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Difficulty: HardCollaboration with Interdisciplinary Team

A registered nurse is conducting an interdepartmental handoff using the SBAR (Situation, Background, Assessment, Recommendation) framework for a 26-year-old client transferring to an acute neuro-rehabilitation unit following a severe traumatic brain injury. During the 'Recommendation' phase, the nurse outlines the necessary interprofessional team involvement. The client has a healing tracheostomy, receives continuous enteral nutrition, exhibits frequent episodes of psychomotor agitation, and requires total assistance with activities of daily living. The family is profoundly overwhelmed by the uncertain prognosis. Which of the following recommendations should the nurse include to ensure appropriate collaborative care and safe management? (Select all that apply)

  1. Consult the speech-language pathologist to evaluate the client's swallowing readiness and cognitive-linguistic deficits.Answer
  2. Involve the medical social worker to help the family navigate long-term care resources and caregiver support options.Answer
  3. Collaborate with the occupational therapist to implement upper extremity motor retraining and promote independence with basic activities of daily living.Answer
  4. D
    Direct the receiving registered nurse to delegate the assessment of the tracheostomy stoma for purulent drainage to the unlicensed assistive personnel.
  5. E
    Request a prescription for chemical restraints from the healthcare provider to utilize as the first-line intervention for psychomotor agitation.
  6. F
    Advise the care team to reassure the family by guaranteeing that young adults typically achieve a full neurological recovery with aggressive rehabilitation.

Answer

The appropriate collaborative recommendations include consulting the speech-language pathologist, involving the medical social worker, and collaborating with the occupational therapist.
The correct actions accurately match the client's complex rehabilitation needs with the specialized scopes of interdisciplinary team members. The speech-language pathologist (SLP) manages dysphagia and cognitive-linguistic deficits, which are critical priorities for a client with a tracheostomy and TBI. The medical social worker (MSW) provides crucial psychosocial support and connects overwhelmed families with long-term care resources. The occupational therapist (OT) focuses on restoring independence in activities of daily living (ADLs) and upper extremity function.

Step-by-Step Solution

1
Analyze the client's clinical presentation and care needs described in the SBAR report.
The client has complex physical (tracheostomy, enteral nutrition), cognitive (agitation), and psychosocial (dependent for ADLs, family distress) needs following a severe traumatic brain injury.
Identifying the specific deficits and barriers to discharge determines which interdisciplinary team members are required for a safe transition.
2
Evaluate the allied health referrals against their respective scopes of practice.
SLP is appropriate for assessing swallowing and cognitive-linguistic deficits; MSW is appropriate for resource navigation and psychosocial support; OT is appropriate for ADLs and upper extremity motor retraining.
Each allied health discipline possesses a highly specialized scope of practice that addresses distinct aspects of this client's neuro-rehabilitation needs.
3
Evaluate the care management and delegation recommendations for safety and therapeutic standards.
Delegating clinical assessment to a UAP, utilizing chemical restraints as a primary intervention, and providing false reassurance to the family are all incorrect practices.
These actions violate nursing standards of practice regarding safe delegation boundaries, restraint protocols, and therapeutic communication techniques.

Key Concept

Interdisciplinary team members possess specialized scopes of practice to address complex client needs. The registered nurse coordinates these referrals while strictly adhering to safe delegation principles, restraint protocols, and therapeutic communication standards.
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Collaboration with Interdisciplinary Team

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