Session 6

Primary group - informal structure, like family

Secondary - structure with designated leader

Factors that impact group dynamic

● Motivation
● Experiences
● Roles
● Decision making
● Communication variable

Group development by margaret mead

● Forming
○ Members familiarize themselves with the task and members of the group
● Storming
○ Issues arise like id of roles, operational rules and an individual’s need of
recognition of their skills
● Norming
○ Resolve issues and begin to develop group cohesion
● Performing
○ Social structure sorted out and begins to move forward with accomplishing
the task
● Adjournment
○ Closure including a ritual. Like a party or celebration

Both influence effectiveness of groups

● Task functions - to achieve task

○ Initiating - propose task
○ Information seeking - asking for relevant information and suggestions
○ Information giving - giving “””””””””””””””””””””””””””””””””””””””””””””””””””””
○ Clarifying ideas - by interpreting and clarifying input, suggesting alternatives
○ Bringing closure - summarizing. Offer solutions
○ Consensus testing - setting up trials and checking for agreements
● Maintenance functions:
○ Encouraging -
○ Improving group atmosphere
○ Harmonizing
 ○ Compromising
○ Gate keeping
○ Standard setting

Leadership styles

● Authoritarian
○ One person makes all decisions
● Democratic
○ Everyone participates in decision making
● Laissez faire
○ Leader is hands off
○ Group members make own decision and is the most ineffective type

Leader tasks

● Pregroup
● Forming
● Norming
● Performing
● Adjourning

8 elements of a healthy workplace environment

1. Collaborative culture
2. Communication rich
3. Defined role expectations with accountability
4. Adequate workforce
5. Competent leadership
6. Shared decision making
7. Employee development
8. Recognition

Interpersonal source of conflict

● Different expectations
● Threats to self
● Differences in role hierarchy
● Clinical situation constraints

Resolution process
 ● ID your goal
● Obtain factual data
● Intervene early
● Avoid negative comments that affect the self esteem of the receiver
● Consider the other viewpoint

Continuity of care

● Relational
○ A therapeutic relationship with a practitioner that spans more than one
episode of care and leads to accumulated knowledge of patient personally
● Informational
○ Continuity of care through accurate communication and transfer of info
between patient-nurse and nurse-nurse
● Management
○ Coordinated transition to another health care setting

SBAR

● Situation - whats happening now

● Background - what led to whats happening now
● Assessment - what is the current problem
● Recommendation - what do you think should happen right now

Session 7

Guidelines for quality documentation

● Factual
● Accurate
● Complete
● Current
● Organized
● Complies with standards

Problem oriented medical record

● Database
○ All assessment information
 ● Problem list
○ List of all the problems the patient faces and includes physiological,
psychological, cultural etc needs
● Care plan
○ Includes diagnosis, expected outcomes and interventions
● Progress notes
○ Records progress
■ Soap
● Subjective
● Objective
● Assessment
● plan
■ Soapie
● Intervention
● evaluation
■ Pie
● Problem
● Intervention
● evaluation
■ Focus charting DAR
● Data
● Action
● Response

Record keeping forms

● Admission nursing history form

○ When a client is admitted and has a complete assessment to id problems and
diagnoses
● Flow sheet and graphic records
○ For assessment data
● Kardex
○ Demographic data
○ Id
○ Medical diagnosis
○ History
○ Care plan
○ Orders
○ Tests and procedures
○ Precautions
○ Activities
○ Contact info
○ Allergies
 ○ Emergency code status
● Acuity records
○ Rating system determine level of care and time needed by nurse
● Standardized care plan
● Discharge summary form
○ Emphasises learning
○ Medication instructions
○ Diet information
○ Rehab techniques