instances where a breakdown in teamwork has occurred as it relates to the specific teamwork skill assigned to your team.
  4. Identify two or three tools or strategies related to the specific teamwork skill assigned to your team that can be applied to remedy the teamwork breakdowns. Refer to your course materials for reference if needed.
  5. Assign character roles among your team members and create a role play script based on the tools and strategies that your team has decided upon.
  6. Present your role play scenario.
  7. A facilitated debrief will wrap up the exercise.

Scenario:

A gastrointestinal outbreak has occurred within the nursing home and has affected the entire house. Most of the residents are exhibiting symptoms and many staff has called out sick as well. Everyone is working extra hours and is tired. Dr. Goldberg, who is notoriously difficult to work with and does not work well under stress, has received many calls and faxes about his patients at the nursing home today already. Then Nurse Corvo calls about a new resident with Parkinson's disease recently admitted to the dementia unit. Dr. Goldberg gives a telephone order for "ropinirole 0.25 mg three times a day" to Nurse Corvo. Nurse Corvo, for whom English is a second language, quickly writes the order and reads back the telephone order as "ropinirole 0.25 mg three times a day" as her check-back. The doctor confirms it is correct.

The written order is faxed to the pharmacy. The receiving pharmacist is a float pharmacist who does not usually work with nursing homes, and he is fatigued from his 7th day of working. He is also overloaded and overburdened by the large number of prescriptions sent in by the area nursing homes. The pharmacist misreads the poorly written transcription as "0.25 mg three times a day of risperidone." At the end of Nurse Corvo's shift, she hands off to Nurse Dabrowski. During the handoff, the Code Team is activated, and Nurse Corvo has to respond. Nurse Dabrowski receives the pharmacy delivery. The pharmacist dispensed risperidone. Nurse Dabrowski, a conventional thinker who does not like to upset the hierarchical structure, suspects something is wrong with the order but decides risperidone must be a generic name for ropinirole. (Risperidone is actually a psychotropic agent.) Nurse Dabrowski administers risperidone to the patient. The patient is later hospitalized due to the medication error.

Current as of June 2012
Internet Citation: Summary Role Play: Exercise Sheet: TeamSTEPPS® Long-Term Care Version: Module 7. June 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/longtermcare/module7/ex7summary.html