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Strategy Submission

Pediatric Simulation and Unfolding Case Study

Author:

Anne McShane

MSN, RN

Title:

Assistant Professor

Coauthors:

Sheila Berkemeyer, MSN, RN

Institution:

Lewis University College of Nursing and Health Professions

Email:

Competency Categories:

Evidence-Based Practice, Patient-Centered Care, Safety, Teamwork and Collaboration

Learner Level(s):

Pre-Licensure BSN

Learner Setting(s):

Skills or Simulation Laboratories

Strategy Type:

General Strategy

Learning Objectives:

Core-Competency: Patient-Centered Care

This teaching strategy is designed to evaluate the following:

Knowledge: Integrates understanding of family-centered care for the pediatric population and involving parents/siblings in all aspects of patient care including plans of care, communication, education, and emotional support.

Attitude: Encourages parental involvement in patient care. Recognizes the need for emotional support of family members.

Skills: Acknowledges family as a part of patient care and outcomes through effective communication and evaluation of parental involvement and knowledge of care.

Core-Competency: Safety

This teaching strategy is designed to evaluate the following:

Knowledge: Describes the nurse’s role in providing safe, effective patient care and the impact of Joint Commission standards on nursing care.

Attitude: Seeks to educate the mother about safety throughout the hospital stay.

Skills: Implements Joint Commission standards of safe patient care through the use of medication reconciliation, communication, error reporting, patient identifiers, medication safe doses, abbreviations, I-SBAR-R technique during patient transfer, and the six rights of medication administration.

Core Competency: Team and Collaboration

This teaching strategy is designed to evaluate the following:

Knowledge: Demonstrates the importance of effective communication and delegation among different healthcare providers (nurses, physician, and Certified Nursing Assistant).

Attitude: Implements the importance of effective communication with physicians and other members of the healthcare team to ensure patient safety and positive outcomes.

Skills: Gives report for a patient using I-SBAR-R technique. Communicates safety threats to the physician prescribing medication orders. Uses the American Nurses Association delegation principles.

Core Competency: Evidence-Based Practice

This teaching strategy is designed to evaluate the following:

Knowledge: Differentiates between clinical opinion and scientific evidence while performing specific diagnostic tests and assessments.

Attitude: Values the use of evidence-based practice to make decisions in the clinical setting.

Skills: Identifies potential medical errors and possible conflicts with other health care providers.

Strategy Overview:

The simulation can be used as an evolving scenario or it could be divided into separate activities based on the various clinical areas. The students have received the lecture on fluid and electrolyte and respiratory content prior to the simulation.

Submitted Materials:

Additional Materials:

Evaluation Description:

Students participate in the simulation as part of the pediatric nursing course. It is a pass / fail activity with formative and summative evaluation by the faculty during debriefing. We have received positive feedback from the students following the simulation. They express how much they learned and recognize how much they need to learn. We have used our simulation in a variety of ways.  Most often, we have three students per clinical area in the roles of Staff Nurse, Certified Nursing Assistant, and Charge Nurse. The other students serve as participant observers. It is possible to have students participate in one setting or to have the various settings used in case study vignettes. We utilize high- or low-fidelity simulation, depending on the availability of the simulation lab on campus. While the skills component is valuable, we have found that the simulation primarily addresses the critical inquiry aspect of the course goals for the students.

We have a faculty-led discussion following the completion of activities in each setting arena for the formative evaluation. The student participant observers are asked to identify areas of strength and areas for improvement related to each of the listed objectives (e.g., infection control practices, communication, delegation, etc.).  Recommendations are identified for the subsequent participants. The summative evaluation consists of having the students identify progress related each of our listed objectives. In addition, the group is asked what they have learned about themselves and their nursing practice related their performance. They identify areas they recognize need improvement moving forward. The faculty at our institution decided not to formally evaluate the students' simulation with a grade. If we do so in the future, we will develop a skills checklist and outline for formal evaluation.

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