Transcript Slide 1

Clinical Outcomes from Human
Patient Simulation
Paula Garvey BSN, RN-BC
No planner or presenter has any conflict of interest in the content to be discussed.
This presentation received in-kind assistance from METI in the form of a simulator to use
for demonstration purposes.
The educational content was not influenced in any way by this in-kind assistance.
Please place cell phones and
pagers on vibrate
Objectives
• Explore the benefits of HPS as a teaching
modality for acute care nurses.
• Examine benefits and challenges to
implementing simulation as a teaching
modality in a hospital-based nursing
education department.
• Demonstrate the care of a patient utilizing
the HPS.
Current Trends
• Due to high patient acuity, patients on
traditional med-surg floors are as critically
ill as some ICU patients.
• Nurses are expected to have a strong
foundation of knowledge
– Physical assessment skills
– Technical skills
– Critical thinking skills
Benefits of Human Patient
Simulation
• Allows the adult learner a degree of selfdirected learning.
• Gives realism to a education scenario
allowing the learner to become engaged.
• The learner gains skills in a safe, nonthreatening environment.
• Classroom theory is put into practice.
Benefits of Human Patient
Simulation
• Teaching of non-technical skills such as
collaboration, leadership, communication, &
professionalism.
• Provides a standardized framework for
managing a patient’s condition.
• Outcomes evaluation and research.
• Improved quality of care and safety of patients.
• Gains a foundation for critical thinking & clinical
judgment.
Take action based upon processed
information; Evaluate
Clinical Judgments
SIMULATION
Critical Thinking
Analyze/Synthesize/Evaluate
© OSUMC 2007
Clinical Reasoning
Current to new knowledge; Recall
facts; Organize; Apply; Re-Evaluate
Simulation Design Approach
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Goal of simulation
Type of simulation learning model
Development of scenario
Prebriefing & Debriefing
Goal of High Fidelity Simulation
• Prepare staff to make sound judgments,
complex problem solving, and think
critically
• Progression to a higher level of
competency and proficiency
• Putting theory into practice
Simulation Learning Models
• Self-Directed-Learning model: The learner is given brief
instructions and to manage the patient as indicated by
the signs and symptoms without any instructor input.
• Self-Directed-Learning model with facilitated debriefing:
The learner is instructed as above but encouraged to
collaborate and make team decisions. Debriefing is to
occur immediately following the scenario.
• Instructor-Modeled learning: The learner observes the
instructor assess and manage the patient, verbalize their
findings along with rationale and are allowed to ask the
instructor questions for approximately 5 minutes. Then
the learner repeats the scenario individually while being
videotaped.
Prebriefing & Debriefing
• Prepares participants for simulation scenario,
sets ground rules, stresses confidentiality and
creation of a non-threatening environment.
• Allows participants to reflect on the facts,
thoughts, impressions, and reactions to the
situation.
• Need to provide a supportive climate in order to
ensure successful debriefing process.
• Participants need to be able to share their
experiences in a frank and honest manner.
• The most important aspect of simulation
education and crucial to the learning process.
Patient Care Management
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Management of Chest Pain
Management of Respiratory Distress
Management of Cardiac Arrest
Management of Sepsis
Management of EKG dysrhythmias
Courses Applicable for Simulation
• Failure to RescueWhen is It Time to
Worry
• ACLS
• Code-Blue Readiness
• Staff communication
and collaboration
• ECG Class
• New Equipment
• Central Nursing
Orientation
• Sentinel Events
• Annual competencies
• Hospital-specific
practices and
protocols
• Verification of general
nursing skills
Facilitator Evaluation
Benefits:
– Some participants seem to lose even the most basic of skills
when placed in a “high-pressure” situation.
– Excellent method to evaluate the most basic competencies
– Method to locate those staff who might be having clinical
difficulty, which isn’t evident using traditional teaching methods
– Differences in comprehension and application from didactic to
hands-on environment
– Decrease in system-wide Code Blue numbers
– Increase in system-wide Code Blue “survival to discharge”
numbers
Challenges:
– Do not have our own simulation lab!
– Unrealistic environment in our training center with a mid-fidelity
simulator
Learner Evaluation
Benefits:
– More comfortable with equipment and assessment skills
– Felt like they had been in a “real” code situation
– Increased the understanding and comfort level of participants in
a cardiac arrest situation
– Take class multiple times and “learn something new each time”
– “This class should be mandatory for every nurse”
Challenges:
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Simulation loses benefit when the environment is not realistic
Difficult to overcome that it is a mannequin
Felt “disorganized” due to the “usual” co-workers are not present
Confusion when nurse is taken out of his/her usual role
Questions
Paula Garvey: [email protected]
References
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