Sheri Howard MSN,RN University Of Memphis Loewenberg School of Nursing

Transcription

1 Sheri Howard MSN,RN University Of Memphis Loewenberg School of Nursing

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3 Paradigm Shift Teacher-Centered Approach (Lecture) Learner-Centered Approach (Simulation) Information explosion in healthcare. Standardized Concepts and Competencies The need for creativity in the teaching/learning process. (Bradley, 2006; Childs & Sepples, 2006)

4 Tremendous growth in schools of nursing as well as in enrollment in established schools has prompted an intense competition for clinical training sites, particularly for specialty areas such as Geriatrics. Schools consistently report that clinical site availability is one of their biggest challenges, along with faculty shortages.

5 Show and Tell Them What We Are Doing Teach in A way That is Non Treating Patient Teaching That They Understand Special Clothes

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7 Integration of simulation into the overall curriculum to overcome the learning by random opportunity associated with traditional clinical rotations.

8 Nursing Homes Assisted Living Senior Centers Retirement Communities Health Fairs Church Groups

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10 . "It was found that up to 50 percent simulation was effectively substituted for traditional clinical experience in all core courses across the pre-licensure nursing curriculum. Additionally, the use of up to 50 percent simulation did not affect NCLEX pass rates." (NCSBN, 2014)

11 The identification of appropriate and available clinical education sites is becoming more difficult as nursing and other healthcare enrollments grow. she concludes. Most are filled to capacity and emerging technologies are further straining their resources. Clinical education must shift strategies.

12 These study results (NCSBN) offer educators the liberty to use more simulation experiences, particularly for those low-incidence, high risk critical behaviors all nurses need to learn and experience. With the right training, a dedicated team, and adequate resources we can confidently increase simulations to alleviate the growing shortage clinical space, knowing that we will not adversely affect educational outcomes. (Jeffers)

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14 cases... facultyresources/aces/unfolding_cases.htm.

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17 Simulation Scenario 1 is set at the 3:00 PM shift change. Millie has been in her room on the medical-surgical unit for about six hours. She was in the Emergency Department overnight because there were no available beds on the medical units. Due to her confusion, Millie did not take her medications properly in the days prior to admission and as a result, her blood pressure is very elevated. Millie's daughter, Dina is at the bedside and is quite concerned about the confusion and elevated blood pressure. The learner receives handoff report from the previous nurse and is expected to perform a general assessment as well as use the SPICES and Confusion Assessment Method (CAM) tools. Objectives for this scenario include the identification and use of appropriate assessment tools for older adults, recognition of an elevated blood pressure and notification of Millie's primary care provider using SBAR format. Click here for Simulation 1 Template Click here for chart materials appropriate for Simulation 1

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21 Millie Larson-Chart Materials

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24 Simulation Scenario 2 occurs at 7:00 AM the following morning. Millie has had a near fall while ambulating to the bathroom. Her confusion has begun to clear and her blood pressure is improving. During the handoff report, the nurse tells the learner that the fall risk assessment has not been done, and discharge teaching should begin, since she is expected to be discharged tomorrow. Millie's daughter has just arrived and is concerned about Millie going home alone when discharged. During the simulation, the learner in this simulation is expected to perform a general assessment, fall risk assessment, and functional assessment (Katz ADL). Additionally, the learner will recognize the conflict developing between Millie and her daughter regarding whether it is safe for Millie to go home alone. In debriefing, discussions may focus around the risks to Millie if she does go home alone versus her desire to go home. Click here for Simulation 2 Template Click here for chart materials appropriate for Simulation 2

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28 Simulation Scenario 3 occurs two hours later at 9:30 AM the next morning. Millie's primary care provider has written discharge orders and Millie is going home. The learner is expected to do an assessment, and complete medication teaching and other discharge teaching. The focus is on the transition of care from the hospital back to the home setting.

29 SPICES* Sleep disorders * Problems with eating and feeding * Incontinence * Confusion * Evidence of falls * Skin breakdown Katz Index of Independence in Activities of Daily Living Pittsburg Sleep Quality Index (PSQI) Elder Mistreatment Assessment Alcohol Use and Screening Heinrich Fall Assessment Confusion Assessment Methods (CAM)

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32 4 Station Approach: Station 1- Simulation with SP with roles for each student. Assessment (physical and environment), Medication (current, past), Tools, documentation. Debriefing Station 2 Tools Workshop Station 3- Care Plan/ Concept Mapping Station 4- (Changes with each simulation) Nutrition, Psychological Changes by System, Safety Risk, Impairment

33 White Boards Rooms with Tables and Chairs to hold 8 students (size of clinical group) Set up for setting of the simulation Debriefing room with screen if session is recorded Printed copies of all tools

34 Make It Fun Make It Hands On Make It Fun Make It Meaningful Make It Fun

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