Reference no: EM133545193

Assignment: Standardized Simulation

Purpose:

The following information is to be used in guiding your preparation and participation in the scenario for this course. This document will provide applicable course outcomes in preparation for your simulation.

Scenario Overview:

Mei Sato (pronouns: she/her/hers) was directly admitted to the medical unit on Tuesday evening at 1700 with a diagnosis of dehydration. Mei has a history of colon cancer. Fifteen days ago, Mei underwent a partial colectomy with creation of a transverse colostomy. Mei's daughter (Katie) has been taking care of her since discharge and reports that Mei has resisted participation in colostomy care. Katie needs to return to her full-time job and is concerned with how Mei will manage without her daily assistance. The scenario takes place Tuesday at 1900. During this scenario, students will have an opportunity to manage care for a patient with fluid and electrolyte imbalances, assess and manage colostomy care, insert an IV and administer medications, and assist the patient to cope with issues of self-care and health literacy.

Student Roles During Simulation:

During pre-briefing, you will be assigned one of these roles according to the description below to participate in the simulation as a nurse.

Charge Nurse (1):

The charge nurse is responsible for the overall organization of safe, quality patient care. You are the team leader and serve as a resource to all interdisciplinary members and are responsible for appropriate delegation of duties. You will serve as the point person for communication and can anticipate speaking with the physician or other primary care provider, ancillary support services, and others directly involved with the care being provided. You must be knowledgeable about the patient's condition and able to dictate orders obtained and assist with implementation if needed. Additionally, be prepared to prioritize care and anticipate future needs.

Documentation Nurse (1):

The documentation nurse is responsible for recording of all patient event activities during the simulation with the exception of medication administration. You are responsible for documenting assessments, interventions, and outcomes on the designated tool (paper or electronic). Be prepared to read back and verify your documentation when requested and/or clarifying the details. Additionally, you will be part of the interdisciplinary team and will contribute observational assessment findings to include but not limited to changes in vital signs, alerts, psychosocial needs, and anticipated care.

Medication Nurse (1):

The medication nurse is responsible for all actions and documentation related to the safe administration of medications. You will identify and correct any medication errors related to prescribing or distribution. This may include speaking with the physician or primary care provider. Prior to administering medication, you will assure the "Rights of Medication Administration." You must be knowledgeable regarding the action and expected effects of the medications being administered and are responsible for monitoring and reporting any adverse reactions or unforeseen consequences of administration. Part of your role includes verifying medication calculations with a colleague and identifying any incompatible drug combinations.

Assessment Nurse (1):

The assessment nurse is responsible for overseeing a comprehensive assessment of the patient. This includes but is not limited to obtaining vital signs, head-to-toe assessment of all systems, and psych/social assessment of the patient. You will be prioritizing care, executing independent interventions, collaborating with interdisciplinary team members, anticipating the needs of the patient/family, and re-assessing or continually monitoring the patient for any changes in condition. You are responsible for implementing all non-medication related interventions, verbalizing your findings to the team, and recommending any actions/interventions required. Additionally, you will be providing appropriate education to the patient and family/significant others.

Observer Nurse (Max of 6):

The observer is a non-participant role and will not communicate directly with the simulation team. The observer nurse will view the simulation in the briefing room through Learning Space as it is occurring. There may be multiple observer nurses in each scenario. The observer nurse will be given an observation guide to complete during the simulation. The data you collect will help the team during the debriefing process and facilitate an open and active discussion regarding the simulation experience. You will be an active participant in the debriefing and will be encouraged to share your observations and thoughts. Please keep in mind that your observations should be conveyed in a respectful, educational manner. The goal is to work together as colleagues in providing safe and effective care.

Course Outcomes:

The NR226 standardized simulation enables the student to meet the following priority course outcomes:

1) Demonstrate the nursing process while providing basic care to individuals and families reflecting different stages of the life span in the extended care, acute care and community-based settings.

2) Participate in health promotion, illness prevention and rehabilitative activities as a member of the healthcare team.

3) Demonstrate communication skills necessary for interaction with other health team members and for providing basic nursing care to individuals and families.

Review and Complete Before the Start of Pre-Briefing:

In order to prepare for the simulation, you should complete your assigned reading for the course. In addition, you should be prepared to complete and document a thorough nursing assessment along with completing the following skills:

1) Nursing Application: The Older Adult
2) Fluid and Electrolytes
3) Elimination: Bowel Diversion Surgeries
4) Nursing Application: Bowel Elimination
5) Utilizing I-SBAR for reporting

Keep in mind you will also be required to recognize a variety of signs and symptoms linked to abnormalities in these skills.

Therefore, in order to prepare for the simulation, you are required to complete the pre-briefing questions below and submit to the faculty facilitating the simulation before the start of pre-briefing. If you do not complete the pre-briefing questions below and submit to faculty facilitating the simulation before the start of pre-briefing, you will not be permitted to participate in the simulation.

Question A. Review the Social Determinants of Health (SDOH) questionnaire. For each of the 5 domains, create a list of resources and nursing interventions that can be performed to support a client experiencing challenges.

a. Economic Stability
b. Neighborhood & Built Environments
c. Healthcare Access & Quality
d. Social & Community Context
e. Education Access & Quality

Question B. What dietary modifications would a patient need to make after a new colostomy? How can a nurse support the patient's cultural preferences into this discussion?

Question C. What assessment findings (cues) and lab values would a nurse anticipate to find in a patient with dehydration? Create a list of priority nursing interventions to correct the patient's fluid and electrolyte imbalances.