Building Nursing Management Skills Study Guide

Analyze effective communication as it relates to eliminating harm.
Analyze TeamSTEPPS 2.0 tools as an evidence-based teamwork system to optimize client outcomes.
Assess the current methods of safe communication including transcription of prescriber’s orders.
Use a standardized hand-off communication tool (SBAR or I-SBAR-R) for exchanging client information.
Discuss strategies to manage and prioritize your time in the clinical setting.
Identify the criteria for supervising and delegating care provided by others.

Communication failures are a leading cause of preventable client deaths.
Integration of teamwork skills is imperative to improve client outcomes and enhance safe nursing practice.

TeamSTEPPS 2.0 is a comprehensive communication and teamwork training program designed to help healthcare teams improve performance and patient safety.

Accept verbal orders only during emergencies or procedures, otherwise request a written order.
Orders must be written down verbatim and read back to the person who provided it for confirmation of accuracy.

Legibility is crucial in written communication.
Avoid the trailing “0” when referring to numbers to prevent misinterpretation (e.g., $0.5$ should not be written as $0.50$).
Avoid unapproved abbreviations to ensure clarity and avoid errors.
Provide written and verbal information in clients’ native languages to bridge cultural variances and enhance understanding.

Improve handwriting and clarity.
Monitor the use of abbreviations.
Use permanent ink and avoid corrections that are unclear (no erasures or cross-outs).
Opt for digital communication when feasible and print all communications.
Avoid neglecting written communication in favor of solely verbal interactions.

All orders should include:
- Client’s identifying information (name, date of birth).
- Current date and time of the order.
- Clarity and legibility of the order.
- If a discrepancy is noted, the physician must be contacted for clarification.
Types of written orders:
- One time only
- PRN (as needed)
- Standing
- STAT
- CPOE (Computerized Prescriber Order Entry): Reduces handwriting errors, integrates with lab and medication records, allows order entry from various locations.

Includes reporting critical high/low lab results and diagnostic values.
Notify the physician of critical test results and document the conversation.
If the physician cannot be contacted, initiate institutional chain of command policies.

Ensure to include:
- Client identifiers (name, date of birth).
- Diagnoses.
- Attending physician.
- Relevant medical and social history.
- Current physical condition (review of systems).
- Resuscitation status and nutritional intake.
- Pending or critical issues and tests.
Bedside report: This involves transitioning reports near the client’s bed, allowing both caregivers and families to engage in their health plans actively.

Recommendations for minimizing distractions during critical times such as medication administration:
- Designate quiet zones around medication areas.
- Utilize brightly colored vests to signal that personnel are engaged in critical tasks.

When using the telephone with healthcare providers:
- Introduce yourself and state your inquiry without apologies.
- Be concise and clear in your communication.
- Document attempts to contact physicians and any relevant interactions.

Strategies to effectively manage time include:
- Organizing before change of shift reports.
- Using prioritization techniques (ABCD System and Maslow’s hierarchy of needs).
- Organizing work by the client, focusing on multitasking during visits to maximize efficiency.

Understand state regulations regarding delegation:
- Delegate stable clients with predictable outcomes first.
- Tasks to delegate may include feeding, bathing, and dressing by unlicensed assistive personnel.
- RN retains responsibility for client education and discharge planning.

When giving feedback to others:
- Sandwich positive recognition with constructive criticisms.
- Focus on factual performance rather than personal character.
- Actively listen to the individual’s perspective and allow self-reflection.

Scenario regarding a nurse and health care provider discussing a client’s need for an x-ray: Assess appropriate actions for order documentation.
Discuss the significance of using approved abbreviations in charting practices for new nurses.
Case scenario analyzing client prioritization based on immediate clinical needs after shift report.
Medication order transcription evaluation based on best practices for clarity.
Strategies for effective discharge instructions for non-English speaking clients.