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Difficulty: MediumCollaboration with Interdisciplinary Team

A nurse is initiating an urgent telephone consultation with the on-call hospitalist regarding a client who suddenly developed respiratory distress two days after a right total knee arthroplasty. Arrange the nurse's statements in the correct chronological sequence according to the ISBAR (Identify, Situation, Background, Assessment, Recommendation) interdisciplinary communication framework. All options must be used.

  1. 1"This is Nurse Taylor on the orthopedic surgical unit calling regarding the client in room 412, Mr. Smith."
  2. 2"The client is experiencing a sudden onset of sharp, right-sided chest pain and severe dyspnea."
  3. 3"He is two days post-operative for a total knee arthroplasty and has a previous medical history of deep vein thrombosis."
  4. 4"His oxygen saturation has dropped to 84% on room air, his heart rate is 118 beats per minute, and I am highly concerned he is developing a pulmonary embolism."
  5. 5"I need a provider to evaluate him immediately, and I would like an order for a stat CT pulmonary angiogram and supplemental oxygen."

Answer

The correct sequence follows the ISBAR framework: Identify, Situation, Background, Assessment, and Recommendation.
The ISBAR (Identify, Situation, Background, Assessment, Recommendation) framework is a standardized interdisciplinary communication tool designed to prevent medical errors during handoffs and provider escalations. It requires a logical progression from introducing the participants, stating the acute problem, providing historical context, sharing current clinical findings, and concluding with actionable requests.

Step-by-Step Solution

1
Place the 'Identify' statement first.
The nurse identifies themselves, the unit, and the client.
Establishes who is calling and who the call is about, which is essential for patient safety and interprofessional record-keeping.
2
Place the 'Situation' statement second.
The nurse describes the sudden chest pain and dyspnea.
Immediately alerts the provider to the primary acute problem requiring interdisciplinary attention.
3
Place the 'Background' statement third.
The nurse shares the surgical status and history of DVT.
Provides contextual information that helps the provider properly interpret the acute situation.
4
Place the 'Assessment' statement fourth.
The nurse reports the vital signs and clinical suspicion of a pulmonary embolism.
Shares objective clinical data and the nurse's professional judgment based on the situation and background.
5
Place the 'Recommendation' statement fifth.
The nurse requests immediate evaluation and specific diagnostic orders.
Directs the collaborative action plan to resolve the client's critical issue.

Key Concept

ISBAR Interprofessional Communication
Estimated Time:1m 30s
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Topics

Collaboration with Interdisciplinary Team

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