A low-fidelity manikin was utilized to simulate a patient who was two days post-CABG. Students assumed the roles of Primary Nurse, Charge Nurse, Patient Spouse, and Observer. Prior to the start of the simulation, the Primary Nurse and Charge Nurse received information about the client (AM assessment information). Scripts for the roles of patient spouse and observer were distributed. The simulation began with the primary nurse entering the room to administer the scheduled 9AM IV antibiotic. Shortly after the start of the simulation, the patient experienced atrial fibrillation, a common complication associated with CABG surgery. Participants were expected to assess the patient, communicate with the patient, family member, and members of the healthcare team, and implement safe and effective nursing care.
Equipment used to care for a post-CABG client was attached to a low-fidelity manikin and available in the simulated patient room. A nurse’s station was created that included a telephone, client records, cardiac monitor, and medication room. A pre-programmed alarm sound was initiated indicating a dysrhythmia on the cardiac monitor. As this happened, a rhythm strip with atrial fib was placed on the cardiac monitor by a faculty person. Students were expected to respond to the dysrhythmia, assess the patient, communicate with the physician and pharmacy, and implement new orders. New orders included a potential drug-drug incompatibility requiring students to identify and take appropriate measures.
Immediately following the simulation, students participated in a 30-minute debriefing activity. Faculty guided students to consider a set of questions related to the simulation experience. Discussion focused on students’ thoughts and feelings as they worked through the simulation. They were asked to reflect on their strengths and on how they may have handled the situation differently. Simulation observers were asked to share their thoughts related to the same questions, along with their observations from an audience perspective—especially on issues related to safety, teamwork, and communication. All students were asked to describe their ability to achieve the simulation objectives.
The attached simulation rubric includes information about equipment, props, scripts, and other information necessary to implement this simulation.