Situation Monitoring. Attention to detail is one of the most important details... Author Unknown
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1 Situation Monitoring Attention to detail is one of the most important details... Author Unknown
2 2
3 A Continuous Process Situation Monitoring (Individual Skill) Situation Awareness (Individual Outcome) Shared Mental Model (Team Outcome) Mod Page 3 3
4 Situation Monitoring (Individual Skill) Process of actively scanning behaviors and actions to assess elements of the situation or environment Fosters mutual respect and team accountability Provides safety net for team and patient Includes cross monitoring Remember, engage the patient whenever possible. Mod Page 4 4
5 Mod Page 5 5
6 Cross Monitoring is Process of monitoring the actions of other team members for the purpose of sharing the workload and reducing or avoiding errors Mechanism to help maintain accurate situation awareness Way of watching each other s back Ability of team members to monitor each other s task execution and give feedback during task execution Mutual performance monitoring has been shown to be an important team competency. (McIntyre and Salas 1995) Mod Page 6 6
7 Cross Monitoring Mod Page 7 7
8 Components of Situation Monitoring: Mod Page 8 8
9 Status of the Patient Patient History Vital Signs Medications Physical Exam Plan of Care Psychosocial Condition Mod Page 9 9
10 Situational Awareness and Status of the Patient Mod Page 10 10
11 Team Members Fatigue Workload Task Performance Skill Level Stress Level Mod Page 11 11
12 I M SAFE Checklist I = Illness M = Medication S = Stress A = Alcohol and Drugs F = Fatigue E = Eating and Elimination An individual team member s responsibility Mod Page 12 12
13 Environment Facility Information Administrative Information Human Resources Triage Acuity Equipment Mod Page 13 13
14 Progress Toward Goal Status of team s patient(s)? Goal of team? Tasks/actions that are completed or that need to be done? Plan still appropriate? Mod Page 14 14
15 Situation Monitoring Recollect examples of situation monitoring, in which you needed to Be aware of what was going on Prioritize and focus on different elements of the situation Share this information with others Select one or two that best represent the concept of situation monitoring Share Mod Page 15 15
16 Situation Awareness is The state of knowing the current conditions affecting the team s work Knowing the status of a particular event Knowing the status of the team s patients Understanding the operational issues affecting the team Maintaining mindfulness Mod Page 16 16
17 Shared Mental Model?? Mod Page 17 17
18 How Shared Mental Models Help Teams Help ensure that teams know what to expect, so if necessary, can regroup to get on the same page Foster communication to ensure care is synchronized Ensure that everyone on the team has a picture of what it should look like Enable team members to predict and anticipate better Create commonality of effort and purpose Shared mental models help teams avoid errors that place patients at risk. Mod Page 18 18
19 What Do You See? Mod Page 19 19
20 When to Share? Briefs Huddles Debriefs Transitions in Care... Share information as soon as possible when a change occurs in the patient s status. Mod Page 20 20
21 BARRIERS Hierarchical Culture Lack of Resources or Information Ineffective Communication Conflict Time Distractions Workload Fatigue Misinterpretation of Data Failure to Share Mod 1 Information Page 21 Team Effectiveness TOOLS and STRATEGIES Brief Brief Huddle Huddle Debrief Debrief STEP Cross Monitoring OUTCOMES Situation Awareness Shared Mental Model Adaptability Team Orientation Mutual Trust 21
22 Teamwork Actions Conduct team exercises to increase situation monitoring skills Share information in a timely fashion Include patient and/or family in communication Use cross monitoring Utilize resources fully (e.g., status board, automation) Apply the STEP process when monitoring the situation Foster communication to ensure that all members of the team have a shared mental model Share information during briefs, team huddles, debriefs, and transitions in care Mod Page 22 22
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