Lessons Learned in Simulation

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Lessons Learned in Simulation

• Mary Beth Parr,
• MSN, RN, CCRN, CNS
• San Diego State University
• Sharp Healthcare HPSC

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Life at HPSC

• Students drive the simulation
• Instructor in the back seat
• Students call- lab, provider, family

• If the simulator dies, call a code
• But Im in 3rd semester, my patient is not
  suppose to die
• Visitors are always welcome

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Anyone can be a photographer
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Anyone can be a model
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Integration into New Course

• Too many students so lets send to HPSC
• Meet with course faculty
• Identify outcomes
• Suggest scenarios
• Review how simulations are run
• Train faculty
• Run the simulation
• EASY as PIE!!!

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Run 2 simulations in one day

• Use of observation or not
• Debrief both simulations
• Peds respiratory distress in newborn and septic
  appendectomy
• MS CHF and PE

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Take Home Tips

• Use as clinical time
• Uniforms
• Expected level of preparation
• Role of Instructor
• Role of Lab Coordinator

• Realism
• Functioning equipment
• Use the supplies
• Try not to re-package

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Chronic Heart Failure

• 67 male, with history of CHF
• Respiratory distress
• Admit, tele
• Oxygen 2-5L for SpO2gt 95
• Daily wt and labs
• Meds

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CHF

• CBC
• WBC 11.9, Hgb 11.5
• Hct 35.1, Plt 250
• Chem
• Na 137, K 3.6, Cl 100
• CO2 24, Glucose 118
• BUN 6, Creat. 1.2
• Mg 1.6

• Cardiac Enzymes
• CPK 86
• CK-MB 0
• Troponin 0.1
• BNP 1200

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Medication Orders

• Digoxin 0.25 mg,daily
• Captopril 6.25 mg every 6 hours
• Metroprolol 12.5 mg, daily
• Furosemide 40 mg twice day

• Potassium 20 mEq every day
• Docusate sodium 60 mg every day
• Morphine Sulfate 2 mg IVP unrelieved chest pain

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Orders

• Fluid restriction 1000 ml per day
• SCDs
• Intake and Output
• Bathroom privileges

• IS every 4 hours
• Daily weights
• VS every 4 hours
• I O every shift

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THANK YOU
 

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