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Zorluk: Çok zorCollaboration with Interdisciplinary Team

A registered nurse is formulating an SBAR (Situation, Background, Assessment, Recommendation) communication for an interdisciplinary care conference regarding a 29-year-old client recovering from severe Guillain-Barré syndrome in an acute rehabilitation unit.

Situation: The client is weaning from nocturnal mechanical ventilation via tracheostomy, receives enteral nutrition via a percutaneous endoscopic gastrostomy (PEG) tube, and exhibits dense bilateral upper extremity weakness with wrist drop.
Background: The client was diagnosed 4 weeks ago and was previously independent. The client has a 2-year-old child at home.
Assessment: The client tolerates a daytime tracheostomy collar but is unable to grasp objects. The client is tearful and expresses overwhelming anxiety regarding future parenting capabilities.
Recommendation: Initiate specific interprofessional collaborations to optimize discharge readiness.

Which of the following recommendations are appropriate for the nurse to include in the interdisciplinary care plan? Select all that apply.

  1. Speech-language pathologist (SLP): Evaluate the client's vocal cord function for a speaking valve and assess swallowing safety for potential oral intake.Cevap
  2. Occupational therapist (OT): Design custom bilateral wrist splints and introduce adaptive equipment to promote independence with feeding.Cevap
  3. Medical social worker (MSW): Facilitate applications for temporary disability benefits and coordinate community-based childcare assistance.Cevap
  4. D
    Physical therapist (PT): Evaluate the client's ability to perform fine-motor activities of daily living (ADLs), including grooming and upper-body dressing.
  5. E
    Unlicensed assistive personnel (UAP): Perform the comprehensive baseline assessment of the client's home environment to identify safety hazards prior to discharge.
  6. F
    Registered dietitian (RD): Administer the prescribed bolus enteral tube feedings via the PEG tube to ensure the client meets calculated daily metabolic demands.

Cevap

The appropriate interdisciplinary recommendations are consulting a speech-language pathologist for swallowing and speaking valve assessment, an occupational therapist for fine motor splints and feeding adaptations, and a medical social worker for disability and childcare coordination.
The correct selections accurately match the client's complex deficits with the specialized scopes of practice of allied health professionals. The SLP manages the tracheostomy speaking valve and swallowing safety; the OT manages fine motor deficits (wrist drop) and ADL independence; and the MSW addresses the profound psychosocial and environmental barriers to discharge.

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1
Analyze the SBAR data to identify the client's specific clinical deficits and psychosocial barriers.
The client presents with dysphagia/communication barriers (tracheostomy, PEG), fine-motor deficits (wrist drop, unable to grasp), and psychosocial barriers (childcare anxiety, financial concerns).
Identifying specific, distinct deficits dictates which specialized interdisciplinary team member is required for safe discharge.
2
Map the identified clinical deficits to the correct allied health discipline's scope of practice.
Dysphagia and speaking valve assessments map to the SLP. Fine motor deficits and feeding ADLs map to the OT. Psychosocial and financial distress maps to the MSW.
Appropriate referrals ensure targeted, specialized care and optimize the client's rehabilitation and discharge readiness.
3
Evaluate the remaining options for scope of practice violations or improper delegation.
The physical therapist focuses on gross motor (not fine motor ADLs). UAPs cannot perform initial assessments. Dietitians calculate nutrition but do not administer tube feedings.
Preventing improper delegation ensures client safety and adheres to legal and ethical nursing standards.

Anahtar Kavram

Interdisciplinary Team Roles and Scope of Practice
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Collaboration with Interdisciplinary Team

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