1.800.553.4291

Situational Awareness

Situational Awareness

HCIS Senior Care Blog

Situational Awareness

Author – Cyndi Siders, RN, MSN, CPHRM, DFASHRM, CPPS
Executive Consultant at Vaaler Insurance
losscontrol@vaaler.com 

What is Situational Awareness?

Situational Awareness is defined as the state of knowing the conditions that affect one’s work. Situational awareness is a dynamic state of awareness for individual care team members and the team.

Source – Agency for Healthcare Research and Quality. TeamSTEPPS® for Long Term Care

Why is Situational Awareness Important for Healthcare Teams?

Situational Awareness is a structured format for obtaining and communicating critical information about the resident, team, environment and overall plan, for the team to provide safe and effective care delivery.

 

What is the Impact of Pro-Active Risk Assessments on Situational Awareness?

A team that is situationally aware is pro-actively assessing risk and safety needs and adjusting care delivery to reduce resident and staff risk, enhance quality of care and reduce team stress and workload.

 

 

What Is The Impact Of “STEP” on Situational Awareness?

STEP is a four-step process for assessing and managing risk and safety for the team. The STEP in TeamSTEPPS® stands for:

  • Status of the Resident
  • Status of the Team
  • Status of the Environment
  • Status of the Plan for the team to deliver care and progress toward that goal

Source – Agency for Healthcare Research and Quality. TeamSTEPPS® for Long Term Care

Components of Status of The Resident

Situational Awareness begins with having complete information regarding resident status at the time of hand-off communication, daily stand-up meetings, shift report and morning briefs or huddles.

Source – Agency for Healthcare Research and Quality. TeamSTEPPS® for Long Term Care

Components Include:

Understanding the Current Status of Resident Safety (including, but not limited to):

  • Mobility Changes/Fall Risk
  • Skin Injury Risk
  • Observed Behaviors That Pose a Safety Risk (e.g., wandering, restless, not using their safety equipment, confusion, aggression, talking about going somewhere – home, to work, etc.)
  • Other

Understanding Current Clinical Condition Changes:

  • Vital signs
  • Nutrition/Hydration
  • Elimination changes (urine, stool)
  • Abnormal lab work including blood sugar
  • Pain
  • Medication response (e.g., effectiveness, reactions, side-effects)
  • Respiratory/cardiac changes
  • Gastrointestinal changes (e.g., nausea, vomiting, diarrhea)
  • Skin changes
  • Behavior/cognition changes
  • Weakness/fatigue
  • Other

Emotional/Social:

  • Complaints
  • Depression/Sadness/Withdrawn
  • Angry
  • Declining Care
  • Good news/bad news
  • Special day

Family Communication:

  • Phone
  • Visited facility today

New Orders:

  • Medications
  • Treatments
  • Diagnostic Testing

Status of the Team

Teams are dynamic and often include full time, part time and temporary or agency staff members with varying levels of experience and skills. A well-functioning team recognizes these daily variations and provides support to ensure that the plan for safe and effective resident care delivery is occurring.

Source – Agency for Healthcare Research and Quality. TeamSTEPPS® for Long Term Care

Red, Green, and Yellow Team Status

A team on green status is meeting the goals of care delivery for the shift including medications, treatments, emotional and social support for residents and appropriate clinical monitoring of changes in resident condition.

An Individual or team on yellow is potentially not meeting the clinical, safety and emotional/social needs of all residents due to extenuating circumstances, lack of structured communication, available staffing and/or an adverse event or change in resident condition that is requiring additional resources.

An individual or team on red is most likely not meeting all of the clinical, safety, and emotional/social needs of all residents due to extenuating circumstances, lack of structured communication, available staffing and/or an adverse event or change in resident condition that is requiring additional resources.

A team providing Mutual Support will be able to recognize the dynamic status of team work and adjust care delivery to support team members and the needs the residents and family members.

 

Status of the Environment

A situationally aware team assesses and manages resources, including the thoughtful delegation of work assignments. One example would be a coordinated staggering of the timing of admissions and discharges.

Source – Agency for Healthcare Research and Quality. TeamSTEPPS® for Long Term Care

Progress Toward the Care Delivery Goal

A team that is situationally aware is pro-actively assessing risk and safety needs and adjusting care delivery to support resident care needs. Examples include:

  • Status of the team’s residents
  • Tasks/actions that are completed
  • Tasks/actions not completed
  • Plan still appropriate (e.g., a resident has fallen and sustained significant injury, do assignments need to be readjusted while that resident is cared for to support the other residents assigned to that team member)?
  • Communication needed

Source – Agency for Healthcare Research and Quality. TeamSTEPPS® for Long Term Care

Situational Awareness Is A Dynamic Process

Situational Awareness is a dynamic process of listening, observing and communicating key information about the residents, team, environment and the plan for care delivery. Situational Awareness is a teachable/learnable skill that is developed through critical thinking scenarios and daily team conversations about care delivery.

Situational Awareness Training

For information about Situational Awareness training at your facility, please contact Cyndi Siders, Executive Consultant for HCIS/Vaaler Insurance at losscontrol@vaaler.com.

 

 

This educational post, which does not reflect any official policy or opinion for Vaaler Insurance, Inc. or Siders Healthcare Consulting, LLC, is provided for informational purposes only. It is not intended to provide legal or medical advice, nor is it intended to be an exhaustive list of all risks that need to be addressed for a healthcare organization. While every effort is made to provide accurate information, changes may occur and inaccuracies happen despite best efforts. This information is not a substitute for individual consultations with professionals in these areas and should not be relied on as such. Please work with your legal counsel and business advisor(s) for a plan that is specific to your organization. ©2017- 2019 Vaaler Insurance, Inc.

Other Posts