TeamSTEPPS® – what is it and why use it?

Team Strategies & Tools to Enhance Performance & Patient Safety

“Initiative based on evidence derived from team performance…leveraging more than 30 years of research in military, aviation, nuclear power, business and industry…to acquire team competencies”

Communication standards are well recognised as one of the most important methods of decreasing healthcare errors

Your assessment is complete, you have discovered a concerning deterioration from “normal” with your patient and realise this needs immediate attention but how do you communicate your assessment to the chain of command whether it be nursing, medical or both

As a nurse at any level you want a tidy, effective communication methodology that will promote your concerns and trigger the response your patient requires.  You would look hard to find a better system than TeamSTEPPS© ISBAR process of safer handover and communication

ISBAR handover

Using a standard mnemonic to improve clinical communication

  • Identify;                          Who you are and what is your role?  Patient identifiers (at least 3)
  • Situation;                       What is going on with the patient?
  • Background;                What is the clinical background/context?
  • Assessment;                 What do I think the problem is?
  • Recommendation;    What would you recommend now and ongoing?

Risks – patient / occupational health and safety? Assign and accept responsibility and accountability

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Example:  You make a phone call to the after-hours intern after assessing your patient

I Introduction – Identify who you are and where you are from

“My name is Jess Citizens and I am a nurse calling from Ward 4D”

S Situation – Describe the situation

“I am calling to get some advice about / I am calling because I need help urgently with … (patient name, UR and location.)  The patient’s condition is…… (stable/unstable ) The issue / problem I am calling about is…….”

B Background – Give relevant background info

“I have just assessed the patient:  The vital signs are: Blood pressure, Pulse, Respiration rate, SpO2 %, temperature.  I am concerned about the: (abnormal findings eg the patient’s chest / abdomen / urine output etc)

A Assessment

“I think the problem …(e.g. I think the patient may be developing acute pulmonary oedema)”  I have sat the patient up, applied O2 per orders etc with minimal effect

R Recommendation

Suggestion or request:

Can you please give me advice about how you would like to manage this?

I want you to please come to see the patient ASAP?”

Should I call an RRS/MET?

Accessed from the Agency for Healthcare Research and Quality website ( 09/12/08