UPDATE 2026
Evidence Based Practice - Answers Problem solving approach to clinical decision making
Where research has indicated best practices that improve or save, patient lives, lower length of stay,
and improve mortality rates
better safety=better quality of care
*Safety & Quality Improvement*
-National Patient Safety Goals
>The Joint Commission
Teamwork & Collaboration - Answers Work with interdisciplinary team members
-communication is KEY
*S*ituation (Dx Admission)
*B*ackground (Hst)
*A*ssessment (Data)
*R*ecommendation (interventions)
Teamwork & Collaboration (*Holistic Multudisciplinary approach*) - Answers Using a holistic
multidisciplinary approach: In critical care, the need for a multidisciplinary approach increases.
Several physician specialties, may be involved in the care of the patient.
Physical therapists, respiratory therapists, pharmacists, occupational therapists, case managers, social
workers, dieticians, and dialysis nurses may all be involved in attaining outcomes in the care of one
patient
WHO COORDINATES ALL OF THESE PEOPLE? THE NURSE!!
Teamwork & Collaboration (*Delegation*) - Answers *Right* task
*Right* circumstance
*Right* person
*Right* supervision
*Right* direction & communication
Communication - Answers Communication is paramount
Ineffective communication is the #1 cause of sentinel events in the hospital
#2 medication
1-Read back of standard orders
2-Use of standard abbeviations
3-Timely & accurate reporting of critical lab results
4-Standardization of "handoff communication"
Factors that make communication difficult - Answers a. Noisy work environment
b. Different accents, dialects and pronunciation patterns
, c. Interruptions
d. Unfamiliar drug names or terminology
e. Medications with sound-alike names
f. Reliance on memory when writing down an order at a later time
g. Speed at which orders are carried out
h. Little time for correction
i. The tendency of the person giving the order to expect the person taking the order to understand
what is being said
Safety measures to ensure concise communication - Answers i. Ask for correct spellings if unsure
ii. Spell out numbers when repeating back orders
iii. Record a verbal order directly onto a physician order sheet or CPOE
iv. Restrict verbal/telephone orders
v. Include the purpose of the drug on the order sheet
vi. Avoid "Do Not Use" abbreviations
vii. SBAR
Communication with patients and significant others - Answers a. Need to evaluate the patient's ability
to see and hear
b. Assess the effect of stress when speaking with the patient and/or family. High stress decreases the
ability to process information.
c. Consider cultural and education factors in the learning process
d. Provide direct, consistent communication in language that is readily understandable to the patient
and family member
e. Repeat information frequently.
f. If you don't know the answer to a question, admit it and instruct the family that you will find the
answer.
g. *NEVER FORGET*: You are the patient advocate! It is your responsibility to assure the
patient/family member has the information needed to make informed decisions regarding care
Teaching/Learning Principles with critically ill patients/family members (*Characteristics of Adult
Learners*) - Answers Malcom Knowles
Adults value
-self-direction
-are motivated to learn when they perceive that they have a *need* to learn
-bring a variety of *life experiences* to the learning situation
-learn best when they can *apply knowledge* immediately and learn how to *problem solve*.
a. Learning is strongly influences by social roles and developmental tasks