Author: Deborah Wood, MSN, RN
Title: Associate Professor of Nursing
Institution: Louisiana State University of Alexandria
Coauthors: Dr. Sarita James, PhD, RN-BC, CNE, Amie Starks, MSN, RN, Julie Bordelon, MSN, RN, Laurie Pittman, MSN, RN, Alexandra Deasis, MSN, RN
Skills or Simulation Laboratories
1. Perform accurate reconciliation of oral and parenteral medications followed by the appropriate medication administration for safe patient-centered care.
2. Perform complete head-to-toe assessment or focused assessment for medical surgical, obstetric, and pediatric patients while following prescribed client orders to safely deliver patient care.
3. Demonstrate accurate dosage calculation of insulin followed by safe medication administration.
4. Demonstrate appropriate intravenous therapy set up according to prescribed orders followed by fluid calculation for the safe administration of intravenous fluids and medications.
5. Demonstrate appropriate sterile technique while delivering care that requires sterile procedure following safe infection control protocols for patient safety (insertion of indwelling catheter, central line dressing change).
6. Demonstrate how to maintain patient safety for the insertion and maintenance of nasogastric tube with enteral feedings and medication administration.
7. Identify nursing implications to promote patient safety and patient-centered care for clients diagnosed with mental health disorders.
8. Demonstrate therapeutic communication techniques in the delivery of safe patient-centered care.
8. Follow appropriate infection control processes for safe patient-centered care.
Each clinical semester, beginning in semester 2 of this concept-based curriculum, students learn skills that complement exemplars learned through didactic lecture and the clinical experience. The simulation of skills day (SOS) is designed to be a progressive clinical activity using patient care scenarios and situations with low fidelity simulation. These activities allow students at levels 2, 3, and 4 an opportunity to review the skills learned in previous semesters and provide faculty with an opportunity to identify deficits prior to students entering the clinical sites. The first semester student does not participate in simulation of skills day as this semester is reserved for skills lab learning basic skills before entering clinical sites. Second semester students for simulation of skills day are expected to complete stations in Medication Administration with Reconciliation, Barcode medication administration, sterile gloving, physical assessment, and infection control practices, including standard precautions. Third semester students are expected to go through each of the stations referenced above with the addition of insertion of indwelling catheter following sterile technique. The fourth semester students are to complete all stations referenced above with the addition of intravenous therapy which includes safe cannulation, performance of an IV push, and IV piggyback. REMOVED THIS STATEMENT … and completion of a simulation for mental health content entitled “Hearing Voices.” (this activity accomplishes a mental health component of the course and was a mistake in original submission)
Attached is the faculty agenda with summaries and explanations. Other materials utilized for the charts for the med admin, etc. are available upon request. Also attached are the evaluations to be completed at each level and samples of the Moodle quizzes. Since completion of the Simulation of Skills Day is required before the student enters the clinical setting, for something different and ease of document archival, students complete the Simulation of Skills Day quiz by scanning a QR code, using their phone, and linking them to a Moodle Quiz. This quiz is non-punitive but provides a method of confirming attendance and key “takeaways” from the activity.
Students who have participated in the Simulation of Skills Day have stated that the opportunity of being able to review patient skills learned prior to going back to clinical helped reduce their anxiety and helped them to remember how to perform skills safely in a non-threatening, non-punitive environment. Using the innovation of low-fidelity simulation with simple patient scenarios and situations is an evidence-based method to safely provide students with the opportunity to practice and demonstrate skills already learned. Faculty satisfaction was positive, reporting that conducting the simulation of skills day enabled them to identify student deficits in knowledge or competencies prior to clinical, enabling them to correct and direct students within the skills lab setting, prior to entering actual patient care settings.
The evaluation students are asked to complete is a self-evaluation to capture both quantitative and qualitative data to evaluate the if the student felt that learning outcomes were met by participation in the learning activity. This evaluation is collected during the simulation of skills day debriefing session. The quantitative data is collected from students answers to questions on each learning outcome, whether the learning outcome was “Met” or “Not Met”. For each “Not Met”, students are requested to provide further comments. Qualitative data is collected from students answering a series of self-reflective questions relative to the activity and their clinical level. 100% (n=124) of the participants answered the student learning outcomes were “Met”. A Simulation of Skills Day Quiz was required at the completion of the activity at each level providing a “non-graded” assessment of important “takeaways” from the activity and an electronic archival of attendance. Students scanned the QR code provided to complete the online quiz through Moodle, confirming that they had completed Simulation of Skills day prior to going to clinical.