higher education emergency relief funding (heerf) proposal

Proposal Recommendation
Please submit this form with any recommendation for Higher Education Emergency Relief Funding (HEERF).
Proposals should identify clear goals, objectives, and quantifiable metrics. There are strict federal guidelines on
how HEERF funds can be utilized. More information can be found on the U.S. Department of Education HEERF
Funding main page, along with an extensive FAQ here.
Proposals that are determined to be an allowable use in accordance with the United States
Department of Education guidelines will be made available to the college community for
comment. Submission of proposals does not guarantee approval or appropriation.
Proposal Title:
Was this part of your departmental budget prior to COVID-19?
If yes, how much was allocated for this purpose?
There are five main categories, and your proposal must fall under one of the following. Please choose
which category your proposal falls under:
Please explain how your proposal fulfills the purpose of the category you selected, what the
current barrier is, why this proposal is needed to address that barrier, and how this proposal
furthers the college’s goal of creating a more equitable institution.
Proposal Description (Attach additional documents above as needed):
Office of the Controller
DocuSign Envelope ID: 6984A501-8284-49CB-BD97-32B910134DB2
Lori Martone-Roberts
Students are experiencing a gap in their clinical skills because of the pandemic and the requirements for social distancing. Currently, there
are limited skills lab and clinical time available to students and this is negatively impacting their ability to practice and master essential
nursing skills as they normally would pre-COVID. With these Modular Skills Trainers, students are able to adequately learn clinical skills
remotely in their home and/or socially distanced in the laboratory on their own individual skills trainer. This reduces the equity gap for
students who need to quarantine, cannot travel to campus, or are financially unable to purchase alternative supplies.
Professor
Yes
Nursing
N/A
See attached quote from Laerdal for the Modular Skills Trainer 2 for 185 portable skills trainers of a variety of diverse patient demographics. It
is requested that each student from the Spring 2022 ADN incoming class have access to a trainer that can be used throughout the program as
a way to address the current limitations of learning essential nursing skills remotely with alternative supplies such as play-doh, construction
paper, and cardboard that was regularly used during the beginning of the pandemic. The remaining skills trainers in the quote will be
disbursed evenly throughout all of the nursing skills laboratories to account for social distancing requirements. These lab trainers can be
loaned out to faculty and students as needed and properly disinfected when returned.
Equipment for Remote Nursing Skills Lab
Please explain how the proposal aligns with one (or more) of the goals outlined
in the Strategic Plan.
Goal 2: Expanding Partnerships and Programs
Goal 3: Strengthening Institutional Effectiveness
Please outline quantifiable metrics of this proposal:
How will this proposal be sustained after the HEERF funding period?
For Administrative Purposes Only
HEERF Funding Alternative Funding
With proper maintenance, these trainers used within the laboratory should be functional for several years which allows for the nursing
students to have consistent access to them in the laboratory and for loaning purposes. Ideally, incoming students in the Fall 2022 will not have
the same restrictions due to the pandemic, however, we may consider adding this to the student required book/supply orders to allow
financial aid to cover the expense for qualifying students.
This proposal aligns with the college's strategic plan by promoting student success and completion through technoloigical advancements and
remote learning. These trainers allow students to work independently and intraprofessionally in a mobile, adaptable learning environment.
As an institution, we have access to the curriculum integration guide for the modular skills trainers developed by the National League for
Nursing in partnership with Laerdal Medical.
X
The Nursing Department has collected metrics on the students who were enrolled in Nursing during the beginning of the pandemic which
indicates a gap in essential nursing skills. The faculty has also qualitatively measured students within labs and clinicals and have noted this
particular necessary area of improvement. Students will continue to be monitored and metrics will be collected. It is the goal of this proposal
to positively impact the student's nursing skill level for successful program completion.
X
X
X
11/10/2021 | 3:53 PM EST HEERF FAQ Question #32 - Institutions may use the funds to purchase equipment
or software... to enable students to transition to DL as such costs are associated
with a significant change in delivery of instruction due to COVID.
Allowable cost 11/12/2021 | 7:21 AM PST
X
National League for Nursing
Teaching Strategies 7
Introduction
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The teaching and learning of essential nursing skills is critical whether learners are engaged in remote learning or face to face content delivery methods.
The Laerdal Modular Skills Trainer provides faculty and students opportunity to watch, practice, and engage in assessment of skills attainment. This guide is intended to provide some ideas for faculty on how they might make use of the skills trainer to advance students through the curriculum. The trainer allows manipulation of realistic equipment and supplies in combination with screen-based learning that is similar to lab or classroom modalities.
Skills covered with the Modular Skills Trainer:
• Nasogastric tube insertion
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For practicing the skills, learners must also have the appropriate supplies available for practice. Since these vary between institutions and vendors, it is suggested to obtain or prepare supply kits to align with the skills trainer.
The User Guide provided by Laerdal Medical describes the assembly and suggested use of the various modules for successful completion of each skill.
Included Parts and Accessories
• Wound pad
• Injection pad
• Ostomy site
• Carry bag
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The Modular Skills Trainer is intended to be used in conjunction with the training or curriculum already developed at your institution.
The trainer allows demonstrations to be provided either in a socially distanced lab or classroom, or online using current remote teaching methods. Suggested integration methods include either providing students with the Modular Skills Trainer for use throughout their program, or having a supply of trainers that can be checked out for additional self or instructor guided-practice when skills are taught.
The advantage of having the skills trainer at home is that students are able to practice in a comfortable environment. Initially students will use the instructions provided on how to adapt to the size, shape, and other attributes of the device. They can then practice multiple skills as often as needed to maintain competence.
The device is designed to be durable for repeated practice, which is helpful if skills are taught over multiple courses and terms. Clinical faculty may also find it helpful to have a skills trainer available in a clinical site for just-in-time practice prior to the performance of a skill.
The initial teaching and learning of psychomotor skills is only the first step in skills acquisition. When there is a delay of weeks or months between the learning of a skill and the opportunity to repeat it, learners may not remember the process and skills decay occurs. Retention of skill is a problem when skills are taught, practiced, and evaluated early in a course or program.
Gonzalez and Kardong-Edgren (2017) have defined a process of deliberate practice that can mitigate this problem. This process does not mean that the learner only practices in isolation. Rather, they state “A large body of research suggests that DP (deliberate practice) in a controlled setting can help identify mediating mechanisms that may produce superior skill performance and retention, such as ‘think aloud,’ motivation, and performance monitoring, and that accumulated amounts of DP are related to attained levels of performance.” (p. 11.)
Individual learners may wish to practice alone in a private setting as well, and Oermann, Muckler, and Morgan (2016) believe that “Not all practice sessions need to be planned by the teacher. Although experts should guide performance during initial learning to reduce errors, students then can practice on their own.” (p. 280).
Keeping this in mind, students can practice on their own with the trainer, and have access to the trainer for periodic supervised skills reviews with feedback either in person or using a screen-based method.
Preparing Students for Use
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Similar to simulation, students should be directed to perform a skill as if they were in a live patient situation when using the skills trainer. Before faculty expect students to perform the skills, it is recommended that faculty also familiarize themselves with the Modular Skills Trainer. Being familiar with the device, allows faculty to provide any specific tips related to preparing and positioning it for best results. It is also advised to orient students to the trainer and the expectations for its use. Just as prebriefing
is recommended prior to simulation, the same practice is useful when incorporating the Modular Skills Trainer. This is done by explaining to students that, while we know the Modular Skills Trainer is not an exact replica of the human body, it is meant to be a helpful training tool to allow for repeated skill practice and retention. Additionally, faculty should provide respectful communication and treatment of the tool as expected in an actual patient situation.
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Depending on current isolation precautions and course delivery methods, there are a number of strategies for using the Modular Skills Trainer. Here are some suggestions for use, which can be expanded upon as needed by innovative faculty and students.
• Skills assessment - The Modular Skills Trainer can be used for skills assessment in addition to practice. From a student perspective, it is preferable to practice on the skills trainer first, rather than being introduced to the product in a “checkoff ” situation. Assessment can then be completed either live in a lab or classroom, or via remote video. Students may also complete peer-to-peer review with consideration given to the competence of the student doing the review.
• Embedding the skill into a patient case study – Begin by giving the student an SBAR of a patient case. Prior to beginning the skill, students are asked how they would adapt the skill for this patient, considering age, diagnosis, current condition, family presence, or other details.
• Exploring concepts within the skill in context such as sterile technique – Prepare questions for each skill that encourage students to explain their rationale and the knowledge guiding their thinking and critical elements of each skill.
• Hybrid use of the Modular Skills Trainer with existing simulation scenarios – This may be done in lab if students are practicing in person, or via remote learning if simulations are being done through video conferencing. A simulated patient/actor can provide the communication portion of the scenario. At the point where a skill is required, students can turn to their own skills trainer and perform the necessary skill without needing to have direct contact with the simulated patient/actor.
• Student remediation – If a student has failed to perform a procedure skillfully in lab or clinical, the Modular Skills Trainer can be available for repeated guided practice until the student is comfortable and competent with the skill.
• Global health considerations – In situations where faculty or students are traveling to other settings to provide patient care or train health care providers in areas where supplies and equipment are limited, the Modular Skills Trainer is an affordable teaching device. It can be used during the visit and left behind so learners in low resource settings can continue to have access to skill practice.
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NASOGASTRIC TUBE INSERTION
Students can be presented with a simple case that involves only a short description of a patient and a pre-op order.
*Mrs. Bates is a 60-year-old woman who is having a colon resection for colon cancer. Her pre-op order states “Insert a 14 french nasogastric tube.” Mrs. Bates is apprehensive about the surgery and the procedure. She is alone since no family visits are currently allowed due to isolation policies.
In this case students would be expected to perform the skill and support the patient in the process.
Critical Thinking Questions:
• What is the rationale for placing the nasogastric tube?
• How will you respond if Mrs. Bates asks whether this will be painful?
• What supplies will you need to obtain before beginning the procedure?”
WOUND CARE (OPEN WOUND)
An example of a more complex case requiring skill performance.
*Jonathan McAdams is an obese 20-year-old man who had surgery 10 days ago for a perforated appendix. He was sent home with supplies and instructions to change the dressing daily. He had been noticing increasing redness and purulent drainage at the incision site on his abdomen and was readmitted yesterday. The wound was opened, drained, and packed with saline dressings. You are to remove his old dressing, clean the wound, and place a new dressing on it.
Considerations for this scenario:
If working remotely with the skills trainer, students would need to first dress the wound, then practice removing that dressing so that they could replace it.
• What risk factors does this patient have for wound infections?
• What other treatments will he likely be receiving for his wound infection?
• What kind of discharge teaching will you do with this patient?
Patient examples are listed below.
For programs using vSim® for Nursing or other virtual cases, faculty can integrate the Modular Skills Trainer when virtual simulated cases require skill performance. A vSim® for Nursing scenario can be paused at the appropriate point while the student performed the skill on the trainer.
This way, students are engaging both high level cognitive skills as well as technical skills. The trainer can also be integrated with any scenarios currently being used in clinical coursework.
TRACHEOSTOMY CARE
*Finley Clark is a 5-month old male who was born prematurely at 29 weeks gestation. Finley has been in the NICU since birth and is ventilator-dependent. His tracheostomy was done at age 3 months due to the need for prolonged ventilatory support. Finley is due for tracheostomy care and you will need to change the ties.
This case can be made more complex in multiple ways. The patient’s family may be present and students will need to teach them the procedure. The patient can require suctioning before or after the procedure is done.
• Is this a clean or a sterile procedure? Share your rationale.
• What challenges does the patient’s age present during the procedure?
• What are your main safety concerns?
CENTRAL LINE DRESSING CHANGE
*Faisal Khaled is a 60-year-old male who is in the ICU post-surgical resection of a liver tumor. He had a central line placed in the left subclavian vein 7 days ago, and is due for a central line dressing change. Mr. Khaled has a transparent dressing over the site. He is alert and communicating with caregivers.
Faculty will need to keep in mind that, in order for students to perform a central line dressing change, they will first need to have a central line in place in the skills trainer, with a dressing over the site. Whether this is done by skills faculty prior to the students’ practice, or students will be setting up the central line in the patient prior to the dressing change will need to be determined in advance.
• What is the rationale for doing dressing changes every 7 days in this patient? When and why might you change this schedule?
• List the equipment you will need to obtain prior to the procedure.
• What signs would concern you related to a potential infection at this site?
• What steps would you take if you noted any of these signs?
• What steps are you taking to prevent central line–associated bloodstream infections, or CLABSIs?
OSTOMY CARE
*In this scenario a 33-year-old female is in the surgical unit, two days post-operative after removal of the colon and rectum due to a long history of ulcerative colitis. A colostomy has been created. The learners are expected to assess and evaluate the colostomy site, explain the procedures to the patient using an appropriate communication framework, and provide colostomy care, including emptying the bag (and reapplying if needed). (Laerdal, Nursing Anne Scenarios).
• What concerns do you expect the patient to have regarding her colostomy?
• When is it appropriate to begin to teach the patient how to care for her colostomy?
• What individuals/specialties need to be on this patient’s discharge planning team?
• What can she anticipate regarding the progression of her ulcerative colitis?
PERINEAL CARE & URINARY CATHETERIZATION
As noted, any of the skills can be done in combination with already developed simulations. This example refers to one of the NLN ACE-V (Advancing Care Excellence for Veterans) unfolding cases. http://www. nln.org/professional-development-programs/teaching-resources/veterans- ace-v/unfolding-cases/jenny-brown.
*Jenny Brown, 29 years old, was admitted yesterday in labor. She gave birth approximately 12 hours ago to Samantha, a 7 lb 10 oz healthy female infant with a right-sided unilateral cleft lip and palate. The vaginal birth was uncomplicated. A neonatologist, NICU nurse, and respiratory therapist attended the delivery and provided immediate newborn care. The boyfriend, Eric, has been here all night. He just went to get some breakfast and will be back soon.
In the scenario, Jenny has been up to void several times since delivery. This report can be changed to state that Jenny has been up several times since delivery but has been unable to void. You will need to do perineal care and perform a straight catheterization for Jenny.
• Why do you suspect this patient is unable to void?
• How will you monitor this patient post catheterization?
ENEMA OR RECTAL SUPPOSITORY
*Mrs. Sanchez is a 90-year-old resident at a skilled nursing facility. She is not ambulatory and is being fed a soft diet with assistance. Mrs. Sanchez has recently developed problems with constipation. Her last stool was 3 days ago and you are to administer a fleets enema (or a glycerin suppository.)
Critical Thinking Questions
• What are the possible contributing factors to her constipation?
• How will you prepare Mrs. Sanchez for this procedure?
• What recommendations can you make to prevent the recurrence of constipation?
INJECTIONS
The skills trainer can be used to prepare students for a flu vaccine clinic. They can give repeated intramuscular injections (using air, not fluid, with the task trainer) until they are comfortable with the equipment and the procedure.
• What are the risks of the flu vaccine?
• How will you screen patients prior to the vaccine? Are there people who should not receive it?
• How will you clean your hands and the immediate area after each dose?
• What teaching will you provide regarding follow up to the vaccine?
• What is the effectiveness of the flu vaccine? Is this known at the time of administration?
• What would an allergic reaction to the vaccine look like?
• What will you do if you see signs of an allergic reaction?
IV CATHETER INSERTION
For faculty and students doing the Laerdal vSim® for Nursing cases, psychomotor skills can be incorporated with the screen-based scenario.
*Skyler Hansen is an 18-year-old male diagnosed with type 1 diabetes 6 months ago. He was brought to the Emergency Department by his friends. The friends report that he started acting “weird” while they were playing basketball. He has not eaten anything for 5 hours. Skyler told them that he felt lightheaded and was going to lie down on the cement. They became nervous and decided to bring him in to the Emergency Department. The patient is drowsy, wakes with stimulus, has slurred speech, is diaphoretic, and is acting irrationally. He has not yet been seen by the provider.
After Skyler’s initial assessment, orders are received to obtain IV access. Students could perform this skill on the skills trainer.
• A patient has an IV in their right wrist area and needs a new IV. Discuss your approach to assessing other possible sites for new IV insertion on the patient’s right extremity.
• How would you respond if Skyler asked you why he needed to have an IV?
• Discuss what are some complications to the patient when using intravenous peripheral therapy?
OXYGEN THERAPY
*As the scenario begins, Mr. Williams presents as follows:
• “Bed is flat. Henry is coughing and short of breath. His nasal cannula has fallen out of his nose
• Vital signs: T 98.2, BP 138/90, P – 112, R - 28;
• Oxygen saturation – 84%
• Henry (wheezing): “I am really short of breath and so tired.”
Nurses would be expected to do the following:
• Performing hand hygiene
• Confirm patient ID
• Replace cannula in nares (which will be done with the skills trainer)
• At what liter flow will you start the oxygen administration?
• What other interventions need to be initiated??
• How is his anxiety impacting his respiratory status?
• If after 1 minute the vital signs are: BP 130/88, P 98, oxygen saturation 88%, what action should be initiated?
NASAL SWAB
*Consider that there have been several community cases of a highly contagious and potentially very serious viral respiratory illness. The illness has been fatal for people in several high risk groups. Due to the seriousness of the illness and the potential exposure of hundreds or possibly thousands of community members, the local hospital is running several screening centers. The nurses will be performing nasal swabs to test for the virus.
• What PPE will the nurses need to run this screening center?
• What information should be obtained from the persons being screened?
• What is the role of the public health department in this case?
G-TUBE CARE
*Sylvia Vronsky is a 45-year-old woman who suffered a stroke one month ago. She has been having difficulties with return of speech and with swallowing. Mrs. Vronsky aspirated during a meal 2 weeks ago and was hospitalized with pneumonia. Her family decided that a gastrostomy tube would be helpful, and it was placed yesterday. The nurses need to demonstrate g-tube care to the family, who will be taking Mrs. Vronsky home tomorrow morning.
• How often do we need to clean around the tube?
• Do you think her speech and swallowing will come back?
• Will she ever be able to take care of this herself?
• What else will the family need to be taught related to the g-tube?
• What types of gastrostomy feedings can be done at home?
• What do we do if it comes out?
Author Mary Cato EdD, RN Assistant Professor Emeritus Oregon Health & Science University
Contributors Cynthia Sherraden Bradley PhD, RN, CNE, CHSE Assistant Professor, Director of Simulation University of Minnesota School of Nursing
Sandra Caballero, MSN, RN, CHSE Texas Tech University Health Sciences Center
Sharon Decker, PhD, RN, FSSH, ANEF, FAAN Texas Tech University Health Sciences Center
Heiddy DiGregorio, PhD, APRN, PCNS-BC, CHSE, CNE Assistant Professor, Director of Simulation University of Delaware College of Health Sciences
Susan Henley Hébert, MSMS, BSN, CHSE PhD Student in Nursing Simulation Director University of Tennessee, Knoxville, College of Nursing
Melissa Leal, EdD©, MSN, RN, CHSE Texas Tech University Health Sciences Center
Kathryn Whitcomb, DNP, RN, CHSE Texas Tech University Health Sciences Center
Susan Gross Forneris PhD, RN, CNE, CHSE-A, FAAN Director, NLN Center for Innovation in Education Excellence
References
NLN Advancing Care Excellence for Veterans. http://www.nln.org/professional-development-programs/teaching-resources/veterans-ace-v
NLN Advancing Care Excellence for Seniors, http://www.nln.org/professional-development-programs/teaching-resources/ace-s
Gonzalez, L., & Kardong-Edgren, S. (2017, January). Deliberate practice for mastery learning in nursing. Clinical Simulation in Nursing, 13(1), 10-14. http://dx.doi.org/10.1016/j.ecns.2016.10.005.
Marilyn H. Oermann, PhD, RN, ANEF, FAAN; Virginia C. Muckler, DNP, CRNA, CHSE; Brett Morgan, DNP, CRNA. 2016.Framework for teaching Psychomotor and procedural skills in nursing. J Contin Educ Nurs. 2016;47(6):278–282 https://doi.org/10.3928/00220124-20160518-10
© 2021 Laerdal Medical AS. All rights reserved. Rev B.
National League for Nursing
CLIENT EXECUTIVE Tara Landry (845) 242-0570 [email protected]
To prevent any delays in processing your purchase, please include your quote # when ordering. DATE: 10/27/2021 QUOTE NUMBER: Q-499263
CREDIT TERMS: 30 days
ATTN: Ms. Lori Martone-Roberts Associate Professor of Nursing/Faculty Simulation Liaison +1(401) 258-3420 [email protected] BILL TO: 00110595 COMMUNITY COLLEGE OF Rhode Island - A/P Dept 400 East Ave Warwick RI 02886
Discounts and free ground shipping per MHEC Contract MC13-D32.
QTY PRODUCT DESCRIPTION LIST PRICE UNIT PRICE EXTENDED PRICE
185 330-15050 Modular Skills Trainer 2 The Modular Skills Trainer is a portable solution for skills practice and competency development. Optimized for distance learning, the Modular Skills Trainer is an affordable, practical solution for repetitive, independent skills practice and to assist with skills validation
$250.00 $212.50 $39,312.50
ITEM TOTAL : $39,312.50 SHIPPING/HANDLING : $0.00 TAX : $0.00 ADDITIONAL CHARGE/CREDIT : $0.00 TOTAL : $39,312.50
There are various payment options; please see bottom of your quote for further clarification. Appropriate Sales Tax will be added to invoice – Pricing and Availability are subject to change
Shipping/Handling costs will be added to invoice By Accepting this Quote, the following terms are hereby incorporated into customer’s order: Products: Products that are currently on contract will be removed immediately if manufacturing or distribution of the product is discontinued.
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Payment: Net 30 Days for approved open accounts; CIA; Credit Cards accepted. Financing options now available – sample leasing payment terms follow. For additional information, ask your Account Manager listed above. Lease term 24 months: USD 1,638.02 * Lease term 36 months: USD 1,092.01 * Lease term 48 months: USD 819.01 * * Quoted payments do not include Interest, Taxes, Maintenance, Cancellation fees or Insurance. Quotes are subject to credit approval and may change without notice. Warranty: One(1) year warranty on manufactured products and 90 day warranty on refurbished products Two(2) year parts replacement warranty with technical assistance by phone on all Hill-Rom refurbished products Delivery: Delivery of product to a specific location within your building, if requested is at an additional charge and not included in this quote Training: Training will be scheduled within a year of the customer’s agreed upon due date. CANCELLATION or RESCHEDULING of EDUCATIONAL or TECHNICAL SERVICES WILL RESULT IN CANCELLATION/RESCHEDULING FEES. 7 DAYS OR LESS: 100% of Course / Service Cost 8 DAYS to 2 WEEKS: 75% of Course / Service Cost 15 DAYS to 20 DAYS: 50% of Course / Service Cost 3 WEEKS or MORE: NO FEE Customer will be required to submit a new PO to reschedule a cancelled course / service.
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higher education emergency relief funding (heerf) proposal

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