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Using the Human Patient Simulator in Nursing Education Sarah J. Clark, RN-C, MSN Davidson County Community College.

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Presentation on theme: "Using the Human Patient Simulator in Nursing Education Sarah J. Clark, RN-C, MSN Davidson County Community College."— Presentation transcript:

1 Using the Human Patient Simulator in Nursing Education Sarah J. Clark, RN-C, MSN Davidson County Community College

2 Where do student nurses learn? Classroom Classroom Content is introducedContent is introduced Concepts are exploredConcepts are explored Lab Lab Skills are taughtSkills are taught Discrete hands on practiceDiscrete hands on practice Clinical Clinical Classroom concepts and clinical skills are applied to patient care situationsClassroom concepts and clinical skills are applied to patient care situations

3 So, what is simulation? Representing certain key characteristics or behaviors of a selected physical or abstract system Representing certain key characteristics or behaviors of a selected physical or abstract system Modeling of natural or human systems in order to gain insight into their function Modeling of natural or human systems in order to gain insight into their function Simulation can be used to show the eventual real effects of alternative conditions and courses of action Simulation can be used to show the eventual real effects of alternative conditions and courses of action

4 Simulation in nursing education Low tech Low tech Skills mannequinsSkills mannequins Inject a padsInject a pads High tech High tech Human patient simulatorHuman patient simulator

5 Human patient simulator

6 Human Patient Simulators Adult Adult Child Child Laboring patient Laboring patient Newborn Newborn Baby Baby

7 Human patient simulator Assessment Assessment BreathesBreathes VocalizesVocalizes Vital signsVital signs PulsesPulses Breath soundsBreath sounds Heart soundsHeart sounds Bowel soundsBowel sounds EKG rhythmEKG rhythm

8 Human patient simulator Interventions Interventions 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

9 Human 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

10 Any Questions?

11 Simulation and the North Carolina Board of Nursing NCBON will accept simulation in lieu of clinical with direct patient care NCBON will accept simulation in lieu of clinical with direct patient care Alternative for clinical experiences with limited opportunities for patient care Alternative for clinical experiences with limited opportunities for patient care PediatricsPediatrics Mental healthMental health MaternityMaternity

12 Why simulate in nursing? Ensure experience with concepts demonstrated in patient situations Ensure experience with concepts demonstrated in patient situations Post op carePost op care Respiratory distressRespiratory distress Chest painChest pain Hip fractureHip fracture Vaginal deliveryVaginal delivery

13 Why simulate in nursing? Remediation Remediation Medication errorsMedication errors FallsFalls Failure to rescueFailure to rescue Make mistakes in a risk free environmentMake mistakes in a risk free environment

14 Why simulate in nursing? Remediation Remediation Teaching Teaching Scenario that teaches application of classroom contentScenario that teaches application of classroom content Assess patient for specific risk factors Assess patient for specific risk factors Assess patient and implement appropriate nursing interventions Assess patient and implement appropriate nursing interventions Evaluate patient responses to medications, interventions Evaluate patient responses to medications, interventions Act as team leader, team member Act as team leader, team member

15 Why simulate in nursing? Remediation Remediation Teaching Teaching Testing Testing Scenario that tests application of classroom contentScenario that tests application of classroom content Assess patient for specific risk factors Assess patient for specific risk factors Assess patient and implement appropriate nursing interventions Assess patient and implement appropriate nursing interventions Evaluate patient responses to medications, interventions Evaluate patient responses to medications, interventions Act as team leader, team member Act as team leader, team member

16 Any Questions?

17 Pitfalls to simulation in nursing education Potential barrier: Financial constraints Potential barrier: Financial constraints SimMan costs $34,000SimMan costs $34,000 VitalSim costs $2035VitalSim costs $2035 SimBaby costs $31,770 without the computerSimBaby costs $31,770 without the computer

18 Potential solutions to pitfalls of simulation in nursing education Get help finding the money Get help finding the money Laerdal has people who find grant moneyLaerdal has people who find grant money NC state is looking favorably toward money for allied health, simulationNC state is looking favorably toward money for allied health, simulation

19 Pitfalls to simulation in nursing education Potential problem: Space Potential problem: Space Rooms are tight everywhereRooms are tight everywhere SimMan must be securedSimMan must be secured

20 Possible solutions to pitfalls of simulation in nursing education Make SimMan mobile Make 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 lock him up when he is doneRole him out when you need him and lock him up when he is done

21 Pitfalls of simulation in nursing education Potential barrier: Mannequin is based on medical model Potential barrier: Mannequin is based on medical model “Bells and whistles” that nurses don’t need“Bells and whistles” that nurses don’t need Settings lend themselves to pathophysiology, medical differential diagnosis and medical interventionSettings lend themselves to pathophysiology, medical differential diagnosis and medical intervention

22 Potential solutions to pitfalls of simulation in nursing education Focus on the nursing process Focus on the nursing process Select the product you want based on what you needSelect the product you want based on what you need Develop scenarios based on nursing experiences, nursing literatureDevelop scenarios based on nursing experiences, nursing literature Define the objectives in nursing termsDefine the objectives in nursing terms Use only the “bells and whistles” that support the scenarioUse only the “bells and whistles” that support the scenario

23 Pitfalls to simulation in nursing education Potential barrier: Faculty resistance Potential 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 scenariosTime and faculty intensive to run the scenarios

24 Potential solutions to pitfalls of simulation in nursing education Have a plan Have a plan Take advantage of educational sessionsTake advantage of educational sessions Manufacturer offers free education Manufacturer offers free education Many articles in the literature Many articles in the literature Inexpensive educational opportunities Inexpensive educational opportunities Network Network Have a championHave a champion Develop one or two experts Develop one or two experts All faculty have a role, but the champion is the simulation expert All faculty have a role, but the champion is the simulation expert

25 Potential solutions to pitfalls of simulation 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 it Find a need and fill it Enlist content experts in scenario building Enlist 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 doing Look at what other programs are doing Look at simulation with curriculum reviewLook at simulation with curriculum review Develop a systematic plan for implementation Develop a systematic plan for implementation Make simulation fit your curriculum, not the other way around Make simulation fit your curriculum, not the other way around

26 Potential solutions to pitfalls of simulation in nursing education Involve the students Involve the students Faculty to develop pre-programmed scenarios that a peer tutor can runFaculty to develop pre-programmed scenarios that a peer tutor can run Students write scenarios to runStudents write scenarios to run Senior students can run scenarios for the newer studentsSenior students can run scenarios for the newer students Have the students evaluate themselves and each otherHave the students evaluate themselves and each other

27 Any Questions?

28 Nuts and bolts of simulation in nursing education Getting started Getting started Identify purpose of simulationIdentify purpose of simulation Remediation Remediation Testing Testing Teaching new content Teaching new content Application of multiple concepts Application of multiple concepts

29 A Teaching Simulation Activity: Client Assessment Objectives: Objectives: Discuss components of a head to toe assessment.Discuss components of a head to toe assessment. Perform a head to toe assessment of the SimMan with a partner.Perform a head to toe assessment of the SimMan with a partner. Assist fellow students in performing a head to toe assessment.Assist fellow students in performing a head to toe assessment.

30 A Teaching Simulation Activity: Client Assessment The Plan The Plan Groups of 4 studentsGroups of 4 students General worksheet and group discussionGeneral worksheet and group discussion Partners perform assessment while fellow students observe and coach as appropriatePartners perform assessment while fellow students observe and coach as appropriate A student who is observing will be the voice of the client.A student who is observing will be the voice of the client. The facilitator is actively teaching throughout the simulation.The facilitator is actively teaching throughout the simulation. All assessment findings on the SimMan will be normal.All assessment findings on the SimMan will be normal.

31 A Teaching Simulation Activity: Client Assessment Debrief Debrief The facilitator is active participant throughout the experience.The facilitator is active participant 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 useful What techniques were useful Anxiety level related to assessment Anxiety level related to assessment

32 A Teaching Simulation Activity: Client Assessment (Part II) Objectives: Objectives: Perform a head to toe assessment of the SimMan with a partner.Perform a head to toe assessment of the SimMan with a partner. Assist fellow students in performing a head to toe assessment.Assist fellow students in performing a head to toe assessment. Identify abnormal findings during the physical assessment.Identify abnormal findings during the physical assessment. Discuss nursing implications related to abnormal assessment findings.Discuss nursing implications related to abnormal assessment findings.

33 A Teaching Simulation Activity: Client Assessment (Part II) The Plan The Plan Groups of 4 studentsGroups of 4 students Partners perform assessment while fellow students observe and coach as appropriatePartners perform assessment while fellow students observe and coach as appropriate A student who is observing will be the voice of the client.A student who is observing will be the voice of the client. The facilitator is actively teaching throughout the simulation.The facilitator is actively teaching throughout the simulation. Some assessment findings on the SimMan will be abnormal.Some assessment findings on the SimMan will be abnormal. Students will call “time out” to stop the simulation to discuss findings and implicationsStudents will call “time out” to stop the simulation to discuss findings and implications

34 A Teaching Simulation Activity: Client Assessment (Part II) Debrief Debrief The facilitator is active participant throughout the experience.The facilitator is active participant 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 process Comfort level with the assessment process Understanding of assessment in the context of client care Understanding of assessment in the context of client care

35 A Teaching Simulation Activity: Evaluation of Assessment Skills Objectives: Objectives: Perform an assessment on the post operative client.Perform an assessment on the post operative client. Identify appropriate nursing and medical interventions for the client.Identify appropriate nursing and medical interventions for the client. Discuss rationales for nursing and medical interventions.Discuss rationales for nursing and medical interventions. Document the nursing assessment and care of the client.Document the nursing assessment and care of the client.

36 A Teaching Simulation Activity: Evaluation of Assessment The Plan The Plan Students receive a brief report from PACUStudents receive a brief report from PACU Admission orders are providedAdmission orders are provided Some assessment findings will be abnormalSome assessment findings will be abnormal Some medical interventions will be incorrect or incompleteSome medical interventions will be incorrect or incomplete

37 A Teaching Simulation Activity: Evaluation of Assessment Skills The Plan: The Plan: Each individual will perform assessment on the post operative client.Each individual will perform assessment on the post operative client. The facilitator is the voice for the client, but is otherwise not an active participant.The facilitator is the voice for the client, but is otherwise not an active participant. Write a narrative nursing note to document the client assessment and interventions performed.Write a narrative nursing note to document the client assessment and interventions performed. Complete the worksheet asking for each intervention and the rationale.Complete the worksheet asking for each intervention and the rationale.

38 A Teaching Simulation Activity: Evaluation of Assessment Debrief Debrief Each student’s written work was returned with comments made by the instructorEach student’s written work was returned with comments made by the instructor Discussion with entire group about observations made by the instructor and facilitator as well as common themes noted in written workDiscussion with entire group about observations made by the instructor and facilitator as well as common 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 activity What do the students feel was valuable in this activity

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