SIM Scenario (Due 24 hours)

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Sampledesign-template-2019.docx

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Simulation Design Template

(revised May 2019)

(name of patient) Simulation

Date:

Discipline: Nursing

Expected Simulation Run Time:

Location:

Today’s Date::

File Name: Student Level:

Guided Reflection Time: Twice the amount of time that the simulation runs.

Location for Reflection:

Brief Description of Client

Name:

Date of Birth:

Gender: Age: Weight: Height:

Race: Religion:

Major Support: Support Phone:

Allergies: Immunizations:

Attending Provider/Team:

Past Medical History:

History of Present Illness:

Social History:

Primary Medical Diagnosis:

Surgeries/Procedures & Dates:

Psychomotor Skills Required of Participants Prior to Simulation

(list skills)

Cognitive Activities Required of Participants Prior to Simulation

(textbooks, lecture notes, articles, websites, etc.)

Simulation Learning Objectives

General Objectives (Note: The objectives listed below are general in nature and once learners have been exposed to the content, they are expected to maintain competency in these areas. Not every simulation will include all of the objectives listed.)

1. Practice standard precautions.

1. Employ strategies to reduce risk of harm to the patient.

1. Conduct assessments appropriate for care of patient in an organized and systematic manner.

1. Perform priority nursing actions based on assessment and clinical data.

1. Reassess/monitor patient status following nursing interventions.

1. Communicate with patient and family in a manner that illustrates caring, reflects cultural awareness, and addresses psychosocial needs.

1. Communicate appropriately with other health care team members in a timely, organized, patient-specific manner.

1. Make clinical judgments and decisions that are evidence-based.

1. Practice within nursing scope of practice.

1. Demonstrate knowledge of legal and ethical obligations.

Simulation Scenario Objectives (limit to 3 or 4)

For Faculty: References, Evidence-Based Practice Guidelines, Protocols, or Algorithms Used for This Scenario:

Setting/Environment

|_| Emergency Room

|_| Medical-Surgical Unit

|_| Pediatric Unit

|_| Maternity Unit

|_| Behavioral Health Unit

|_| ICU

|_| OR / PACU

|_| Rehabilitation Unit

|_| Home

|_| Outpatient Clinic

|_| Other:

Equipment/Supplies (choose all that apply to this simulation)

Simulated Patient/Manikin/s Needed:

Recommended Mode for Simulator:

(i.e. manual, programmed, etc.)

Other Props & Moulage:

Equipment Attached to Manikin/Simulated Patient:

|_| ID band

|_| IV tubing with primary line fluids running at __mL/hr

|_| Secondary IV line running at ___mL/hr

|_| IVPB with _______ running at mL/hr

|_| IV pump

|_| PCA pump

|_| Foley catheter with ___mL output

|_| 02

|_| Monitor attached

|_| Other:

Other Essential Equipment:

Medications and Fluids:

|_| Oral Meds:

|_| IV Fluids:

|_| IVPB:

|_| IV Push:

|_| IM or SC:

Equipment Available in Room:

|_| Bedpan/urinal

|_| 02 delivery device (type)

|_| Foley kit

|_| Straight catheter kit

|_| Incentive spirometer

|_| Fluids

|_| IV start kit

|_| IV tubing

|_| IVPB tubing

|_| IV pump

|_| Feeding pump

|_| Crash cart with airway devices and

emergency medications

|_| Defibrillator/pacer

|_| Suction

|_| Other:

Roles

|_| Nurse 1

|_| Nurse 2

|_| Nurse 3

|_| Provider (physician/advanced practice nurse)

|_| Other healthcare professionals:

(pharmacist, respiratory therapist, etc,)

|_| Observer(s)

|_| Recorder(s)

|_| Family member #1

|_| Family member #2

|_| Clergy

|_| Unlicensed assistive personnel

|_| Other:

Guidelines/Information Related to Roles

Learners in role of nurse should determine which assessments and interventions each will be responsible for, or facilitator can assign nurse 1 and nurse 2 roles with related responsibilities.

Information on behaviors, emotional tone, and what cues are permitted should be clearly communicated for each role. A script may be created from Scenario Progression Outline.

Pre-briefing/Briefing

Prior to report, participants will need pre-briefing/briefing. During this time, faculty/facilitators should establish a safe container for learning, discuss the fiction contract and confidentiality, and orient participants to the environment, roles, time allotment, and objectives.

For a comprehensive checklist and information on its development, go to http://www.nln.org/sirc/sirc-resources/sirc-tools-and-tips#simtemplate.

Report Students Will Receive Before Simulation

(Use SBAR format.)

Time:

Person providing report:

Situation:

Background:

Assessment:

Recommendation:

Scenario Progression Outline

Patient Name: Date of Birth:

Timing (approx.)

Manikin/SP Actions

Expected Interventions

May Use the Following Cues

0-5 min

(Verbal information provided by manikin or SP should be in quotes so a script can be created for individuals in those roles.)

Learners should begin by:

· Performing hand hygiene

· Introducing selves

· Confirming patient ID

Role member providing cue:

Cue:

5-10 min

Learners are expected to:

Role member providing cue:

Cue:

10-15 min

Learners are expected to:

Role member providing cue:

Cue:

15-20 min

Learners are expected to:

Role member providing cue:

Cue:

Debriefing/Guided Reflection

Note to Faculty

We recognize that faculty will implement the materials we have provided in many different ways and venues. Some may use them exactly as written and others will adapt and modify extensively. Some may choose to implement materials and initiate relevant discussions around this content in the classroom or clinical setting in addition to providing a simulation experience. We have designed this scenario to provide an enriching experiential learning encounter that will allow learners to accomplish the listed objectives and spark rich discussion during debriefing. There are a few main themes that we hope learners will bring up during debriefing, but if they do not, we encourage you to introduce them.

Themes for this scenario:

·

·

·

We do not expect you to introduce all of the questions listed below. The questions are presented only to suggest topics that may inspire the learning conversation. Learner actions and responses observed by the debriefer should be specifically addressed using a theory-based debriefing methodology (e.g., Debriefing with Good Judgment, Debriefing for Meaningful Learning, PEARLS). Remember to also identify important concepts or curricular threads that are specific to your program.

1. How did you feel throughout the simulation experience?

2. Give a brief summary of this patient and what happened in the simulation.

3. What were the main problems that you identified?

4. Discuss the knowledge guiding your thinking surrounding these main problems.

5. What were the key assessment and interventions for this patient?

6. Discuss how you identified these key assessments and interventions.

7. Discuss the information resources you used to assess this patient. How did this guide your care planning?

8. Discuss the clinical manifestations evidenced during your assessment. How would you explain these manifestations?

9. Explain the nursing management considerations for this patient. Discuss the knowledge guiding your thinking.

10. What information and information management tools did you use to monitor this patient’s outcomes? Explain your thinking.

11. How did you communicate with the patient?

12. What specific issues would you want to take into consideration to provide for this patient’s unique care needs?

13. Discuss the safety issues you considered when implementing care for this patient.

14. What measures did you implement to ensure safe patient care?

15. What other members of the care team should you consider important to achieving good care outcomes?

16. How would you assess the quality of care provided?

17. What could you do improve the quality of care for this patient?

18. If you were able to do this again, how would you handle the situation differently?

19. What did you learn from this experience?

20. How will you apply what you learned today to your clinical practice?

21. Is there anything else you would like to discuss?

Simulation Design Template (revised May 2019)

© 2019, National League for Nursing Originally adapted from Childs, Sepples, Chambers (2007). Designing simulations for nursing education. In P.R. Jeffries (Ed.) Simulation in nursing education: From conceptualization to evaluation (p 42-58). Washington, DC:  National League for Nursing.  

This Simulation Design Template may be reproduced and used as a template for the purpose of adding content for specific simulations for non-commercial use as long as the NLN copyright statement is retained on the Template.  When used for this purpose, no specific permission is required from the NLN. 

Simulation Design Template (revised May 2019)

© 2019, National League for Nursing

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