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Understand the roles of healthcare team members, interprofessional competency frameworks, evidence-based team communication tools, shared decision-making, and how to navigate hierarchy safely. Directly prepares for CASPer teamwork and interprofessional scenarios.
Who does what — and why knowing this improves patient outcomes
The RN holds primary accountability for patient assessment, nursing diagnosis, care planning, and evaluation (ADPIE). Can delegate implementation tasks to LPN/RPN and UAP but retains accountability. Holds a university degree (BScN) in Canada. Regulated by provincial colleges (e.g., CNO, CRNBC). NCLEX-RN in the US; NCLEX-RN with Canadian adaptation (NCJEX) being phased in for Canada.
RPNs/LPNs work with patients whose conditions are stable and predictable. They perform assessments and implement care within a defined scope that varies by province/state. They do not independently formulate care plans for complex or unstable patients. They report to the RN for complex or deteriorating patients. College diploma plus NCLEX-PN.
Physicians diagnose disease, prescribe medications, and perform procedures and surgery. Nurse Practitioners (NPs) in Canada hold advanced nursing degrees and have independent practice authority in most provinces — they can diagnose, prescribe, and manage primary and specialty care independently or in collaboration. The nurse-physician relationship is collaborative, not hierarchical in modern healthcare — both roles are essential.
Physiotherapist (PT): mobility, rehabilitation, respiratory therapy. Occupational Therapist (OT): activities of daily living, adaptive equipment, return to function. Respiratory Therapist (RT): ventilation management, airway suctioning, ABG interpretation. Pharmacist: medication reconciliation, drug interaction review, patient education. Registered Dietitian (RD): nutritional assessment and therapy. Social Worker (SW): discharge planning, social determinants of health, mental health support.
Personal Support Workers (PSW/CCA/HCA) provide direct care (bathing, feeding, positioning, vital signs when specifically trained and delegated) under the supervision of regulated professionals. They cannot independently assess, diagnose, or make clinical decisions. The delegating RN retains accountability for the safety of delegated tasks.
An RN can SAFELY delegate which of the following tasks to an unregulated care provider (PSW)?
IPEC core competencies and why they matter for patient outcomes
IPEC Core Competencies for Collaborative Practice
The Interprofessional Education Collaborative (IPEC) defines four core competency domains for collaborative practice: (1) Values and Ethics — all team members share a patient-centered orientation, maintain respect for each profession's role, and commit to safe, high-quality care. (2) Roles and Responsibilities — understanding what each profession contributes and what falls within or outside their scope. (3) Interprofessional Communication — communicating with team members in a way that supports safe, effective, team-based care. (4) Teams and Teamwork — applying relationship-building and team dynamics principles to effectively collaborate across professions.
Why Interprofessional Collaboration Improves Patient Outcomes
A nursing student observes that the physiotherapist, nurse, and physician all have different ideas about the patient's mobility goals. The MOST appropriate interprofessional response is:
SBAR, check-backs, call-outs, and TeamSTEPPS tools
TeamSTEPPS — Evidence-Based Teamwork
TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) is an evidence-based teamwork framework developed by the Agency for Healthcare Research and Quality (AHRQ) and the Department of Defense. It comprises four core skills: Team Structure (defining roles and responsibilities), Communication (SBAR, check-backs, call-outs, handoffs), Situation Monitoring (cross-monitoring, STEP: Status of patient, Team members, Environment, Progress), and Mutual Support (task assistance, advocacy-inquiry, two-challenge rule, CUS words). Studies demonstrate that TeamSTEPPS implementation reduces surgical adverse events, medication errors, and HAIs.
Closed-Loop Communication Tools
Check-Back (Read-Back):
"Administer 2 mg IV morphine." → "Confirmed — 2 mg IV morphine." → "Correct."
Every verbal order must be read back and verified before execution.
Call-Out:
"Patient's BP is now 80/40!" (said loudly for all team members to hear)
Critical information announced to the whole team simultaneously — no one left uninformed.
SBAR Handoff:
Situation, Background, Assessment, Recommendation — structures all patient handoffs for completeness.
Situation Monitoring — STEP
A physician verbally orders 'Furosemide 40 mg IV now.' The nurse's next action is to:
Shared decision-making and the patient as a team member
SDM is a collaborative process where the patient and healthcare team together make decisions about treatment, based on the best available evidence AND the patient's informed values, preferences, and goals. Three-talk model: (1) Team Talk — 'We want to make this decision together with you.' (2) Option Talk — 'Here are the options and their evidence-based pros and cons.' (3) Decision Talk — 'What matters most to you? What decision feels right?' SDM improves adherence, satisfaction, and clinical outcomes.
The phrase 'nothing about me without me' captures the principle that patients should be active participants in care decisions, not passive recipients. Best practices: introduce all team members at rounds, ask the patient to share their own assessment of their condition, explicitly ask about the patient's goals for the hospitalization, and ensure language access for patients who do not speak English.
Healthcare has real power gradients — physician over nurse over student, senior over junior. But patient safety requires that safety-relevant information flow in all directions. Tools that reduce hierarchy barriers: structured communication (SBAR puts the concern in a framework the physician expects to receive), CUS words signal urgency non-threateningly, two-challenge rule requires two voiced concerns before escalation. Psychological safety — the team culture where people feel safe to speak up — is the strongest predictor of team performance.
components.interactiveLearning.terms
components.interactiveLearning.definitions
A physiotherapist tells the nurse that the patient is declining all mobility sessions. The nurse's MOST appropriate response using an interprofessional framework is:
