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1. K Bronson V Sim
26
Welcome
Virtual Simulation
Framework
Break!
BREAK!
Documentation
1
Medical Surgical Nursing II
K. Bronson V Simulation
Student Expectations
WELCOME
The Nursing Student handbook can be found on blackboard in your LAB shell under Course Essentials
Your university student handbook can be found by accessing this website:
https://concordia.csp.edu/cspstudent/
Student handbook!
Netiquette
We believe that everyone participating at activities at CSP is intelligent, capable, cares about doing their best, and wants to improve. AND THIS IS HOW WE ENSURE THIS WILL HAPPEN...
OUR CODE OF CONDUCT
This is virtual simulation-VSim might be a deifferent format than traditional simulation i-person at your lab site. However, it IS simualtion. We will follow thesame Code of Conduct and Fiction Contract that we use in traditional simualtion.
GOAL
The goal of simulation in the nursing program is to provide nursing students with opportunities to practice their clinical and decision-making skills and increase individual confidence and clinical judgement in a safe learning environment.
OUR CODE OF CONDUCT
PSYCHOLOGOCIALLY SAFE: This is a no judgement zone. there will be no critizing or judging.
MISTAKES/LEARNING OPPORTUNITIES We learn from our mistakes. Understanding thought processes that led to a mistake allow is a;; to learn fomr them and decreases the chance of it happening again. Hence, a learning opportunity! None want mistaked to repeat.
CONFIDENTIALITY - What hapeend in Virtual Simulation,stays iin virtual simulation. this will preserve learning and maitain the integrity of the simulation/learning for other groups. Also, this maintains confidentiality within our own group.
I
EXPECTATIONS- Try to suspend disbelief and immerse yourself in the scenario. Be an active participant in whatever role you are in at the tme. There is no lurking in the cyberspace background.
RESPECT- Be respectful of your peers and your faculty. We live in an ethnically rich and deverse, multi-cultural world. Please do not use language thatis, or could be misconstrued to be, offensive toward others. There will be zero tolerance for racist, sexist, hetrosexist comments or jokes, as well as deragatory or sarcastic comments and jokes directed at religious beliefs, diaabilities and age.
PERSPECTIVE - Similar to traditional simulation, instead of being critical of others actions, be inquisitive and attemp to understand. Be supportive and provide your perspective and observations ina thoughtful, honest, articulate, and constructive manner. We are all professionals and need to behave that way all the time.
Final Though: No matter where you ar ein your learning, simulationis always a great way to expand skills and knowledge.
Final thought:
What happens in VSim, stays in VSim.
Dress Code
Dress code
- Students are required to:
- wear school uniform per policy
- wear solid color long sleeves under uniform tops, no hoodies/jackets over uniform tops
- pull back hair
- display name badge
You may be asked to leave if
you are unable to follow
the dress code.
Environment
Pick somewhere quiet
Avoid guest appearances
Make the most of your break times to avoid distractions during clinical
Remain on mute when not sharing
Work Environment
Use a virtual background if there are distractions in your space
Phone use
Phones should
- be on silent
- put away
- only used for emergency
Phone use
Please do not use your phone during clinical.
You are not sneaky. We can all tell when you are on it.
It is distracting!
There is a ZERO tolerance for late work.
All assigned tasks must be submitted prior to the end
of the semester (even if you will receive a zero on the work). Not doing so may result in failure in the course. NO submissions are accepted week 16.
Prework & Postwork are NOT group work.
(review subtopic: Pre and Post work
Grading
Midterm and Final Evaluations must be submitted on time. If not turned in within 4 days of due date, the evaluation will recieve a fail. This will put you at risk for failure in the course.
Be sure to review all of your instructor feedback attached to
your grade in BB. This is how you make your work better.
Before you email your instructor, be sure you have used your resources and worked to find your answer!
Emailing your instructor
Emailing your instructor
It is best if you can email your instructor directly from Blackboard.
Assure you are emailing the correct instructor?
Be sure to include your section number.
Are you emailing the correct instructor?
Okay, I've already used my resources and I can't find I am looking for. ..
Reach out early. Sometime it takes time to hear back. So, review your assignment early and don't wait to ask questions.
If you require an extension on your POSTWORK assignment these accommodations must be made with your instructor via email prior to the due date.
RESOURCES
Blackboard Course Information
Reread that BB course informatation you just skimmed
Other classmates
What are my resources?
VIRTUAL SIMULATION
2
Breakout rooms with 3 students
Each student will share their screen and perform the virtual simulation. Your goal: 80% final grade, repeat as necessary to achieve 80%. Don't worry if your first.
Medication/Procedures: Faculty will be dropping into your breakout room randomly and may review procedures and focused assessments or pass a medication with you. Similar to the live clinical environment
10 MINUTES to complete
Prebrief
Learning Objectives:
General:
• Selects appropriate patient assessments
• Evaluates patient assessment data
• Identifies the primary patient care problems/nursing diagnoses
• Prioritizes patient care
• Implements patient care that meets quality, safety, and evidence-based standards
• Utilizes team members as appropriate
• Provides patient education
Scenario Specific:
• Implements a focused respiratory assessment for a patient with pneumonia
• Recognizes signs and symptoms of an adverse drug reaction (ceftriaxone)
Learning objectives
Medications
Acetaminophen
Cephtriaxone
Diphenhydramine
Epinephrine
Methylprednisolone
Medication
Scenario: Kenneth Bronson
Location: Medical Unit
Kenneth Bronson is a 27-year-old male
who was just admitted to the Medical Unit
from the Emergency Department. He presented to the Emergency Department two hours ago with chest tightness, difficulty breathing, productive cough for a week, and fever.
- Chest x-ray revealed right lower lobe pneumonia.
- IV was started of normal saline at 75 mL per hour.
- He is receiving oxygen at 2 L/min per nasal cannula. SpO2 on room air was 90%, which increased to 95% with supplemental oxygen.
- He had a temp of 102.6°F and was given acetaminophen 1,000 mg in the Emergency Department.
- Pharmacy just delivered the antibiotics to be given.
SCENARIO
What clarification do you need of simulation ?
Reminder: Step into the sim world with authenicity of work world
Prework/Shift preparation
Using the Think in action tool
Divide into groups of 3 and review your handover report and information within the EMR
1. Complete first four columns: (Recognize Cues, Analysis, Priotize Hypothesis)
2. Create three interventions you may anticipate to perform
3. List the tasks that the orders direct you to complete as you care for the patient.
4. Now prioritize both lists
NURSING CARE PLAN
Interpreting - Client Problems (analyze
cues/formulate hypotheses)
Pre-work assessment collection/Post-Work
What problems can you expect?
Responding - Nursing Interventions
Pre-Work Assessment collection/Post-Work Update
OUR CODE OF CONDUCT
This is virtual simulation-VSim might be a deifferent format than traditional simulation i-person at your lab site. However, it IS simualtion. We will follow thesame Code of Conduct and Fiction Contract that we use in traditional simualtion.
GOAL
The goal of simulation in the nursing program is to provide nursing students with opportunities to practice their clinical and decision-making skills and increase individual confidence and clinical judgement in a safe learning environment.
OUR CODE OF CONDUCT
PSYCHOLOGOCIALLY SAFE: This is a no judgement zone. there will be no critizing or judging.
MISTAKES/LEARNING OPPORTUNITIES We learn from our mistakes. Understanding thought processes that led to a mistake allow is a;; to learn fomr them and decreases the chance of it happening again. Hence, a learning opportunity! None want mistaked to repeat.
CONFIDENTIALITY - What hapeend in Virtual Simulation,stays iin virtual simulation. this will preserve learning and maitain the integrity of the simulation/learning for other groups. Also, this maintains confidentiality within our own group.
I
EXPECTATIONS- Try to suspend disbelief and immerse yourself in the scenario. Be an active participant in whatever role you are in at the tme. There is no lurking in the cyberspace background.
RESPECT- Be respectful of your peers and your faculty. We live in an ethnically rich and deverse, multi-cultural world. Please do not use language thatis, or could be misconstrued to be, offensive toward others. There will be zero tolerance for racist, sexist, hetrosexist comments or jokes, as well as deragatory or sarcastic comments and jokes directed at religious beliefs, diaabilities and age.
PERSPECTIVE - Similar to traditional simulation, instead of being critical of others actions, be inquisitive and attemp to understand. Be supportive and provide your perspective and observations ina thoughtful, honest, articulate, and constructive manner. We are all professionals and need to behave that way all the time.
Final Though: No matter where you ar ein your learning, simulationis always a great way to expand skills and knowledge.
Final thought:
What happens in VSim, stays in VSim.
PRE-QUIZ TIME
Take the pre-quiz and
Note the items you miss.
Jot them down for your reference and learning.
These nuggets will guide your study and add to your knowledge and professioanl practice.
3
Before you start
90 minutes to complete
- Work in groups of three
- We will rotate who will go first with each new simulation
- Think out loud
- Support your Peer
- this is a Safe Space for LEarning
**Remember: to call instructor for medication Administration or Procedure **
4
In your breakout group, open the V-Sim to access your patient information. Use the patient data sheet to obtain initial information from your patient chart prior to running the VSim.
Use your Patient Preparation Worksheet to obtain initial information from your patient chart prior to running the VSim and continue to fill out during the simulation. Charting later will be easier with this filled out.
During your vSim
vSim
Open EHRTutor as you observe your peers first time consider what you would need to chart. Second time you are observing you may want to start working on your documentation assignment as you go though. Remember charting should always be in your own words!
Patient Preparation Worksheet
Medication Pass
Peer to Peer Medication Pass
Right Reason: Did the student nurse understand why the medication is being given?
Assessments Necessary: What assessment data is necessary to evaluate before administration of this medication? Does this assessment data support administration of this medication?
5 Rights of Medication Administration:
Right Patient
Right Medication
Right Dose
Right Route
Right Time
3 Checks to assure the correct med
Check against the MAR as you are getting the medication (5 rights above)
Check the medication as you pull and prepare it
Check when you administer (Scan Patient ID, Scan the med)
Patient Education: Was the patient education provided appropriate and include why the patient was given the medication, name of the drug, dose of the drug, frequency of administration and possible side effects the patient should notify the RN with.
Medication Documentation: Document the med pass in EHR Tutor
Right Response: Did the student check with the patient to see if the patient had the right response to the medication? What is the patient assessment post adminstration?
2 Patient Identifiers requested? (even if the software doesn't request you to do that)
Patient Name
Patient DOB
Allergies checked?
At the MAR when preparing med
Asking the patient at the bedside
Instructor will be entering breakout rooms to spot evaluate proper medication administration. Questions related specifically to medications may be put on hold until debriefing.
Click to edit text
Click to edit text
Why Document???
Documentation is a crucial component of our nursing role.
Our teams use documentation for many reasons:
Nursing documentation guides providers; provides information on patient progression and future orders
Insurance companies base payment on our documentation
Courts will rule if our care meets nursing standards.
If documentation is missing or neglected, we place our patient and our roles at risk.
Please ensure complete submissions of your documentation when completing your VSim documentation.
Write what you need to remember on your Patient Preparation Worksheet.
THEN....Document these findings:
Vital Signs (at least one set)
Assessment: Physical, IV lines, pain, CBG, etc
Medication Administration
Procedure Note
Event Note
Patient Education
5
Subject Material
Subtopic
Click to edit text
Click to edit text
SHARE
Work independently over the next 10-15 minutes to complete your simulation post quiz.
Take a break!
Post-Quiz!
120 minutes to complete
DEBRIEF And DISCUSSION
6
Debrief
Woo hoo you made it through!
1
This is a safe space to share and learn
To sum things up!
2
Reaction: what did you think?
3
Let's summarize the case
4
Analyze our interventions
5
Final take away?
6
What happens in simulation stays in simulation. Do not share/spoil anothers learning opportunity
Debrief Topics
Initial Reactions
How did the scenario make you feel?
What was your firsts reaction when you noticed his signs and symptoms?
3
What further needs does Kenneth Bronson have at the end of the scenario that future nursing care should address?
What educational topics would a nurse need to cover with this patient?
What discharge path do you anticipate for this patient?
- What discharge information/education is pertinent to the patient to prevent a readmission?
- What discharge medication can you anticipate teaching about?
- What medication/supplies/ aides will this patient need to prevent a readmission?
IDEAL Discharge Model
Reflect on how you would communicate with family members in an emergency situation if they were present at the bedside.
6
7
After completing the simulation and reflecting on your experience, what would you do differently (or the same) for the patient experiencing acute respiratory distress?
How could you prepare for clinical in order to plan ahead for potential patient emergencies?
8
1
- What signs and symptoms led you to the conclusion that Kenneth Bronson was experiencing an allergic reaction?
- Discuss the differences between mild, moderate, and severe anaphylactic reactions.
Think in Action
Using the Think in action tool
Divide into groups of 3 and review
your pre-brief tool and move to the next page. Using your patient preparation sheet or reviewing your vsim log (It may help you by group findings and thoughts by admission, event, follow-up)
1. Complete first four columns: (Recognize Cues, Analysis, Priotize Hypothesis)
2. Create three interventions you may anticipate to perform
3. List the tasks that the orders direct you to complete as you care for the patient.
4. Now prioritize both lists
5. As a group we eill share and dicuss your findings
Discuss the importance of follow-up assessments post-reaction.
2
7
Post work
YOU DID IT!!!! YOU COMPLETED vSIM #1!!!!
All assigned tasks must be fully competed within 72 hours after your clinical. Late work will not be accepted without prior arrangements made.
Check list
Assure these 3 scores are in your Laerdal course:
1. Pre-Simulation Quiz
2. 80% or higher for simulation execution
3. 80% or higher on the post quiz
Submit your completed post work to Blackboard:
-Student evaluation of virtual simulation learning event
-Simulation Reflection-On-Action
Note: Documents should only have your name on it. Post work is not a group project. Including your name means you are signing off that the work is yours, valid and complete.
Do you have everything done?
All assigned tasks must be fully competed within 72 hours after your clinical. Late work will not be accepted without prior arrangements made.
Check list
Earn an 80% or higher on the simulation
Earn an 80% or higher on the post quiz
Submit your completed work to Blackboard:
-Include completed guided reflection and documentation documents.
-Documents should only have your name on it. This means you are signing off that the work is valid and complete.