Author: Matthew Fox, MSN, RN-BC
Title: Assistant Professor of Nursing
Institution: Ohio University
New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN
Skills or Simulation Laboratories
Discuss general categories of errors and hazards in care when working in the acute care setting.
Participate in error and hazard identification room check.
Value self reporting of errors identified in healthcare environments.
The teaching strategy focuses on identifying errors in the acute care environment. A simulated hospital room was equipped with a manikin, medical equipment, and the following safety hazards:
-Bed not in the lowest position.
-NC Oxygen device inserted upside down.
-MAR record with a different patient name/DOB than on the manikin.
-Continuous pulse-oximetry probe not placed correctly.
-Linen laying on the floor with soiled gloves.
-Uncapped syringe laying on the patients bed.
-Uncapped syringe laying on the bedside table.
-IV Inserted in the incorrect direction.
-IV fluids infusing at a different rate than is ordered on the physician order sheet.
Students in a senior level clinical judgement course were allotted 3 minutes after entering the simulated hospital room to identify and record the safety hazards on the identification sheet. The faculty member collected the identification sheet as the student exited the room. Each student entered the room independently. To ensure validity students were held in two separate rooms so that discussion of safety hazards identified did not occur with students not yet completing the activity. A debriefing session occurred at the conclusion of the activity.
1. Physician Orders
2. Safety Identification Sheet
3. Safety Simulation Debriefing Form
4. Debriefing PowerPoint
A debriefing session was held when all student completed the safety hazard identification activity. Students were provided with a one page debriefing form and were given 10 minutes to complete. After 10 minutes, the faculty member presented a PowerPoint to guide the debriefing session and to illustrate the safety hazards in the room.