Strategy Submission

This is a brief simulation centered on the principles of effective communication, patient centered care, and team work. This is designed to be student's first exposure to a simulation activity involving a human patient simulator. Thus, the activity is completed in 30 minutes and involves basic role playing with a high fidelity simulator. Beginning nursing students are assigned roles and asked to role play a comfort care scenario designed to introduce first year students to the importance of effective communication, team work, and delivering comfort care to patients experiencing pain. Groups of no more than 5 students are suggested for this activity. Objectives: 1. The student will be able to assess Mr. Burns' level of comfort using the nursing process. 2. The student will be able to provide nursing interventions to address the need for increased level of comfort. 3. The student will be able to formulate a nursing diagnosis and plan of care for Mr. Burns as a post-reflection activity. 4. The student will involve the patient, patient's wife, and the other nursing student(s) to deliver effective comfort care. 5. The student will demonstrate teamwork and collaboration while delivering effective comfort care interventions. The simulation is introduced with a 5 minute introductory video created to visually introduce students to Mr. Burns, a 63 year old male who is 3 days post right knee replacement. The video begins with Mr. Burns being wheeled back to his room by a physical therapist after his morning PT session. The students see and hear Mr. Burns moaning in pain as his visually upset wife trails behind. After the video, the students are given a brief set of instructions, asked to draw one of five roles, and then instructed to begin delivering care to Mr. Burns, played by Sim Man, a human patient high fidelity simulator. The 5 roles for the experience are Student Nurse 1, Student Nurse 2, Mrs. Burns, and Observer 1 and 2. Props for the scenario include an ice pack, blanket, pillow, music, deck of cards, portable phone, TV remote, lotion, pain scale, and bath blanket. The focus of the simulation is to encourage the 2 nursing students to work as a team and implement the effective communication skills and non-pharmacological comfort care measures (positioning, elevating extremity, assessing pain level, applying ice, using distraction, music, TV, playing cards, etc) they learned in lecture during the previous week. The experience addresses the QSEN competencies of Patient Centered Care as well as Teamwork and Collaboration. Students are given the opportunity to work as a team to implement effective nursing interventions with a patient experiencing pain. Students role play with a high fidelity simulator to deliver patient centered care while also trying to accommodate Mrs. Burn's needs. Students are give up to 10 minutes to role play the scenario with minimal prompting from faculty. Sim Man has been programmed to give appropriate responses related to pain including location, intensity, aggravating and alleviating factors, that assist in answering students questions. Faculty are always on hand to provide helpful responses to keep the simulation running. The observers are asked to take notes during the simulation, noting signs of patient centered care, teamwork strategies, and effective and non-effective interventions that will be shared during the 10 minute debriefing session. When time allows, it is often helpful to repeat the scenario and have students assume a different role the second time. It should be noted this experience is student's first exposure to a human patient simulator so the simulation is brief, involves role play, and focuses on the very basic achievement of effective communication, working as a team, and patient centered care. We feel strongly that students should be exposed to simulation in their very first nursing course. Simulations should build in their complexity as the student progresses through their program. For more advanced students, we would involve the roles of PT, physician, advanced practice nurse to promote more in-depth levels of teamwork and collaboration. This scenario could be adapted to the advanced learner or student who has completed TEAM steps training with a more in-depth focus on teamwork and collaboration. Every simulation conducted in our school identifies the QSEN competencies addressed, the KSA's associated with the simulation, NCLEX test plan categories addressed, suggestions for changing the complexity of the scenario, and a list of QSEN focused questions for the debriefing session to assess whether the QSEN competencies were obtained or not.