Graded assertiveness

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Graded assertiveness

Graded assertiveness is a technique for managing conflict and preventing critical errors in a crisis. It allows all team members to feel empowered to voice their concerns over a planned action that risks patient safety in an assertive (not aggressive) manner. Probe, Alert, Challenge, Emergency (PACE) is a four-step technique of increasing urgency. It provides a graded assertiveness pathway for rapid, effective, but respectful, escalation of the response (Foot, Steel and Campher (2011).

A nurse is about to administer amoxicillin to a patient who is allergic to penicillin. Another nurse present uses PACE to advocate for the patient, escalating her response as is necessary.

HOTSPOT

Patient scenario

Mrs Jones has been admitted with pneumonia.  The doctor has just left the ward after reviewing Mrs Jones. The nurse calls the doctor as she has just performed a set of vital signs and has noticed her SpO2 has decrease to 93% on room air. 

HOTSPOT

Patient scenario

Mrs Jones has been admitted with pneumonia.  The doctor has just left the ward after reviewing Mrs Jones. The nurse calls the doctor as she has just performed a set of vital signs and has noticed her SpO2 has decrease to 93% on room air. 

Use the statements below to drag and drop the graded assertive responses the nurse uses.

References

Foot, Steel and Campher