Communication/TEAMStepps Presentation Case Worksheet
Winston has just completed her annual physical exam of Sue Garber. Ms. Rosenthal, the nurse for Hall B, asks, “Isn’t Mrs. Garber a little confused today? I think she’s depressed about her daughter moving away last month. I was wondering if she should be sent to the emergency room for evaluation.” Dr. Winston replies, “Yes, I think she may be confused, but according to her record, her confusion has existed for more than a month. I think she may have something organic going on. We need to rule out a medical cause for her confusion.” “Now that you say it,” Rosenthal observes, “her daughter mentioned that her confusion was not a new phenomenon. Maybe we just need to get an outpatient consult for a formal evaluation. Would you like me to order a consult, Dr. Winston?” Dr. Winston replies, “Yes, please order a consult.”
What tools were used in this scenario? Please list the examples.
2.It is late at night during a particularly hectic shift. A distressed young female having an allergic reaction arrives in the ED. She has developed a rash and is beginning to wheeze. Dr. Andrew, who is new to the ED, orders Benadryl 125 mg IV. Clara, an experienced pharmacy technician, questions the drug dosage. Dr. Andrew repeats his order for Benadryl 125 mg IV. Clara pursues her challenge a second time, stating, “Dr. Andrew, that dose seems high. I’ve never dispensed more than 50 mg IV at a time before.” “Yes, you’re right. I was confusing the dose with that for Solu-Medrol,” states Dr. Andrew. Dr. Andrew changes his order, she repeats the correct order back to him, and the correct dose of Benadryl is administered.
What tools were used in this scenario? Please list the examples.
3.A 34-year-old who had a ruptured appendix 9 days previously presents at Triage with a complaint of back and neck pain and a feeling of dread. At Triage, the patient’s vital signs are pulse 120, temp 98.9, and respiratory rate 28. The Triage Nurse discusses the case with one of the physicians, who recommends ABGs and a STAT portable chest x ray. The x ray is abnormal with changes consistent but not diagnostic for pulmonary embolism.
The physician orders a PA and lateral chest x ray in the Radiology Department. The patient’s tachypnea and tachycardia are exacerbated, and the nurse is concerned about sending the patient out of the ED without a monitor. She voices her concern to the physician, who reevaluates the patient and judges him to be safe to travel to Radiology without a monitor.
What tools can the nurse use for the safety of the patient? Please provide examples on how you would use those tools in these cases?
4.In performing an extraction, tooth #14 instead of #16 is removed. The dentist and assistant had been discussing both teeth before the procedure.
What tool could have been used to prevent this?
5.The nurse thinks the patient needs a physical therapy evaluation after a knee procedure, but the nurse practitioner (NP) taking care of that patient is not present when the physical therapist (PT) is on the unit. The nurse asks the physical therapist to work with the patient.
The PT thinks that the NP has been notified and evaluates the patient. When the NP finds out, they are angry and yell at the PT and nurse in front of staff.
What tool could be used to respond to the NP by the PT or RN? Please state how you would use this tool
