The nurse educator is preparing a presentation on the use of SBAR to improve the quality and safety of clients on the unit. When using the SBAR tool, which information should the nurse include for each component?
For each definition, click in the box for the component of the SBAR tool with which it correlates.

Rationale:
A. Nuchal rigidity, or stiffness of the neck, is a hallmark sign of meningeal irritation such as in meningitis, not botulism. While it is a neurological finding, it is not associated with the neuroparalytic effects of botulism.

B. Ptosis (drooping of the eyelids) is a classic early sign of botulism. Botulinum toxin blocks acetylcholine release at neuromuscular junctions, leading to descending flaccid paralysis, which often begins with cranial nerves. Ptosis is a direct result of this cranial nerve involvement.

C. Dysphagia (difficulty swallowing) occurs because botulinum toxin impairs the muscles involved in swallowing. This is another common early manifestation, reflecting bulbar muscle involvement.

D. Fever is generally not present in botulism. Botulism is a toxin-mediated disease rather than an infectious or inflammatory process that triggers systemic fever. Presence of fever might suggest another infection.

E. Diplopia (double vision) results from paralysis of extraocular muscles, which is another early cranial nerve sign of botulism. It reflects the neurotoxin’s effect on the neuromuscular junction of eye muscles.

Rationale:

A. This style occurs when one individual pursues their own goals aggressively, often at the expense of others. In nursing, coercion may involve insisting on a particular plan of care without considering colleagues’ input. It is not an example of putting aside one’s own goals; rather, it prioritizes personal objectives over others’ needs. Using coercion can create tension or resentment among staff and is generally appropriate only in emergencies where quick, decisive action is required.

B. This is the correct example of a nurse putting aside her own goals to satisfy the other nurse. Accommodation involves yielding, cooperating, or giving in to another person’s preferences, sometimes to maintain harmony, avoid conflict, or preserve relationships. In the nursing context, this might look like a nurse agreeing to follow a colleague’s preferred approach to patient care even if she personally disagrees, prioritizing teamwork or unit harmony over personal opinion. While it can reduce immediate conflict, overuse may lead to resentment or feelings of being undervalued.

C. Collaboration is a problem-solving approach where both parties work together to find a mutually acceptable solution. It is a win-win strategy because it addresses the needs and goals of all involved. In nursing, collaboration might involve two nurses discussing differing approaches to patient care and developing a combined plan that satisfies both clinical judgment and unit policies. Collaboration requires active communication, negotiation, and shared responsibility; it does not involve one person fully sacrificing their goals.

D. Compromise occurs when both parties give up something to reach an agreement. It is a mutual concession approach. For example, two nurses might have different preferences for scheduling breaks and agree to split their choices to meet halfway. Compromise is not one-sided; unlike accommodation, each participant sacrifices a portion of their goals rather than one person yielding completely.