LEC 14.3: Evidence Based Practice & Collaboration and Teamwork

Evidence Based Practice

The integration of research evidence, clinical expertise, and patient preferences to guide clinical decision-making.

Evidence-Based Practice

Involves collecting, processing, and applying research findings to improve clinical outcomes, work environments, and nursing practices.

Problem-solving approach to clinical practice that encourages individualized, high-quality, and cost-effective patient care.

• RN deliver care to patients by applying validated interventions

• In BSN program, nurses learn about EBP which aids them in pinpointing care strategies that can help patients

• In current decades, EBP has become a key component of exceptional patient care

Why is EBP in nursing so important?

1. Form a clinical question to identify a problem

2. Gather the best evidence

3. Analyze the evidence

4. Apply the evidence to clinical practice

5. Assess the result

Steps of EBP

1. Randomized Controlled Trials

2. Evidence gathered from cohort, case-control analysis or observational studies

3. Opinions from clinical experts that are supported by experiences, studies, or reports from committees

4. Personal experience

4 Kinds of Research Used in EBP (Strongest to Least Strongest Evidence)

1. Provides nurses with the scientific research to make well founded decisions

2. Nurses can stay updated about new medical protocols for patient care

3. By searching for documented interventions that fit the profiles of patients, nurses can increase patients chances of recovery

4. Enables nurses to evaluate research so they understand the risks or effectiveness of a diagnostic test or treatments

5. Application of EBP enables nurses to include patients in their care planb

6. Allows patients to have a proactive role in their own healthcare

Benefits of EBP to Nurses and Patients

1. Better patient outcomes, which can decrease the demand for healthcare resources

2. Thus, HC orgs can reduce expenses

Advantage of EBP for Healthcare Orgs

1. Outdated practices may have included supplies

Example of EBP is advantageous for HC Orgs

1. Identifying and screening potential patients

2. Ensuring patients have all the necessary info to allow them to make a dully informed decision

3. Ensuring patients give fully informed consent before they are enrolled in a study

4. Support the Principal Investigator (PI)

Research-Related Roles and Responsibilities of Nurses

• Nurses

• Teamwork and collaboration

Who serves as a bridge between doctors, patients, and the hospital? And what is critical to this role?

Collaboration

Joint efforts between various independent teams or groups

Teamwork

Efforts within one team to produce the highest quality and most efficient results

1. Establish team goals

2. Assign roles within the team

3. Allow for open communication

4. Promote mutual respect

5. Handle conflict proactively

6. Be an effective leader

6 Principles of Teamwork & Collaboration

1. Establish Team Goals

Principle of Teamwork & Collaboration

Examples: Improving px care, shortening resp times and decreasing wate

2. Assign Roles within a team

Principle of Teamwork & Collaboration

• Crucial to have an understanding of key roles within individual teams

3. Allow for Open Communication

Principle of Teamwork & Collaboration

• Nurses must develop keen listening skills

• Breakdowns in HC communication can happen due to

  • Transfer of members to another dept

  • During shift changes

  • Poor transfer of info

  • When px changes nurses

4. Promote Mutual Respect

Principle of Teamwork & Collaboration

• This is critical in HC settings

• If we respect each other’'s time, effort experties

5. Handle Conflict Proactively

Principle of Teamwork & Collaboration

• Unavoidable but it is how we deal with it that is important

6. Be an Effective Leader

Principle of Teamwork & Collaboration

• Collectively decide as a team to enhance px outcomes

Self Awareness

Involves being aware of different aspects of the self including traits, behaviors and feelings

Psychological state in which oneself becomes the focus of attention

Anterior cingulate cortex (in frontal lobe region)

What part of the brain important in developing self awareness?

1. Public

2. Private

Types of Self Awareness

Public Self Awareness

• People are aware of how they appear to others

• Often emerges in situations when ppl are the center of attention

• Compels people to adhere to social norms

• Can lead to evaluation anxiety in which people become distressed, anxious, or worried

Private Self Awareness

• Happens when people become aware of some aspects of themselves but only in a private way

Self-Consciousness

Overly self-aware

Heightened state of self-awareness which can leave you feeling awkward and nervous in some instances

Temporary- arises when in the spotlight

Self-Awareness

Having an accurate view of one’s skills abilities and shortcomings

• Staff see most of the problems, while executives don’t see them (only recieve summary of reports)

Iceberg of Ignorance

Direct

Relationship betwen self-awareness and team-performance

1. Being present increases productivity

7 Ways to Develop Self-Awareness in Teams

• Actively participating, being able to experience what is happening

2. Move from blind spots to bright spots

7 Ways to Develop Self-Awareness in Teams

• 4 cmn blind spots:

  • Knowledge

  • Beliefs

  • Thoguhts

  • Emotional Blindness

Miscommunication

What is the main reason behind most team tensions?

3. Nurture a culture of clarity and transparency

7 Ways to Develop Self-Awareness in Teams

• Done to prevent miscommunication

4. Turn awareness into a team practice

7 Ways to Develop Self-Awareness in Teams

• Promote ongoing feedback

• Turn every team member into a coach

5. Self-aware people don’t fight reality - they adapt and thrive

7 Ways to Develop Self-Awareness in Teams

• Adaptability is a critical advantage to thrive in a fast-paced and unexpected world

• Adjust to whatever they are facing

6. Self awareness encourages curiosity - rather than resisting change, people pay attention and ask quesitons

7 Ways to Develop Self-Awareness in Teams

• Accepting realitiy is not passive or means giving up

• Teams need to have:

  • An objective and unfiltered assessment of reality - Acknowledge

  • Understand why things are happening - Learns

  • Adjust their mindsets, strategies, and behaviors

• Help team embrace the unknown rather than resisting

6. Go deep, but mind the gap

7 Ways to Develop Self-Awareness in Teams

• Uncovering biases and blind spots

7. Encourage self development, not just awareness

7 Ways to Develop Self-Awareness in Teams

• Self-development is an ongoing practice - it’s a habit that takes a lifetime to master

Dyad

Mini teams of two people who work together as coleaders of a specific system, division, clinical service line

One Plus One is Greater than Two

Dyad leadership in HC

Dyad

• A partnership

• Dates back to 1908

• Have physician and administrative leader

1. Role Definition

2. Accountability

3. Respect

3 Critical Success Factors for High Performing Dyads

Role Def

One of the 3 Critical Success Factors for High Performing Dyads

• Each leadership role has disciplined scoping and explicit delineating of responsibilities

Accountability

One of the 3 Critical Success Factors for High Performing Dyads

• Leaders are held __ for specific, measureable goals — some shared, some separate, but always complementary

Respect

One of the 3 Critical Success Factors for High Performing Dyads

• Third

1. Follower

2. Leader

What is the Dyadic Relationship between in the Leader Member Exchange?

Dyad

Partnership where Administrative or Nurse Leader is paired with a Physician Leader, bringing together complementary skills and expertise

Triad

Bringing all three- Nurse Leader, Physician Leader, and Administrator - for complementary skills and expertise

Group

Collection of individuals who interact with each other such that one person’s actions have an impact on the others

Group

Two or more individuals, interacting and interdependent who have come together to achieve particular objectives

Group

Have regular contact and frequent interaction, mutual influence, common feeling of camaraderie and who work together to achieve common set of goals

1. Working on a complex and independent task that is too complex for an individual to perform and that cannot be easily broken down into independent tasks.

2. Generating new ideas or creative solutions to solve problems that require inputs from several people

3. Serving liaison or coordinating functions among several workgroups whose work is to some extent independent

4. Facilitating the implementation of complex decisions. A group composed of representatives from various working groups can coordinate the activities these interrelated groups.

5. Serving as a vehicle for training new employees, groups teach new members methods of operations and group norms.

Functions of a Group

Types of Groups

Formal Group

• Created to achieve specific organizational objectives

• Usually, they are concerned with the coordination of work activities

• People are brought together based on different roles within the structure of the organization. The nature of the task to be undertaken is a predominant feature of the formal groups

Informal Group

• Within the formal structure of the organization, there will always be an ___ structure

• The formal structure of the organization and system of role relationship, rule, and procedures, will be augmented by interpretation and development at the informal level

Managed Group

• Groups may be formed under a named manager, even though they may not necessarily work together with a great deal. The main thing they have in common, at least the manager and perhaps a similar type of work

Processed Group

• Acts together to enact a process, going through a relatively fixed set of instructions. The classic environment is a manufacturing production line, where every movement is prescribed.

• There may either be little interaction within process groups or else it is largely prescribed, for example where one person hands something over to another

Semi-Formal Groups

• Many groups act with less formality, in particular where power is distributed across the group, forcing a more collaborative approach that includes- negotiation rather than command and control

• Families, communities and tribal groups often act as semi-formal ways as they both have nominal leaders yet members can have a high degree of autonomy

Goal Group

• Acts together to achieve a shared objective or desired outcome. Unlike the process groups, there is no clear instruction on how they should achieve this, although they may use some processes and methods along the way

• As there is no detailed instruction, the members of the goal group need to bring more intelligence, knowledge, and experience to the task

Learning Group

• Comes together to increase their net knowledge. They may act collaboratively with discussion and exploration, or they may be a taught class, with a teacher and a syllabus

Problem-Solving Group

• Come together to address issues that have arisen. The have a common purpose in understanding and resolving their issue, although their different perspectives can lead to particular disagreements

• ____may rang along a spectrum from highly logical and deterministic, t uncertain and dynamic situations there creativity an instinct may be better ways o resolving the situation

Friendship Group

• Groups often develop because individual member have one or more common characteristics. We call thes formations of this group

• Social alliances, which frequently extend outside the work situation, can be base on similar age or ethnic heritage, support for Kolkat Knight Riders cricket, or th holding of similar politic views, to name just a fe such characteristics

Interest Group

• People who may or may not be aligned into a common command or task groups may affiliate to attain a specific objective with which each i concerned

• Employees who band together to have their vacation schedules altered, to support a peer who has been fired, o to seek improved workin conditions represent th formation of a united body t further their common interest

Team

Group of individuals (human or non-human) working together to achieve their goal

Team

Group of people who are interdependent with respect to information, resources, knowledge and skills who seek to combine their efforts to achieve a common goal

False; A group does not necessarily constitute a team

True or False: A group usually constitute a team

Teams

normally have members with complementary skills and generate synergy through a coordinated effort which allows each memebr to maximize their strengths and minimize their weaknesses.

Team Nursing

Defined as “a group of people who are mutually dependent on one another to achieve a common goal.” The primary benefit of this approach is that pairing nurses provides a resource and supplement to patient care.

WWII; Nurse aids were utilized to decrease workload of nurses and allow them to focus on specialized tasks.

Where does Team Nursing date back from?

1. Charge Nurse (RN)

2. Primary Nurse (RN)

3. Ancillary Personnel (CNA)

What does Team Nursing typically look like today and is the most common format for Team Nursing today?

• LPNs

Another Nursing Aid that may be employed

True

True or False: Giving a novie nurse or new hire a more seasoned or senior nurse as a partner can build relationships and take pressure off a charge nurse to act as the only resource

Healthcare Team

regardless of whether you’re treated at a large academic institution or a small rural private practice, is the group of professionals who contribute to your care and treatment as a patient