National Content Series Discussion Guide - The Culture of Culturing: The Importance of Knowing When To Order Urine Cultures

Discussion Questions About the Ineffective Role-Play

1. What went wrong during this interaction between Nurse Nohai and Dr. Killbug?

2. What could Dr. Killbug have done differently?

3. What could Nurse Nohai have done differently?

Discussion Questions About the Effective Role-Play

1. How was this interaction between Nurse Nohai and Dr. Killbug a more effective conversation?

2. Nurse Nohai used SBAR to improve communication with Dr. Killbug. Identify the SBAR elements of Nurse Nohai's communication using the following prompts:

• Situation – What is going on with the resident?

   

   

• Background – What is the clinical background or context?

   

   

• Assessment – What did Nurse Nohai think was the problem?

   

   

• Recommendation – What was Nurse Nohai's recommendation for Mrs. Mullins' care?

   

   

Practicing SBAR Using Case Scenarios

Scenario Instructions: Work individually,with partners, or in small groups to determine the appropriate next steps for Mr. Bell's and Ms. Colbert's cases. Craft SBAR scripts a nurse could use to explain to a physician the next steps for both residents' care.

Scenario 1

Mr. Bell is an 85-year-old resident with dementia who has a chronic indwelling urinary catheter. Mr. Bell does not usually have a problem getting around, but he fell three times in the past week. Today the certified nursing assistant (CNA) notices that his urine bag is cloudy.

Scenario 2

Ms. Colbert is a 75-year-old female with neurogenic bladder. She has a chronic indwelling urinary catheter to help manage her condition. She has refused to eat her last two meals. It's Friday at 4 p.m., and the nurse knows the doctor is extremely difficult to reach on the weekend.