Course Objectives Identify opportunities to utilize simulation
as a tool in Orientation to bridge the gap for new graduate nurses
Identify simulation modalities and determine the appropriate
use
Slide 3
Hospital Based Simulation Center 3 Hospital System 4,500+
Employees 450 Patients Community Focused Faith Based
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22,700 Square Feet 2 ICU/ED/Med-Surg Simulation Rooms OR Suite
12 Bed Simulation Lab Pediatric Simulation Lab Cardiac Simulation
Lab 6 Task Training Rooms
Slide 5
Our Team
Slide 6
With the growing knowledge that millions of patients are being
harmed daily throughout the world as a consequence of preventable
adverse events, the urgency could not be greater for patient safety
solutions that will help practitioners and health care
organizations avoid these tragic occurrences. - Dennis S.
OLeary
Slide 7
Simulation as an Orientation Strategy Simulation has been
demonstrated to be an effective strategy for education healthcare
professionals Simulation is beneficial for transitioning new
graduates into professional roles Simulation can be used to
evaluation clinical judgment and competence (Olejniczak, Schidt
& Brown, 2010)
Slide 8
Study of Graduate Nurse Health Assessment Knowledge &
Skills Learning Modalities Self Directed Learning Packet (SDLP)
SDLP plus Power Point SDLP plus High Fidelity Human Patient
Simulations 80 GNs assigned to random groups Upon completion of
Orientation participants were individually tested using low
fidelity HPS
Slide 9
Study of Graduate Nurse Health Assessment Knowledge &
Skills Results of Correctly Completed Assessments 87% HPS Group 72%
SDLP Only 53.8% Power Point (Shepherd, et al, 2007)
Slide 10
Bridging the Gap Socialization into the professional role
Development of confidence and competence Simulation provides a safe
environment in which to learn (Olejniczak, Schidt & Brown,
2010)
Slide 11
Simulation Based Orientation Goals & Objectives Identify
opportunities to use simulation to enhance the orientation
experience for new graduate nurses and experienced nurses
Streamline and personalize the orientation experience Improve
outcomes by enhancing teamwork, communication, and clinical skills
through the use of high fidelity human patient simulation
Slide 12
Simulation in Nursing Orientation Cognitive Domain Initial
Learning & Application of Knowledge Critical thinking, problem
solving & conflict resolution Psychomotor Domain Technical
Skills & Tasks Affective Domain Values & Attitudes
Integrity, Communication, Commitment to Professional Development
and Reflective Practice (Bloom, 1956)
Slide 13
Simulation in Nursing Orientation Traditional Skills Lab Task
Trainers Scenario Based Orientation High Fidelity Human Patient
Simulation Standardized Patients Confederates Non-Technical Skills
SMART Training
Slide 14
Traditional IV Pump & Tubings Glucometer Pain Pump
Restraints Feeding Pumps Safety Devices Skills Lab IV Catheter
Insertion Foley Blood Administration Wound Care Dressing Changes
Drains & Tubes
Slide 15
Scenario Based Orientation Recognize signs & symptoms
Implement appropriate nursing interventions Set priorities
Determine plan of care and incorporate patient and family
Slide 16
Scenario Based Orientation COPD Pneumonia Post-Op Patient
Trauma Assessment
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SMART Training Based on principles of Crew Resource Management
(CRM) Teamwork Communication Situational Awareness
Assertiveness
Slide 18
Crew Resource Management A flexible, systemic method for
optimizing human performance in general, and increasing safety in
particular, by Recognizing the inherent human factors that cause
errors and the reluctance to report them
Slide 19
Crew Resource Management Recognizing that in complex, high risk
endeavors, teams rather than individuals are the most effective
fundamental operating units Cultivating and instilling customized,
sustainable and team-based tools and practices that effectively use
all available resources to reduce the adverse impacts of those
human factors.
Slide 20
Communication Introductions SBAR Hand-Off Communication Team
Lead One Voice Closed Loop Communication
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Situational Awareness
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Assertiveness A single hesitant attempt to communicate
important data fails to discharge individual responsibility. Kanki
& Palmer
Slide 23
Assertiveness Opening State a concern or owned emotion State
the problem Offer a solution Obtain agreement
Desired Outcomes Improved Quality of Care Reduced Errors
Reduced Turnover Rates Improved Patient & Staff
Satisfaction
Slide 26
Questions?
Slide 27
References Bloom, B. (1956). Taxonomy of Educational
Objectives: Handbook 1: The Cognitive domain. New York. David
McKay. Olejniczak, E. A., Schmidt, N. A., & Brown, J. M.
(2010). Simulation As an orientation Strategy for New Nurse
Graduates: An Integrative Review of the Evidence. Simulation in
Healthcare, 52 - 57. Shepherd, I., Kelly, C., Skene, F., &
White, K. (2007). Enhancing Graduate Nurses' Health Assessment
Knowledge and Skills Using Low-Fidelity Adult Human Simulation.
Simulation in Healthcare, 16- 24. Marshall, David. (2010). Crew
Resource Management: From Patient Safety to High Reliability. Safe
Health Care.