Maintaining Quality and Safety During a Disaster

Submitter Information

Author: Kathleen Szymanski, MSN, RN
Title:
Institution: Lake Michigan College
Email: kszymanski@lakemichigancollege.edu

Competency Category(s)
Patient-Centered Care, Safety, Teamwork and Collaboration

Learner Level(s)
Pre-Licensure ADN/Diploma, Pre-Licensure BSN

Learner Setting(s)
Skills or Simulation Laboratories

Strategy Type
Case Studies

Learning Objectives

Patient-Centered Care
1. Students will discuss the ethical challenges and limitations related to delivering patient-centered care using the START triage algorithm.
2. Students will demonstrate methods of effective communication when interacting with simulated patients and team members.

Teamwork and Collaboration
1. Students will demonstrate awareness of their own strengths and limitations as a team member.
2. Students will communicate with team members, adapting their own style of communicating to the needs of the team and situation.
3. Students will act with integrity, consistency, and respect for differing views.
4. Students will contribute to the resolution of conflict and disagreement through working as a team to decide upon triage categories for patients.

Safety
1. Students will demonstrate the effective use of the START triage algorithm in prioritizing safe care during an emergency.
2. Students will verbalize the value of using standardized algorithms in providing safe care.

Strategy Overview

This strategy is based upon Sund’s (2013) “Start Triage Practice-Who Wants to be an EMT?” case study exercise. This can be implemented in a simulation lab in whatever method preferred (low fidelity manikins that have been “moulaged”, standardized patients as “victims”, etc..). When COVID made in-person simulation impossible, the strategy was turned into a case study using pictures that had been taken of the manikins during a prior simulation. If the simulation is not being done in person, it can be done using discussion board groups or online synchronous discussions.
Students are broken into groups of 2-4 participants. Depending on the size of the group, a team leader may be chosen. Students are given colored “tags” and asked to triage the victims using the START triage algorithm that has been presented in class (United States Department of Health and Human Services, 2021). As they triage, they are asked to critically think, discuss their concerns and rationale as a team, and then come to a consensus on one triage color per patient. Once the group has completed the exercise, each participant is asked to fill out the reflection questions. For the final debriefing, the small groups come together for a large group discussion related to their findings and their reflections.

References
Sund, S. (2013, January 18). START Triage Practice-Who Wants to be an EMT? Disaterdoc.
https://disasterdoc.net/2013/01/18/start-triage-practice-who-wants-to-be-an-emt/
United States Department of Health and Human Services. (2021). START Adult Triage Algorithm.
Radiation Emergency Medical Management.
https://chemm.nlm.nih.gov/StartAdultTriageAlgorithm.pdf

Submitted Materials

QSEN-289-TS-Quality-and-Safety-Disaster-Sim-Student-Worksheet.docx
QSEN-TS-289-Quality-and-Safety-Disaster-Sim-Instructor-KEY.docx
QSEN-TS-289-Disaster-Teaching-Strategy-Evaluation-Rubric.docx

Additional Materials

See attached:
Student Worksheet
Instructor Key
Evaluation Rubric
START triage algorithm

Evaluation Description

See Attached Rubric

Students were able to meet their learning objectives when this teaching strategy was performed in the sim lab and when the simulation was converted to a case study. In both settings, students demonstrated critical thinking and stated a better understanding of the learning objectives after completing the exercise.