Improving Patient Care: Simulation Analysis

This simulation experience allowed me to practice my focused assessment skills, delegation of tasks, prioritization on of tasks, interdisciplinary communication skills, and skills that I have not been able to participate in such as blood administration. I learned that my strengths are patient education, delegation, noticing changes in patient condition, and working as a member of a team. I need to improve my speed of completing tasks, my confidence, and my process of working through new skills.

The intent of clinical simulations is to provide a safe environment for students to practice and implement skills. This is a way in which to help prepare the student for the hospital setting. Enhanced confidence, clinical judgment, knowledge, and competence are factors that come from these situations. I gained further knowledge, but I did not experience the other skills during simulation. During the postpartum-hemorrhage and birthing simulation, I purposefully picked the scenarios that I felt most comfortable with. That entailed being the spouse of the woman in labor, the nursing assistant, and the patient’s family member. When embodying those roles, I felt at ease, because I was not the fixation; I was not the one in charge of the situation. During the preeclampsia simulation, I was “dubbed” the staff nurse. I was definitely out of my comfort zone. I was in the second group, and this allowed me to observe the first group. I learned and made alterations from the first group’s performance. Observing the first group helped, but my performance was poor. I made several mistakes and was embarrassed by the end result. I did not do well with the assessments, answering the patient’s questions appropriately, and when calling the doctor, I was not fully prepared. Despite all the mistakes and feelings of embarrassment, I learned. I am very thankful for the awareness of what things went wrong. With further practice and

The simulation environment offers a safe place for students to practice critical scenarios and gain confidence in proscribed settings (Decker, Sportsman, Puetz, & Billings, 2008). Simulation helps faculty to facilitate learning which meets one of the NLN’s core competencies. Simulation also enhances communication through emerging leadership and delegation skills, and builds teamwork through goal and priority setting (Dillon, Noble, & Kaplan, 2009). Therefore, according to Lasater (2007) simulation is highly effective as an adjunct teaching strategy in clinical practice.

Since the capstone project started early on beginning of the Doctor of Nursing Practice (DNP) program, I was able to discuss and work personally with Dr. Spicer as my practice mentor in selecting the appropriate topic for my project. Dr. Spicer was very involved in choosing my second option for new capstone project # 1 related to simulation lab and faculty teaching and learning. The patient simulation laboratory (SIM lab) uses state-of-the-art equipment that provides students and faculty with the opportunity to tackle real-life scenarios in a safe and supported environment. Further, I learned that active learning involves the faculty through participation and investment in exploring content knowledge in all phases of the learning process. It requires educational activities that provide faculty with the opportunity to engage actively in courses and respond to the learning situation.

-The effectiveness of simulation and use of manikins are directly related to the method of presentation of the materials. Studies have shown that the use of simulations have a 75% retention rate. The only method that allows for better retention was to teach the material to others.

Simulation labs and clinical placements are effective for practicing skills and building hands-on dexterity, habits, rhythms, and confidence. Not every facet of nursing education prepares student nurses with this kind of learning; originally an, most commonly clinical hours spent in simulation labs were integrated strictly into BSN programs, eliciting the statement made by Taylor (2008) that ADN programs have had to expand their curricula and offer students more content (p.613). According to Go’s (2012) dissertation on High Fidelity Patient Simulation (HFPS), simulation labs are advantageous because they give student nurses a venue for instruction while working in a clinical setting (p. 34). HFPS promotes and validates the clinical judgment competency of nursing students; it offers opportunities for feedback, debriefing, and guided reflection; it increases the student's ability to synthesize knowledge and insight, forming the bridge between theory and practice (Go, 2012, p. 34). However, hours spent in standard clinical settings are often inadequate in preparing

The second stage of the simulation is during the scenario interaction, at which point the group was required to utilize the clinical reasoning cycle to guide, generate and

Deliberate practise also allows us to standardise exposure for all trainees and try to combat stress that may arise from students feeling inadequately prepared for their role. Simulation also allows for learners to choose which skills they feel they need to improve and removes the need for a specific surgical scenario to arise before they can practice it. adult learning thing.

As many of us know today Baby Boomers and some of Generation X’s are coming to the age of retirement. Many of them have learned that just finding a place for them to retire or a great nursing home difficult. Many times, we find out too late that the place we chose is not the place we would like to be. All too often the people don't care how they treat people or their belongings because the people or item don't belong to them. We may want to stay in a place that we built and know better, or where we raised our love ones. To many times we have to fight our loved ones to go somewhere like nursing homes, but this way everyone wins.

While I didn’t realize it at the time, the process of answering key questions about why the Clinic would build a family history-based clinical decision support platform exposed dimensions that are clearly linked to macroergonomics.

My answers were not decisive which reflect my weak critical thinking skill. For example, when it comes to medication administration, in instances where things are not clear, it should always be referred to the doctor which in this case I belatedly remembered. Nurses should also make sure that they knew how to use all the equipment that is used in the nursing care. In a medical emergency situation, every second counts. In the simulation, epinephrine administration was delayed since the nurse did not know how to use the automatic injection. Over-all the simulation had a significant impact to my learning process.

These skills may be compromised if majority of the student’s training is focused on the Sim Man. In a experiment done comparing the test results from students using traditional teaching methods and HFS, twelve different studies showed no dramatic increase or decrease in a students testing ability after training from both styles. (Robyn and Simon 2010) However, students noted that HSF training allowed them to implement their prior textbook knowledge in practical procedures.

Sometimes failure can really be the best teacher. This was the case with the Lakeview Regional Hospital Simulation Exercise. During the simulation, I learned a lot about working with a team, knowing when to stand firm and when to compromise. I have been a part of plenty of projects, but sometimes I can be a little lost when it comes to the healthcare aspects of things. It was during these times that I looked to my teammates to assist with filling in some valuable blanks about the healthcare environment. I do have a lot of experience with introducing technology, training and media relations. It was during these parts of the simulation that I could really lend a helping hand. The simulation illustrated the importance of buy-in amongst the implementation team as well as other members of the entire organizations. It showed that there will always be some inherent resistance, but that doesn’t mean that change is impossible as long as there is some flexibility.

Hospitals are working towards a more team-based training. The last couple years most of my training has been in a simulation lab. I feel it improves communication, teamwork, reinforces skills and new practices. Hands-on simulation experience allows healthcare workers to get messy, make mistakes and sharpen problem-solving skills — with no risk to patients. As nurses, we collaborate with each other on a daily basis but we are trained and tested individually on our skills, theory, and practical situations. As healthcare evolves, stimulation labs should be part of all healthcare works training and testing, that way everyone is better prepared to handle real time events.

A well-designed simulation meets all of John Keller’s goals in the ARCS model (attention, relevance, confidence and satisfaction). It presents a problem to be solved, allows the learner to make choices, shows the consequences of those choices, and builds confidence in the learner when the problem is mastered.