using the human patient simulator in nursing education sarah j. clark, rn-c, msn davidson county...
TRANSCRIPT
Using the Human Using the Human Patient Simulator in Patient Simulator in Nursing EducationNursing Education
Sarah J. Clark, RN-C, MSNSarah J. Clark, RN-C, MSN
Davidson County Community CollegeDavidson County Community College
Where do student nurses learn?Where do student nurses learn?
ClassroomClassroom• Content is introducedContent is introduced• Concepts are exploredConcepts are explored
LabLab• Skills are taughtSkills are taught• Discrete hands on practiceDiscrete hands on practice
ClinicalClinical• Classroom concepts and clinical skills Classroom concepts and clinical skills
are applied to patient care situations are applied to patient care situations
So, what is simulation?So, what is simulation?
Representing certain key Representing certain key characteristics or behaviors of a characteristics or behaviors of a selected physical or abstract systemselected physical or abstract system
Modeling of natural or human Modeling of natural or human systems in order to gain insight into systems in order to gain insight into their functiontheir function
Simulation can be used to show the Simulation can be used to show the eventual real effects of alternative eventual real effects of alternative conditions and courses of actionconditions and courses of action
Simulation in nursing educationSimulation in nursing education
Low techLow tech• Skills mannequinsSkills mannequins• Inject a padsInject a pads
High techHigh tech• Human patient simulatorHuman patient simulator
Human patient simulatorHuman patient simulator
Human Patient SimulatorsHuman Patient Simulators
AdultAdult ChildChild Laboring patientLaboring patient NewbornNewborn BabyBaby
Human patient simulatorHuman patient simulator
AssessmentAssessment• BreathesBreathes• VocalizesVocalizes• Vital signsVital signs• PulsesPulses• Breath soundsBreath sounds• Heart soundsHeart sounds• Bowel soundsBowel sounds• EKG rhythmEKG rhythm
Human patient simulatorHuman patient simulator
InterventionsInterventions• IV insertion and careIV insertion and care• IM injectionsIM injections• NG insertion and careNG insertion and care• Urinary catheter insertion and careUrinary catheter insertion and care• Oxygen administrationOxygen administration• Medication administrationMedication administration• IntubationIntubation• Chest decompressionChest decompression
Human patient simulatorHuman patient simulator
Pre-program Pre-program • Program scenarioProgram scenario• Program responses to interventionsProgram responses to interventions
Run “on the fly”Run “on the fly”• Operator runs the scenarioOperator runs the scenario• Original assessment findings are setOriginal assessment findings are set• Responses are programmed in real timeResponses are programmed in real time
Any Questions?Any Questions?
Simulation and the North Carolina Simulation and the North Carolina Board of NursingBoard of Nursing
NCBON will accept simulation in lieu NCBON will accept simulation in lieu of clinical with direct patient careof clinical with direct patient care
Alternative for clinical experiences Alternative for clinical experiences with limited opportunities for patient with limited opportunities for patient carecare• PediatricsPediatrics• Mental health Mental health • MaternityMaternity
Why simulate in nursing?Why simulate in nursing?
Ensure experience with Ensure experience with conceptsconcepts demonstrated in patient situations demonstrated in patient situations • Post op carePost op care• Respiratory distressRespiratory distress• Chest painChest pain• Hip fractureHip fracture• Vaginal deliveryVaginal delivery
Why simulate in nursing?Why simulate in nursing?
RemediationRemediation• Medication errorsMedication errors• FallsFalls• Failure to rescueFailure to rescue• Make mistakes in a risk free Make mistakes in a risk free
environmentenvironment
Why simulate in nursing?Why simulate in nursing?
RemediationRemediation TeachingTeaching
• Scenario that teaches application of Scenario that teaches application of classroom contentclassroom content
Assess patient for specific risk factors Assess patient for specific risk factors Assess patient and implement appropriate Assess patient and implement appropriate
nursing interventionsnursing interventions Evaluate patient responses to medications, Evaluate patient responses to medications,
interventionsinterventions Act as team leader, team memberAct as team leader, team member
Why simulate in nursing?Why simulate in nursing?
RemediationRemediation TeachingTeaching TestingTesting
• Scenario that tests application of Scenario that tests application of classroom contentclassroom content
Assess patient for specific risk factors Assess patient for specific risk factors Assess patient and implement appropriate Assess patient and implement appropriate
nursing interventionsnursing interventions Evaluate patient responses to medications, Evaluate patient responses to medications,
interventionsinterventions Act as team leader, team memberAct as team leader, team member
Any Questions?Any Questions?
Pitfalls to simulation in nursing Pitfalls to simulation in nursing educationeducation
Potential barrier: Financial Potential barrier: Financial constraintsconstraints• SimMan costs $34,000SimMan costs $34,000• VitalSim costs $2035VitalSim costs $2035• SimBaby costs $31,770 without the SimBaby costs $31,770 without the
computercomputer
Potential solutions to pitfalls of Potential solutions to pitfalls of simulation in nursing educationsimulation in nursing education
Get help finding the moneyGet help finding the money• Laerdal has people who find grant Laerdal has people who find grant
moneymoney• NC state is looking favorably toward NC state is looking favorably toward
money for allied health, simulationmoney for allied health, simulation
Pitfalls to simulation in nursing Pitfalls to simulation in nursing educationeducation
Potential problem: SpacePotential problem: Space• Rooms are tight everywhereRooms are tight everywhere• SimMan must be securedSimMan must be secured
Possible solutions to pitfalls of Possible solutions to pitfalls of simulation in nursing educationsimulation in nursing education
Make SimMan mobileMake SimMan mobile• Put SimMan on a rolling stretcherPut SimMan on a rolling stretcher• Put his components on a rolling cartPut his components on a rolling cart• Role him out when you need him and Role him out when you need him and
lock him up when he is donelock him up when he is done
Pitfalls of simulation in nursing Pitfalls of simulation in nursing educationeducation
Potential barrier: Mannequin is based Potential barrier: Mannequin is based on medical modelon medical model• ““Bells and whistles” that nurses don’t Bells and whistles” that nurses don’t
needneed• Settings lend themselves to Settings lend themselves to
pathophysiology, medical differential pathophysiology, medical differential diagnosis and medical interventiondiagnosis and medical intervention
Potential solutions to pitfalls of Potential solutions to pitfalls of simulation in nursing educationsimulation in nursing education
Focus on the nursing processFocus on the nursing process• Select the product you want based on Select the product you want based on
what you needwhat you need• Develop scenarios based on nursing Develop scenarios based on nursing
experiences, nursing literatureexperiences, nursing literature• Define the objectives in nursing termsDefine the objectives in nursing terms• Use only the “bells and whistles” that Use only the “bells and whistles” that
support the scenariosupport the scenario
Pitfalls to simulation in nursing Pitfalls to simulation in nursing educationeducation
Potential barrier: Faculty resistancePotential barrier: Faculty resistance• ““We’ve always done it this way”We’ve always done it this way”• No one knows how to do thisNo one knows how to do this• Time to develop learning activitiesTime to develop learning activities• Time and faculty intensive to run the Time and faculty intensive to run the
scenariosscenarios
Potential solutions to pitfalls of Potential solutions to pitfalls of simulation in nursing educationsimulation in nursing education
Have a planHave a plan• Take advantage of educational sessionsTake advantage of educational sessions
Manufacturer offers free educationManufacturer offers free education Many articles in the literatureMany articles in the literature Inexpensive educational opportunitiesInexpensive educational opportunities NetworkNetwork
• Have a championHave a champion Develop one or two expertsDevelop one or two experts All faculty have a role, but the champion is All faculty have a role, but the champion is
the simulation expertthe simulation expert
Potential solutions to pitfalls of Potential solutions to pitfalls of simulation in nursing educationsimulation in nursing education
Integrate slowly into the curriculum Integrate slowly into the curriculum • Start small and work upStart small and work up
Find a need and fill itFind a need and fill it Enlist content experts in scenario buildingEnlist content experts in scenario building
• Consider simulation when preparing a courseConsider simulation when preparing a course Identify content that can be taught or reinforced Identify content that can be taught or reinforced Look at what other programs are doingLook at what other programs are doing
• Look at simulation with curriculum reviewLook at simulation with curriculum review Develop a systematic plan for implementationDevelop a systematic plan for implementation Make simulation fit your curriculum, not the other Make simulation fit your curriculum, not the other
way aroundway around
Potential solutions to pitfalls of Potential solutions to pitfalls of simulation in nursing educationsimulation in nursing education
Involve the studentsInvolve the students• Faculty to develop pre-programmed Faculty to develop pre-programmed
scenarios that a peer tutor can runscenarios that a peer tutor can run• Students write scenarios to runStudents write scenarios to run• Senior students can run scenarios for Senior students can run scenarios for
the newer studentsthe newer students• Have the students evaluate themselves Have the students evaluate themselves
and each otherand each other
Any Questions?Any Questions?
Nuts and bolts of simulation in Nuts and bolts of simulation in nursing educationnursing education
Getting startedGetting started• Identify purpose of simulationIdentify purpose of simulation
RemediationRemediation TestingTesting Teaching new contentTeaching new content Application of multiple conceptsApplication of multiple concepts
A Teaching Simulation Activity: A Teaching Simulation Activity: Client AssessmentClient Assessment
Objectives:Objectives:• Discuss components of a head to toe Discuss components of a head to toe
assessment.assessment.• Perform a head to toe assessment of the Perform a head to toe assessment of the
SimMan with a partner.SimMan with a partner.• Assist fellow students in performing a Assist fellow students in performing a
head to toe assessment.head to toe assessment.
A Teaching Simulation Activity: A Teaching Simulation Activity: Client AssessmentClient Assessment
The PlanThe Plan• Groups of 4 studentsGroups of 4 students• General worksheet and group discussionGeneral worksheet and group discussion• Partners perform assessment while fellow Partners perform assessment while fellow
students observe and coach as appropriatestudents observe and coach as appropriate• A student who is observing will be the voice of A student who is observing will be the voice of
the client.the client.• The facilitator is actively teaching throughout The facilitator is actively teaching throughout
the simulation.the simulation.• All assessment findings on the SimMan will be All assessment findings on the SimMan will be
normal.normal.
A Teaching Simulation Activity: A Teaching Simulation Activity: Client AssessmentClient Assessment
DebriefDebrief• The facilitator is active participant The facilitator is active participant
throughout the experience. throughout the experience. • Review the objectives for the activityReview the objectives for the activity• Summarize the activitySummarize the activity• Give feedback on students’ performanceGive feedback on students’ performance• Ask the students’ feedbackAsk the students’ feedback
What techniques were usefulWhat techniques were useful Anxiety level related to assessmentAnxiety level related to assessment
A Teaching Simulation Activity: A Teaching Simulation Activity: Client Assessment (Part II)Client Assessment (Part II)
Objectives:Objectives:• Perform a head to toe assessment of the Perform a head to toe assessment of the
SimMan with a partner.SimMan with a partner.• Assist fellow students in performing a Assist fellow students in performing a
head to toe assessment.head to toe assessment.• Identify abnormal findings during the Identify abnormal findings during the
physical assessment.physical assessment.• Discuss nursing implications related to Discuss nursing implications related to
abnormal assessment findings.abnormal assessment findings.
A Teaching Simulation Activity: A Teaching Simulation Activity: Client Assessment (Part II)Client Assessment (Part II)
The PlanThe Plan• Groups of 4 studentsGroups of 4 students• Partners perform assessment while fellow Partners perform assessment while fellow
students observe and coach as appropriatestudents observe and coach as appropriate• A student who is observing will be the voice of A student who is observing will be the voice of
the client.the client.• The facilitator is actively teaching throughout The facilitator is actively teaching throughout
the simulation.the simulation.• Some assessment findings on the SimMan will Some assessment findings on the SimMan will
be abnormal.be abnormal.• Students will call “time out” to stop the Students will call “time out” to stop the
simulation to discuss findings and implicationssimulation to discuss findings and implications
A Teaching Simulation Activity: A Teaching Simulation Activity: Client Assessment (Part II)Client Assessment (Part II)
DebriefDebrief• The facilitator is active participant The facilitator is active participant
throughout the experience. throughout the experience. • Review the objectives for the activityReview the objectives for the activity• Summarize the activitySummarize the activity• Give feedback on students’ performanceGive feedback on students’ performance• Ask the students’ feedbackAsk the students’ feedback
Comfort level with the assessment processComfort level with the assessment process Understanding of assessment in the context Understanding of assessment in the context
of client careof client care
A Teaching Simulation Activity: A Teaching Simulation Activity: Evaluation of Assessment Skills Evaluation of Assessment Skills
Objectives:Objectives:• Perform an assessment on the post Perform an assessment on the post
operative client.operative client.• Identify appropriate nursing and medical Identify appropriate nursing and medical
interventions for the client.interventions for the client.• Discuss rationales for nursing and Discuss rationales for nursing and
medical interventions.medical interventions.• Document the nursing assessment and Document the nursing assessment and
care of the client.care of the client.
A Teaching Simulation Activity: A Teaching Simulation Activity: Evaluation of AssessmentEvaluation of Assessment
The PlanThe Plan• Students receive a brief report from Students receive a brief report from
PACUPACU• Admission orders are providedAdmission orders are provided• Some assessment findings will be Some assessment findings will be
abnormalabnormal• Some medical interventions will be Some medical interventions will be
incorrect or incompleteincorrect or incomplete
A Teaching Simulation Activity: A Teaching Simulation Activity: Evaluation of Assessment SkillsEvaluation of Assessment Skills
The Plan:The Plan:• Each individual will perform assessment on the Each individual will perform assessment on the
post operative client.post operative client.• The facilitator is the voice for the client, but is The facilitator is the voice for the client, but is
otherwise not an active participant.otherwise not an active participant.• Write a narrative nursing note to document the Write a narrative nursing note to document the
client assessment and interventions client assessment and interventions performed.performed.
• Complete the worksheet asking for each Complete the worksheet asking for each intervention and the rationale.intervention and the rationale.
A Teaching Simulation Activity: A Teaching Simulation Activity: Evaluation of AssessmentEvaluation of Assessment
DebriefDebrief• Each student’s written work was returned with Each student’s written work was returned with
comments made by the instructorcomments made by the instructor• Discussion with entire group about observations Discussion with entire group about observations
made by the instructor and facilitator as well as made by the instructor and facilitator as well as common themes noted in written workcommon themes noted in written work
• Review the objectives for the activityReview the objectives for the activity• Discuss the RN’s role in this scenarioDiscuss the RN’s role in this scenario• Summarize the activitySummarize the activity• Ask the students’ feedbackAsk the students’ feedback
What do the students feel was valuable in this activityWhat do the students feel was valuable in this activity
The EndThe EndTo request a copy of this To request a copy of this
presentation, e-mail me atpresentation, e-mail me at
[email protected]@davidsonccc.edu