LESSON 7

CONCEPTS AND PRINCIPLES OF

PARTNERSHIP, COLLABORATION,
AND TEAMWORK
DEVELOPMENT OF TEAMWORK AND
COLLABORATION
• It is the ability to “function effectively
with nursing and interprofessional
teams, fostering open
communication, mutual respect, and
shared decision-making to achieve
quality patient care” (Quality and
Safety Education for Nurses Institute,
2019)
• Eckroth-Bucher (2010), defines the
concept as “Self-awareness involves
the cerebral exercise of introspection
(a looking into one’s own thoughts,
feelings, beliefs, values, behaviors,
limitations and the feedback from
others).
• Self-awareness is getting to know
about one self as a person and the
important things in life which
influences us in different ways.
• It also includes the reflection of how
our attitude and belief can influence
others.
• If we get the awareness of our own
life then we can understand another
person better.

SELF-AWARENESS • We will be able to recognize that

everybody is unique.
• It is a process of objective
• A self-aware nurse is able to respect
examination of oneself.
and avoid projecting his or her own

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 beliefs onto others, to suspend - what is unknown by the person
judgment, focus on the needs of the about him/herself but which
client, even if they differ from those others know.
of the nurse and will not force other 3. Hidden Area
people to agree with what she - what the person knows about
believes in. him/herself that others do not
• Teams rely on a combination of self- know.
awareness and trust. 4. Unknown Area
• Members were all open and honest - what is unknown by the person
with one another will result to about him/herself and is also
effective work output. unknown by others.

JOHARI WINDOW DYAD

• Johari Window by Joseph Luft and

Harry Ingham

• It refers to a pair of persons in an

interactional situation.
• Example; a patient and a nurse, a
nurse and the doctor, and nurse and
FOUR REGIONS OF THE
watcher among others.
JOHARI WINDOW
GROUP
1. Open/Free Area
- what is known by the person • Two or more people who interact
about him/herself and is also with one another, share similar

known by other. characteristics, and collectively have

2. Blind Area a sense of unity.

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 TEAM • CASE MANAGER
- Communicates care plan to family
• “It is a group of people who are
and other providers.
interdependent with respect to
• MEDICAL DOCTOR
information, resources, and skills
- Develops medical care plan,
and who seek to combine their
prescribes medications and
efforts to achieve a common goal”, as
treatments.
defined by Professor Leigh
• RESPIRATORY THERAPIST
Thompson of the Kellogg School of
- Provides breathing treatments.
Management.
• DIETITIAN
HEALTH CARE TEAM - Creates low-salt diet.
• It is also referred to as the providers • OCCUPATIONAL THERAPIST
of health care or health - Design self-care activities that
professionals, are nurses and health reserve client’s energy.
personnel from different disciplines CASE MANAGER
who coordinate their skills to assist
• Her or his role is to ensure that
clients and their support people.
clients receive fiscally sound,
HEALTH CARE SITUATION appropriate care in the best setting,
Patient: 73 years old with a heart failure, the one most involved in the client’s
and short of breath. care who may be a nurse, a social
worker or any member of the health
care team.

• REGISTERED NURSE
- Develops the nursing care plan.

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 MULTIDISCIPLINARY TEAM
KEY ELEMENTS OF TEAMWORK
1. Communication
- One likely cause of errors is when
a health professional
communicates with a colleague
but does not check whether that
colleague has correctly received
the message, and/or when the
colleague does not check that
they have understood it.
2. Situational Awareness
- It is defined as an “accurate
awareness or understanding of
the situation in which the team is
functioning” (Alonso
Dunleavy, 2013).
- In simple terms, it is knowing
what is going on around us.
- We maintain our situational
awareness by scanning
environment for clues about what
is happening.
3. Leadership
- Sometimes errors happen
because staff are not comfortable
raising concerns or clarifying
ambiguous messages or
situations. If you are a team
leader, you can create a positive
culture by telling your team you
want them to raise any concerns
and ask any questions they may
have, however trivial, without fear.
4. Mutual Support
- Failure to offer, ask for or accept
help leads to stress and work
overload, increasing the risk of
errors and harm. We must
become better these things as
patient safety may depend on
them. Staff need to feel that it is
acceptable to ask for help if they
feel overwhelmed, that they will
not be deemed ineffective or
and unable to manage their time.
• These form the basis of Team STEPPS
(Team Strategies and Tools to
our Enhance Performance and Patient
Safety), a training program from the
United States that has been shown to
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 improve team effectiveness and of our own vulnerability and
patient safety. potential for making errors. This
can be done through a simple
TOOLS IN FACILITATING TEAMWORK
self-checking exercise using
1. Closed-Loop Communication either the I’M SAFE checklist or
- It is a technique that reduces the the “three bucket” model.
risk of errors arising from - The I’M SAFE checklist, which is a
misunderstandings and wrong Team STEPPS tool, stands for;
assumptions. I – illness (Am I so ill or
2. Readback feeling bad that I can’t be
- It involves reading back to the sure I’m performing care
sender information they have safely?)
given to you in order to check you M – medication (“Is a
have correctly understood it. medication I am taking
- Read back can also help clarify impairing my ability to
who is responsible for what, as monitor the care
this can be unclear at handover environment for unsafe
and important interventions might situation?”)
thus be missed or delayed. S – stress (“Is there
3. SBAR Tool something on my mind that
- SBAR Tool stands for; is distracting from my
S – situation ability to maintain a
B – background mindful focus on patient
A – assessment care delivery?”)
R - recommendation A – alcohol and drugs (“Is
4. Checklist my use of alcohol or illicit
- As well as maintaining our drugs affecting my focus
situational awareness and and performance? Am I fit
sharing observations with for duty?”)
colleagues, we need to be aware

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 F – fatigue (“Am I suffering
from lack of sleep to the
degree that my judgment
or abilities may be
impaired?”)
E – eating and elimination
(“Has it been more than six
hours since I have eaten or
used the restroom?”)
- Going through the list, you ask
yourself whether or not you might
be affected by any of these
factors. For example, if you have
had too much alcohol the night
before, your ability to perform
certain tasks may be hampered
the next morning. The more
positive answers you obtain, the
more likely you are to make an
error.
- The “three bucket” model works
as follows:
o The “self” bucket –level of
skill, knowledge, expertise;
Current capacity to do task
(Fatigue and time of day;
Negative life events;
Feeling under the weather.
o The “context” bucket fills if
your ward or department is
NCM 103: FUNDAMENTALS OF NURSING PRACTICE
understaffed, poorly led or
lacking equipment.
o The “task” bucket fills if the
tasks assigned to you are
unfamiliar or technically
demanding.
- The fuller each bucket is, the
greater the likelihood of you
making an error.
- As a team, all staff can run
through one of these two
checklists at the beginning of a
shift, for example. If you feel
vulnerable and therefore prone to
errors, you should share this with
your colleagues so they can keep
an eye on you.
5. Safety Huddles
- A safety huddle is a brief coming
together of staff, once or more in
a shift, aimed at maintaining
situational awareness, sharing
observations and going through
risks.
- Which patients are causing
concern? Is anyone at risk of
deterioration? How is staffing?
How is workload?
6
6. Debriefs - It shows concern for client
- Debriefs are short meetings at welfare and acceptance of the
the end of a shift to review how client as a person.
the team has performed. Debrief 2. Teacher
can be done towards the end of - It provides information and helps
the shift, rather than once it has the client to learn or acquire new
ended. The nurse in charge of the knowledge and technical skills.
shift may lead a debrief. - It encourages compliance with
7. Human Factors prescribed therapy.
- Human Factors is defined as the - It promotes healthy lifestyle.
environmental, organizational - It interprets information to the
and job factors, and individual clients.
characteristics which influence 3. Counselor
behavior at work. - It helps client to recognize and
cope with stressful psychological
ROLES AND RESPONSIBILITIES OF A
or social problems; to develop an
PROFESSIONAL NURSE
improved interpersonal
1. Caregiver relationship and to promote
- The traditional and most essential personal growth.
role, functions as nurturer, - It provides emotional, intellectual
comforter, provider. and psychologic support.
- It is the “mothering actions” of the - It focuses on helping a client to
nurse. develop new attitudes, feelings
- It provides direct care and and behaviors rather than
promotes comfort of client. promoting intellectual growth.
- The activities involve knowledge - It encourages the client to look at
and sensitivity to what matters alternative behaviors, recognize
and what is important to clients. the choices and develop a sense
of control
4. Change Agent

NCM 103: FUNDAMENTALS OF NURSING PRACTICE 7

 - It initiates changes or assist - It participates in scientific
clients to make modifications in investigation and must be a
themselves or in the system of consumer of research findings.
care. - It must be aware of the research
5. Client Advocate process, language of research,
- It involves concern for and and sensitive to issues related to
actions in behalf of the client to protecting the rights of human
bring about a change. subjects.
- It promotes what is best for the
client, ensuring that the client’s
needs are met and protecting the
client’s rights.
- It provides explanation in clients
language and supports client’s
decisions.
6. Manager
- Makes decisions, coordinates
activities of others, allocates
resources, evaluates care and
personnels.
- It plans, gives direction, develops
staff, monitors operations, gives
rewards fairly and represents
both staff and administrations as
needed.
7. Researcher
- It participates in identifying
significant researchable
problems.

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