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Team Strategies and Tools in Nursing Practice


Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is a system of evidence-based tools with the primary goal to improve patients’ outcomes through the development of teamwork skills among health care providers (Clancy & Tornberg, 2007).

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TeamSTEPPS can be used to improve the quality of medical services as it is aimed to optimize the use of data, staff, and resources available. The key opportunity the system provides is to ensure patients’ safety as it allows controlling performance, knowledge, and attitudes of the personnel. TeamSTEPPS is applied to assess the safety culture and develop a plan for improvement (Clancy & Tornberg, 2007).

The principles of TeamSTEPPS can and should be integrated into the nursing curriculum to teach students to reduce the number of professional errors and provide safe care through effective collaboration. TeamSTEPPS can assist in acquiring team “language” and skills, which is especially important for beginners (Clancy & Tornberg, 2007).

If I taught in a pre-licensure nursing program, I would use the tool dividing the implementation plan into three phases. The intervention phase would feature workshops for nursing students presenting the system’s fundamentals. The course would include role-playing and simulation of real scenarios from medical practice (quasi-experimental design). The effectiveness of teamwork would be assessed with the help of questionnaires.

In the second stage, TeamSTEPPS modules would be developed to introduce them to the curriculum according to the students’ level. At the final stage, the results will be enhanced by creating blogs, websites, organizing conferences, etc. to disseminate information (Agency for Healthcare Research and Quality, 2015).

Nursing Practice Act: Florida and California

According to the Board of Nursing in Florida, pre-licensure nursing education has to meet the following requirements (Billings & Halstead, 2015):

  • at least 50% of the program’s faculty members must be registered nurses with at least a master’s degree;
  • minimum of 50% of the program must be devoted to clinical training in the US;
  • no more than 50% of the training should consist of simulation;
  • the exact number of hours varies across the institutions;
  • students must be supervised by a faculty member or preceptor;
  • indirect supervision is possible only if there is direct supervision by a preceptor or a faculty member can be reached by phone;
  • the curriculum must document the clinical experience and theoretical instructions as well as training experience.

The Florida Board of Nursing does not provide any regulations for post-licensure nursing education programs (neither RN-BSN nor any other advanced degrees).

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There exist differences between for-profit and not-for-profit education programs. State schools reject more applicants in BSN programs whereas both state and private institutions reject the equal number of ADN program applicants. For-profit organizations have more seats left vacant both in BSN and ADN programs.

Nursing education in California is regulated by the following rules (Billings & Halstead, 2015):

  • it must be administered by an institution that can provide baccalaureate or a higher degree in medicine;
  • it must include all theoretical and practical experience information;
  • the program can be both full- and part-time and should contain no less than 58 semester and 87 quarter units including students’ clinical practice;
  • 1 unit equals one hour of theoretical instruction and three hours of practice;
  • 1 semester lasts 16-18 weeks and 1 quarter – 10-12 weeks;
  • the program must provide supervised practice in clinical settings;
  • simulation is possible, however, at least 12 units of the program have to be devoted to ground-based experience.

As far as the post-licensure regulations are concerned, they run as follows:

  • 1 hour of theoretical education equals 1 hour of continuing education;
  • three hours of practice in clinical settings equal one hour of continuing education;
  • approval requires at least one hour in duration;
  • 1 continuing education unit equals 10 contact hours;
  • 1 quarter unit equals 10 education hours.

The situation with for-profit and not-for-profit programs is the same as in Florida. However, in California, private schools are much more expensive. Despite that, programs guarantee that a student will graduate in four years. The competition is low, and all the programs are easily accessible.

Articles Discussion

The article by Waznonis discusses debriefing as an integral part of simulated learning. It claims that real practices of it are not evidence-based though there are a lot of expert approaches to simulation in education that nursing can rely upon.

However, terminology inconsistency makes it very difficult to identify and differentiate the strategies and methods of debriefing. Besides, there are scare means of assessment. The article examines existing methods and ways of evaluation that allow using debriefing in nursing education. The author singles out 22 methods and 7 ways of evaluation. The review manages to clarify terminology and explain the interconnection of all the aspects of simulation debriefing (Waznonis, 2014).

The second article investigates the NLN Jeffries Framework that concerns simulation in nursing practice. The model is implemented for the successful development of simulation scenarios and provides a theoretical background for all kinds of studies concerning the use of simulation in education. The author proves that, despite being created for pre-licensure nursing programs, this model can be applied to build simulation scenarios for post-licensure students that want to acquire the role of a nursing educator.

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The interactive environment that the framework manages to create provides a good chance for nurses to obtain practical knowledge of teaching strategies and methods. The article goes into detail about the ways to guide simulation practice with the help of the model. The author claims that the NLN Jeffries Framework implementation guarantees that the core competencies of a nurse educator will be supported by necessary practice (Young & Shellenbarger, 2012).


Agency for Healthcare Research and Quality: about TeamSTEPPS. (2015). Web.

Billings, D. M., & Halstead, J. A. (2015). Teaching in nursing: A guide for faculty. Amsterdam, the Netherlands: Elsevier Health Sciences.

Clancy, C. M., & Tornberg, D. N. (2007). TeamSTEPPS: assuring optimal teamwork in clinical settings. American Journal of Medical Quality, 22(3), 214-218.

Waznonis, A. R. (2014). Methods and evaluations for simulation debriefing in nursing education. Journal of Nursing Education, 53(8), 459-465.

Young, P. K., & Shellenbarger, T. (2012). Interpreting the NLN Jeffries framework in the context of nurse educator preparation. Journal of Nursing Education, 51(8), 422-428.

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