2nd Annual HCSSC Symposium presentation(Barbara)

Report
Simulation Coordinator and
NUR 270 Course
Coordinator met to discuss
format of Capstone
 Simulation based
competency blueprint
mutually agreed upon
 Previous competency was
inherited as a skill based
demonstration lab.
 Objectives formulated

Faculty training
session -Dry Run
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After the 2012 Symposium in
Charleston, we changed the skills
based competency to a
simulation focusing on leadership,
resource allocation, delegation,
critical thinking, communication
and prioritization.
Consultation with the GHS
Simulation Center resulted in the
current simulation involving 5
students and 7 faculty.
The current simulation allows us to
facilitate 40 students in 4.5 hours
with 7 facilitators.
Consistent faculty
 Time management – have
increased the time from a 20
minute stagger to 30 minute
stagger starts
 Effective
communication/scheduling
between multiple staff,
multiple entities, students etc.
 Organization and
consistency in a purposefully
chaotic environment.

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Faculty hours0.80 faculty hours per
student during
simulation with 40
students.
This does not include
prep time on the
part of the simulation
center or course
leadership.
Student recognizes patient needs and
prioritizes patient care
 Student performs initial and focused
assessment
 Student communicates effectively
 Student provides a safe environment
 Student delegates appropriately
 Student demonstrates appropriate
leadership skills

Student
Prep
Debriefing
During
Simulation
Reflection
on
Learning
4 Different Patients selected for student
assignment
 Post Partum Hemorrhage, COPD- Rapid
Response, DKA ready for discharge,
Pediatric Head Injury
 All patients had a safety error to correct;
critical decisions to make;
communication to Charge Nurse/MD;
and reassessment of the patient’s
changing condition.

Student name_________________
Time_______________ May 22 2013
RAPID RESPONSE- Check List
RAPID RESPONSE
INITIAL ASSESSMENT- total time frame not to exceed 9 minutes
1
Enter room to check patient
2
Did not perform IWIPE
 Identify self
 Wash hands
 Identify patient
 Provide privacy
 Explain procedure
3
 Did not check patient chart
4
 Did not perform initial assessment
 Checks VS –normal VS
 Pulse
 RR
 O2Sat
 B/P
5
 Did not complete a focused Neuro Assessment
 Did not complete a focused Cardiac Assessment
 Did not complete a focused Respiratory Assessment
NURSING INTERVENTIONS- total time to decide to call Rapid Response 5 minutes
8
 Did not rechecks vital signs – BP is low must recognize and please show rhythm SVT 180 narrow QRS
at 9 min mark
 Pulse
 RR
 O2Sat
 Did not reassess B/P
 Did not reassess Heart sounds
 Did not reassess Breath sounds
9
Pulse OX- change in O2 SAT down to 80% at 10 minute mark RR increased to 25
10
 Increases Oxygen to patient via NC
11
Change in neuro status- pt states I don’t feel good
 Did not reassess neuro status
 IV for KVO
12
 Did not recognize need for Rapid Response Team
13
 Did not communicate with Charge Nurse
14
 Did not utilize ISBARR format (for MD or Rapid Response Team )
15
 Did not communicate effectively with the patient
SAFETY VIOLATIONS
 Intervention/therapy in place that was not ordered
 Patient left alone during critical period
 Bed left in high position/unlocked
 Inappropriate use of side rails
 Patient not identified properly
 Personal protective equipment
 Failure to recognize
ISBARR - Identify, Situation, Background, Assessment, Recommendation, Read back

Organizational grid:
› Time slots
› Faculty



Patient Charts
Charge Nurse Report
Scenario Checklists

Debriefing Room students receive a 23 minute individual
debriefing from the
faculty running their
scenarios and are
then sent into the
debriefing room to
talk about the
scenario as a group.
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Addition of Scenarios to interchange cases
Continue to refine checklists
Addition of a rubric to grade the simulation
Develop the preparatory assignment for the
students- Admission Ticket
Addition of EHR documentation
Utilization of individual rooms rather than
quad room
Video evaluation of charge nurse

SIMULATION SPECIALIST- Paula Rozov
Melanie Cason , RN, MSN, CNE
 Fran Lee, DBA, CHSE


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