Maximizing Simulator Usage at a Health Science College

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Maximizing Simulator Usage at a Health Science
College

• Joseph Corvino B.S.
• Simulation Coordinator
• Kristen Zulkosky R.N., M.S.N., C.C.R.N.
• Nursing Instructor
• Dolores Minchhoff R.N., M.S.N., C.R.N.P.
• Nursing Instructor

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Learning Objectives

• Describe how a two year nursing program
  incorporated a simulator into their curriculum
• Discuss other healthcare and non-healthcare uses
  of a simulator
• Provide open dialogue to exchange additional ideas

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College Overview

• Lancaster General College of Nursing Health
  Sciences
• Private two-year college offering associate and
  diploma programs in healthcare
• Enrollment - 730 students
• More than 100 years in education
• Located in Lancaster, Pennsylvania

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College Overview

• Academic Programs
• Cardiovascular Invasive Specialty
• Clinical Laboratory Science
• Diagnostic Medical Sonography
• Nuclear Medicine Technology
• Emergency Medical Technician
• Nursing (Day Evening/Weekend)
• LPN assessment module
• Paramedic
• Radiography
• Surgical Technology

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Simulation Facilities

• 3 Simulators HPS, ECS, BabySIM
• PNCI and DMR Modules
• 2 Labs and a control room (2,500 square feet)
• 6 Ceiling mounted cameras
• 2 Classrooms adjacent to labs for debriefing
• Integrated assessment software module
• Educational Management Solutions (EMS)
• Arcadia Total Sim, Digital AV
• www.ems-works.com

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Simulation Facilities
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Student RN Utilization

• Semester 1
• Assessment lab
• Medication administration
• Clinical make-up

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Student RN Utilization
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Student RN Utilization

• Semester 2
• IV Lab
• Orientation to Pediatrics Normal Assessment
• Post Conference Scenarios

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Student RN Utilization

• HPI
• A 6-month-old male infant, Sammy, was just
  admitted due to increasing respiratory distress.
  He was seen in the Emergency Department. A CXR
  revealed pulmonary infiltrates in the right upper
  lobe. CBC WBC 17.1. He was given Xopenex X 1
  treatment in the ED 2 hours PTA to the Pediatric
  Unit.
• Physical Exam
• T-36.8 tympanic, HR 160-170s RR-50s PO 94 on
  RA Wt. 9.5 kg.
• crackles throughout lung fields
• mild substernal retrations, right otitis media.
  Remainder of exam is WNL. He is not on oxygen.
• Social
• His mother is with him at the bedside.

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Student RN Utilization

• PMH
• SVD, mother was GBBS at delivery and received
  antibiotics. Immunizations are up to date. No
  prior illnesses or hospitalizations.
• Family history
• Father with asthma. MGM with DM type 2. No
  smokers in the home.
• Physician Orders
• DX Bronchiolitis, right OM. Diet for age. (He
  is bottle fed).
• VS every 2 hours. Xopenex 0.63 mg every 3 hours,
  q 1 hour prn.
• IV D51/2 NS at 42 cc/hr. Add 20 mEq/L of KCL
  after the child voids. (He has not voided).
• Rocephin 1000 mg IV BID administer at 0900 and
  2100. (It has not yet been given as it was just
  ordered).
• Keep PO 93. Notify MD is FiO2 requirements are
  greater than 50.

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Student RN Utilization

• Semester 2
• Infant Assessment Video Tape

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Student RN Utilization
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Student RN Utilization
Respiratory Anterior ? posterior ? side
to side ? Cardiovascular and PV Apical ?
branchial ? femoral ?Capillary refill ?
warmth ? GI Bowel sounds ? soft ?
non-tender ? Other Wash hands before ?
after ? Put name on board as nurse caring
for child ? Check ID ? Mention consideration
of temperature ? Check pulse ox site and change
if needed ?
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Student RN Utilization

• Semester 3
• Assessment Lab Abnormal Findings

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Student RN Utilization

• Semester 4
• Rotation 1 What Would You Check?
• Objectives
• Identify the need to evaluate not only the
  patient, but also the room/patient setting for
  abnormal assessments and needs.
• Verify information given in shift report to the
  patients clinical picture.
• Incorporate the practice of assessing the
  patients setting into normal routine.

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Student RN Utilization

• Report Information
• NG to LIWS
• IV is D5 0.45 NSS with 20 mEq KCL _at_ 125 mL/hr

• Actual Occurrence
• NG is turned OFF
• The student should recognize the NG canister has
  1100 mL and will need changed
• IV is D5 0.9 NSS with 20 mEq KCL _at_ 60 mL/hr
• IV tubing will need changed today

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Student RN Utilization

• Semester 4
• Rotation 2 and 3 Scenarios
• Anaphylaxis
• Spinal Cord Injury
• Post Conference Scenario
• Heart Failure

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Student RN Utilization

• Semester 4
• Open Labs
• Physical Assessment
• Cardiac Rhythms
• Chest Tubes
• Admission Orders
• Hemodynamics

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OPEN LAB HEMODYNAMIC SIMULATION

• During this session you will assess the
  clients monitor for hemodynamic values. Look at
  the monitor and answer the following questions.
  When you have completed your answers, you can
  compare your findings with the answer key.
• First- Review the Swan Ganz Catheter
• Where does the tip of the catheter sit?
• What readings are continuously seen on the
  monitor?
• What does a PCWP tell us?

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HEMODYNAMIC SIMULATION LAB

• Rachel Ray is admitted to the ICU following Open
  Heart Surgery. You assess the following on the
  monitor
• CVP- 20 mmHg
• PAP- 20/10 mmHg
• CO- 2 L/min
• What do you suspect is happening?
• What other assessments would you perform?

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Student LPN Utilization

• Practical Nurse Program Partnership
• 239 students
• Lab Evaluation
• Skill Performance
• Professional Performance
• Peer Review
• Best Practice Award Pennsylvania Practical
  Nursing Coordinators Conference

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Student LPN Utilization
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Health Science Utilization

• Cardiac Invasive Specialty
• 9 Students
• Mock Cardiac Catheterization
• Pharmacology
• Cardiac Rhythms
• ACLS

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Health Science Utilization
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Health Science Utilization

• Nuclear Medicine
• Pharmacology
• Surgical Technology
• 6 Students
• Cardiac Rhythms
• Intubation

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General Education Utilization

• General Education
• Anatomy and Physiology
• Public Speaking

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Pre-Hospital Utilization

• Lancaster Emergency Medical Services Association
  (LEMSA)
• Susquehanna Valley Emergency Medical Services
  (SVEMS)
• State Regulations

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Pre-Hospital Utilization
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Staff Development Utilization

• Institute for Professional Development
• 6000 Employees
• ACLS
• PALS
• BLS
• Pediatric Mock Code

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Staff Development Utilization

• Women and Babies Hospital
• Mock Code Blue
• Labor and Delivery OB Mock Codes
• Safety Environment of Care
• Mass Casualty Simulation
• Bioterrorism CMEs

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Staff Development Utilization
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Staff Development Utilization
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Professional Nursing Utilization

• Continuing Care Communities
• Staff Development Managers Inservice
• Nurse Aids
• RN
• LPN
• Administrators
• Mechanical

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Non-Healthcare Utilization

• Tomlinson and Bomberger
• Pennsylvania Pest Control Association
• Occupational Medicine
• Monthly Seminars
• Employee Safety (Kelloggs)
• Admissions and Marketing
• High School Student Career Day
• Health Fairs/Science Business Expo
• Take Your Child to Work Day

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Open Dialogue

• How are you using simulation?

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Contacts

• jacorvin_at_lancastergeneralcollege.edu
• kdzulkos_at_lancastergeneralcollege.edu
• daminchh_at_lancastergeneralcollege.edu
• www.lancastergeneralcollege.edu