Teamwork and Collaboration: Caring for a pediatric non-accidental trauma patient

Submitter Information

Author: Linda Roney, RN-BC, CPEN, CNE
Title: Assistant Professor and Director of the Undergraduate Nursing Program
Institution: Fairfield University
Email: lroney@fairfield.edu
Coauthors: Amanda Harper-Leatherman PhD, Associate Professor

Competency Category(s)
Teamwork and Collaboration

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

Learner Setting(s)
Classroom, Skills or Simulation Laboratories

Strategy Type
Case Studies

Learning Objectives

· Enhance learner knowledge and confident care of a victim of suspected non-accidental trauma that presents to the hospital for care (Knowledge, Skills)
· Orient learner to the key elements of the interdisciplinary team management of the pediatric patient who is the victim of suspected non-accidental trauma (Knowledge)
· Describe the role of the nurse in functioning as a member of the interdisciplinary team, caring for pediatric patients who are suspected victims of non-accidental trauma and require the collection of forensic evidence. (Attitudes)

Strategy Overview

Due to programmatic and hospital guidelines, many nursing students do not have the opportunity to care for patients in the clinical setting who are suspected victims of abuse or require forensic evidence collection by the nurse. Upon graduation, this may be an expectation in many types of clinical settings. This teaching strategy helps fill this gap in nursing education. In the activity, students learn about the principles of forensic science, collecting forensic evidence, and the care of the patient who is a suspected victim of abuse. In addition, interprofessional education is also included. Not all nursing programs have the opportunity to collaborate with other types of allied health programs and their students to create interprofessional educational learning activities on campus. However, many nursing programs do have the potential to collaborate with colleagues in a chemistry department and campus public safety. This teaching strategy also can include non-nursing students who have an interest in forensic science or pre-health science students.

Advanced readings include key forensic and nursing terms related to the patient population of those who may be victims of crime and a written introduction to the case. Two brief YouTube videos introduce students to the room where the patient is cared for and the chemistry lab where the evidence is analyzed. During the activity, a member of the chemistry faculty and the director of campus public safety present an introduction to forensic science, the sequence of evidence collection, recording methods, and principles of (fiber) evidence analysis. A member of the nursing faculty presents an introduction to forensics in the healthcare setting, care of the pediatric patient who is a suspected victim of abuse with need for forensic evidence collection, and presents the pre-brief of the case. Three pre-assigned student teams (up to three nursing and up to three science students per group) proceed to a skills/simulation laboratory space where they meet their pediatric patient (low or high-fidelity mannequin) and his/her mother (standardized patient).

The nursing students collaborate with campus security to activate a security alert for this pediatric patient who is a suspected victim of abuse. In addition to assessing, planning, and implementing the care of the patient, nursing students also document all findings in the simulated electronic health record or another type of patient chart. They provide SBAR report to the advanced practice nurse who specializes in child abuse regarding the patient and work in their teams to collect forensic (fiber) evidence from the patient. Evidence is collected, and chain of custody is maintained by providing the evidence to campus security who brings the evidence to the chemistry (crime) lab for analysis. If time permits, students work in small groups (5-6 students) to analyze the fiber evidence in the chemistry lab to compare the fibers with fibers found at the scene of the mock crime. Using the PEARLS Healthcare Debriefing Tool, a safe context for debriefing is ensured, feelings about the simulation are explored, facts are clarified, performance analysis is shared, and each participant shares two take-aways from the activity.

Submitted Materials

StudentChecklistPEDS_NAT_11.15.19.pdf
IPE-Template_11.15.19-1.pdf
Forensic-Nursing-Simulation_Survey-Questions.pdf
Forensic-tip-sheet.pdf
References.pdf

Additional Materials

If you have any questions about this activity, especially if you are interested in setting this up with colleagues in the Department of Chemistry, we would be happy to speak with you. Please contact us at lroney@fairfield.edu.

Evaluation Description

Participant knowledge, confidence, and attitudes regarding the teamwork and collaboration needed to care for pediatric patients who are victims of suspected child abuse and require forensic evidence collection are assessed before and after completion of the learning activity. The facilitator uses a checklist to evaluate the nursing students as they perform their roles in the simulation allowing for feedback to be provided to the students upon completion.