TeamSTEPPS® 2.

0 AU

ISBAR Case Study Scenario:

Clinical Staff ANSWER FACILITATION GUIDE
COMMUNICATION

Clinical Scenario in ISBAR:

Handover from attending MO to MO at receiving institution.

Identify:
> ‘This is Dr Neil calling from XXX can I please discuss a patient with the Doctor in charge.’
> Doctor in charge comes to the phone and identifies herself to Dr Neil, and Dr Neil identifies
himself again.
> ‘I would like to discuss one of my patients, Mrs Elizabeth Dunbar, date of birth XX/XX/XXXX,
Medical Record Number 123456’

Situation:
>> ‘Mrs Dunbar presented to our emergency department today at XXXX with chest pain and shortness
of breath. She is markedly unwell and I suspect she is suffering with infective exacerbation of chronic
obstructive airways disease. We are over capacity due to a mine collapse and do not currently have
resources to provide the level of care she requires.’

Background:
>> ‘Mrs Dunbar has a long history of chronic obstructive airways disease and anxiety, with increasing
hospital admissions over the last X years. Her last hospital admission was XX/XX/XXXX. She is a
reformed smoker. Her medication regime includes home oxygen, inhaled corticosteroid, theophylline
and a long-acting bronchodilator. Mrs Dunbar lives with her daughter due to limitation in her activities of
daily living. She does not have an advanced care directive in place, but she does have modifications in
effect for her vital signs given the chronic nature of her airways disease.’

Assessment:
> ‘Mrs Dunbar is extremely anxious and distressed. Her presentation for this event is more severe
than on previous occasions. An ECG was negative for acute changes. On physical assessment her
temperature is XX, blood pressure XX/XX mmHg, heart rate XXX bpm, respiratory rate XX per minute,
oxygen saturations XX on 4 litres of oxygen per minute via nasal specs. She is unable to perform a peak
flow reading. Inspiratory and expiratory accessory muscle use is evident. This is consistent with acute
exacerbation of her chronic obstructive airways disease. Blood and sputum specimens have been taken
prior to commencement of an intravenous fluid regime and antibiotics.’

Recommendation:
> ‘I recommend that Mrs Dunbar be retrieved to your institution for definitive management of exacerbation
of chronic obstructive airways disease as soon as possible.’

For more information

SA Health
TeamSTEPPS®
Email: Health.TeamSTEPPS@sa.gov.au
© Department for Health and Wellbeing, Government of South Australia. All rights reserved. FIS:
17039.12.4 (FG ISBAR Case Study Scenario Clinical Staff Answer) v1.0 June 2018.
Official Use Only-I1-A1.