In-Hospital Crisis Management

Faculty/Staff Leader Summary

In-hospital crisis management saves lives. All nurses, physicians and other healthcare providers must be prepared to assist with in-hospital crisis management at any time. Best patient outcomes require interprofessional teams to work together in synergy, communicate effectively and understand each team member’s unique roles and dynamics. Currently, seven scenarios have been developed involving patients with a variety of medical and surgical diagnoses (ex: Crohn’s Disease, influenza, aortic aneurysm, etc.) as well as comorbidities that provide challenging cases. Senior-level nursing students begin the scenario with a handoff report and initial assessment of the patient. As the case unfolds, students use critical thinking to recognize changes in patient status and the need for additional team support (Rapid Response Team and Code Team). Throughout the scenario, the physician may be contacted for updates and orders; the MD arrives last on the scene. TeamSTEPPS tools are utilized to promote effective communication and teamwork.

Required skills include: ECG interpretation, lab (including ABG) analysis, respiratory/oxygenation intervention, and IV antidysrhythmic/vasoactive medication understanding and calculation. Both BLS and ACLS algorithms are employed with patients advancing to various life-threatening dysrhythmias (VT, PEA, V-fib, etc.). Potential for transcutaneous pacemaker, advanced airway/intubation, and invasive intravenous and arterial lines exist depending on progression of scenario and patient response to treatment. These combined factors lend to complex, dynamic simulations that promote development of clinical reasoning and enhance interprofessional education.

IPEC Competency Domain(s)
Communication
Roles & Responsibilities
Teams & Teamwork
Values & Ethics

IPEC Sub-Competencies Targeted
TT2: Appreciate team members’ diverse experiences, expertise, cultures, positions, power, and roles towards improving team function.
TT3: Practice team reasoning, problem-solving, and decision-making.
TT6: Reflect on self and team performance to inform and improve team effectiveness.
TT7: Share team accountability for outcomes.
TT8: Facilitate team coordination to achieve safe, effective care and health outcomes.
TT9: Operate from a shared framework that supports resiliency, well-being, safety, and efficacy.
VE3: Uphold the dignity, privacy, identity, and autonomy of persons while maintaining confidentiality in the delivery of team-based care.
VE5: Value the expertise of health professionals and its impacts on team functions and health outcomes.
VE8: Apply high standards of ethical conduct and quality in contributions to team-based care.
VE9: Maintain competence in one’s own profession in order to contribute to interprofessional care.
RR1: Include the full scope of knowledge, skills, and attitudes of team members to provide care that is person-centered, safe, cost-effective, timely, efficient, effective, and equitable.
RR4: Differentiate each team member’s role, scope of practice, and responsibility in promoting health outcomes.
RR5: Practice cultural humility in interprofessional teamwork.
C1: Communicate one’s roles and responsibilities clearly.
C2: Use communication tools, techniques, and technologies to enhance team function, well-being, and health outcomes.
C4: Promote common understanding of shared goals.
C5: Practice active listening that encourages ideas and opinions of other team members.
C6: Use constructive feedback to connect, align, and accomplish team goals.