Communication Breakdown and Effective Teamwork in Healthcare, Exams of Nursing

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NUR 410 IPE Module Questions With Complete Solutions A patient in the ICU should have had orders written for a liquid diet. No one on the team added the order to the patient's chart. As a result, the hospital kitchen delivered a lunch of Salisbury steak and salad, which the patient could not eat. What is this an example of? A. A medical error. B. A lack of patient advocacy. C. A power struggle between professionals. D.A gap in service to the patient. Correct Answers D.A gap in service to the patient. At Maria Garcia's follow-up rehabilitation appointment, Alice (physical therapist) learned for the first time that Robin (occupational therapist) recommended a lift chair for Maria. We view her surprised reaction. What is this incident an example of? Click all that apply: A.Excluding members of the team on decision making B. Communicating too late C. Ascribing tone or intent to others' messages or actions D. Taking personal offense to feedback or comments E. Not resolving issues quickly F. Not providing enough information, omitting information, or providing inaccurate information Correct Answers A & B

Based on what you know about Maria, which of the following values is most likely a high priority to her? A.Discipline B.Treatment adherence C.Family D.Respect for health care providers Correct Answers C.Family By calling a conflict a "miscommunication," how might that change the nature of the conversation when seeking a solution? Select all that apply: A. It can allow one or more parties to "save face" and avoid an overt confrontation about who is to blame. B. It allows both parties to address and clarify their position in a non-accusatory way. C. It limits each parties' perception of the severity of the conflict. Correct Answers A & B Communication breakdown: Communicating too late Correct Answers Clear communication: Call team huddles-share information frequently and "check in" to update each other. Communication breakdown: Excluding members of the team on decision making. Correct Answers Clear communication: Assign clear roles and tasks to members of a team and involve those members in relevant actions.

Communication breakdown: Lack of follow-up Correct Answers Clear communication: Make an action plan and timeline for following-up on these actions. Communication breakdown: Not providing enough information, omitting critical information, or providing inaccurate information. Correct Answers Clear communication: Be specific and detailed to ensure others understand your message; confirming their understanding. Communication breakdown: Not understanding the information being shared (and being too embarrassed to ask for clarification). Correct Answers Clear communication: use a common language and avoid profession-specific terms and medical jargon. Cultural competence Correct Answers A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enable effective work in cross-cultural situations. Demonstrating respect, flexibility, and openness to patient needs. Correct Answers Maria's team makes time to rethink the plan and returns to discuss more patient-centered options Demonstrating team engagement and collaborative support. Correct Answers Phyllis (SW) suggests and outpatient stroke facility; Jane (SLP) supports her by offering to contact a colleague there.

Ethical Dilemma Correct Answers Issues that may stem from a conflict between moral beliefs and values. Ethics Correct Answers Moral principles that help determine what one should do. Forming Correct Answers Members become oriented to each other, team goals, and tasks to be done. They seek acceptance and safety in the group. Health equity Correct Answers The right of every individual to achieve their highest level of health. How did the follow-up conversation between Robin (OT) and Alice (PT) help promote their future working relationship? Select all that apply: A.Robin's actions led to a potential role conflict, but made sure to address it quickly. B. Alice will allow Robin to make future recommendations regarding physical therapy without consulting her, as long as it benefits the patient. C. The exchange helped build trust which will serve them well going forward. D. Alice finally had a chance to vent her frustrations with Robin overstepping her boundaries.

E. Both providers felt it was right to resolve the issue before the end of the work day. Correct Answers A, C, & E How did the introduction of the additional team member, Dr. Osgood, change the dynamics of the meeting? A. Dr. Osgood's demonstration of flexibility and openness added to the team's overall flexibility and openness to achieve consensus. B. A change in Dr. Osgood's clinical opinion convinced several team members to also change their minds. C. Dr. Osgood learned about the conflict from the prior meeting and felt that she needed to attend to help mediate this conflict. D. Dr. Osgood's addition as a new member of the team reset their development to the Forming phase. E. Dr. Osgood stepped in as new team leader to help the team achieve a resolution Correct Answers A. Dr. Osgood's demonstration of flexibility and openness added to the team's overall flexibility and openness to achieve consensus. How does providing patient-centered care promote health equity? A. Listening to the values and beliefs of patients and including them in the plan of care should help the patient reach their optimal level of health.

B. Educating patients on the recommended guidelines will help providers create a plan of care that yields the best outcomes. C. Identifying whether the patient's beliefs conflict with the plan of care should help the provider determine the best way to get the patient to adhere to the treatment plan. D. Educating patients about lifestyle modification and the importance of treatment adherence will help to optimize outcomes. Correct Answers A. Listening to the values and beliefs of patients and including them in the plan of care should help the patient reach their optimal level of health. In an interprofessional team model, who should take responsibility for organizing the team prior to a meeting with a patient/family? A. The team should alternate, depending on the patient issues/needs. B.The team member who spent the most time with the patient. C.Any member of the team who arrives first. D. No one. No sole members should lead team meetings. E. The attending physician. Correct Answers A. The team should alternate, depending on the patient issues/needs.

Interprofessional Collaborative Practice Correct Answers Different members of the healthcare team who work together to provide the highest quality of care (WHO, 2010). Managing competing ideas in order to come up with a unified interprofessional plan. Correct Answers With a new discharge plan and family commitment, an alternative to inpatient rehabilitation is found. Norming Correct Answers Rules and processes are decided and members adjust expectations. Mutual trust contributes to group cohesion. Patients and their caregivers are more likely to comply with treatments when they are able to play an active role in their health care. Which of the following actions could the health care team encourage Tania to do for her mother?Select all that apply. A. Ask questions when terms or next steps are not clear B.Give the provider a list of medications, supplements or vitamins C. Do exactly what her health care provider recommends as a course of treatment D.Find good health care providers E.Avoid questioning her health care provider Correct Answers A, B, & D

Patients and their families are participating partners in the health care team. What do you think is most important outcome when meeting with a patient and family to discuss recommendations for the patient's discharge plan, post-hospitalization? A. The patient and family agree to be compliant with the medical recommendations. B. The medical team understands the patient/family needs. C.The patient and family understand the medical recommendations. D. The medical team and patient/family collaborate to create a workable plan. Correct Answers D. The medical team and patient/family collaborate to create a workable plan. Performing Correct Answers Members work in total collaboration with an emphasis on productivity. Accomplishments boost team identity and morale. Practicing effective team leadership skills Correct Answers Rose (RN) apologizes for her facilitation of the prior meeting and for not getting Phyllis' report. Rose should not have referred the family to a nutritionist since providing dietary advice is well within her scope of practice as a registered nurse. A. True B.False Correct Answers B.False Storming Correct Answers A struggle for power and control is common when roles and group rules are unclear. Members may withdraw or turn dominant.

What did Rose (RN) do to defuse the tension with the family? Select all that apply: A.Introduced herself and her role in the team. B.Communicated the next steps for Maria's recovery. C.Inappropriately recommended that the family see a nutritionist. D.Validated the family's concerns and frustrations. E.Defended the actions of CNA Henderson concerning the need to obey Maria's dietary orders. Correct Answers A,B, and D What is the first thing the transporters should have done? A. confirmed the transfer orders with the patient's family. B. Asked the neurology ICU nurse to speak with Maria to explain why she was being moved to the step-down neurology unit. C. Introduced themselves, their job title, and their role. Correct Answers C. Introduced themselves, their job title, and their role. What is the most immediate risk to this patient and family resulting from the discharge plan that was preasented? A.Re-hospitalization of the patient due to her failure to complete prescribed rehabilitation exercises. B. Burn out by overstressed caregivers, resulting in a high potential for elder abuse and neglect. C.The patient and family's inability to express their concerns can result in a failure to follow through on the discharge plan.

D. The family's frustrations with the process could be labeled as 'non-compliant' and services could be discontinued. Correct Answers C.The patient and family's inability to express their concerns can result in a failure to follow through on the discharge plan. What leadership strategies would you use....to introduce an engage a new member of you team? Correct Answers Review member roles/responsibilities, remind team of mission and shared goals, review ground rules and work processes, set clear expectations. What leadership strategies would you use...to advance team performance? Correct Answers Utilize strengths and abilities of members, manage time effectively, debrief to assess outcomes, recognize team/member accomplishments and collaborative behaviors, keep members accountable. What leadership strategies would you use...to manage conflict within the team? Correct Answers Demonstrate flexibility and openness, mediate disagreements, encourage open discussion, correct assumptions, encourage positive behaviors and discourage negative behaviors, keep team on task. What should Valerie Henderson, the Certified Nursi Assistant (CNA), have done when she first entered Maria's room? Select all that apply: A. Introduced herself, her job title, and her role. B.Asked Ms. Garcia to name the medications she takes.

C.Explained that Maria's vitals will be taken every 4 hours and that this is normal. D.Explained that she is busy because a coworker on the prior shift didn't perform a task that she now must do. Correct Answers A and C What were some differences you observed regarding team functioning in this meeting compared to their prior meeting? A. The team mission and goals were more united and shared among members in this meeting compared to the prior meeting. B. This meeting had a lot less misinformation and off-task remarks being shared by members. C. This meeting was more structured and organized. D. Team member conflict was not managed as well in this meeting compared to before. Correct Answers A. The team mission and goals were more united and shared among members in this meeting compared to the prior meeting. What would be a good response to Tania's concerns? A.Suggest that Maria remain as an inpatient in hospital to work through a couple more days of therapy with Tania observing to prepare for transfer to home and out-patient therapy. B. Agree with her and restate why discharge and transfer to an in-patient rehabilitation center is best, reminding her of the team's overwhelming consensus in this being best for Maria's

health. Correct Answers A.Suggest that Maria remain as an inpatient in hospital to work through a couple more days of therapy with Tania observing to prepare for transfer to home and out-patient therapy. When the team assembled to discuss Maria's status with her daughter Tania, Joseph (MD) decided to lead the meeting. Which of the following actions by the other team members would support the tenets of a highly functioning team? A. Phyllis tells Sandra (RN) that she is displeased about how the meeting was run. B. Sandra insists on running the meeting since she knows the most about the patient C.Joseph asks Phyllis if she would like to facilitate the meeting. D.Phyllis (SW) states, "I called the meeting so I will run it." Correct Answers C.Joseph asks Phyllis if she would like to facilitate the meeting. Which actions were demonstrated by the team leader [Rose] that supported team development? Select all that apply: A. She introduced Dr. Osgood and explained her roles and responsibilities to the team. B.She demonstrated flexibility in allowing the team to explore alternatives and engage in shared decision-making.

C. She held herself accountable for past leadership actions/decisions. D. She corrected other members' assumptions about Maria's willingness to enter inpatient rehabilitation. Correct Answers C & D Which of the following actions violates the ethical principle of autonomy? A. Creating a treatment plan without considering the beliefs and values of the patient. B. Advocating for a patient's belief even through they conflict with recommended treatment guidelines. C.Sharing information with the patient's daughter before getting permission from the patient. D. Providing a member of the health care team with the expressed wishes of the patient. Correct Answers A.Creating a treatment plan without considering the beliefs and values of the patient. Which of the following stages of development do you think this team has experienced from the time Phyllis first joined up to now? A. Storming-Norming B. Storming-Performing C.Forming-Norming

D. Forming-Storming E. Performing-Forming Correct Answers D. Forming-Storming