Simulation Student Objectives

The fourth semester student will:

1. Process MD orders
2. Maintain safe environment (i.e.: fall risk, isolation, Five Med Rights, Patient Identification)
3. Document in paper and electronic patient record
4. Reconcile medications from physician orders to MAR
5. Transcribe physician orders to MAR
6. Correctly calculate medications, ABGs, infusion rates
7. Clarify incorrect or unclear orders/meds
8. Use protocols appropriately
9. Explain relevance of lab values
10. Recognize signs of decreased perfusion
11. Delegate and use resources appropriately
12. Communicate significant patient information in an appropriate and timely manner to
other disciplines (physician, laboratory, pharmacy, family).
13. Recognize life threatening ECG rhythms
14. Correctly administer IV infusions, primary, secondary/use of back flush technique
15. Manage specific oxygen adjuncts and include rationale for use
16. Perform airway management and basic life support

The following may be included in Sim Fair/Sim Eval scenarios:

1. Patient safety risks
2. Medication preparation
3. PO, IVPB, SQ, IM, and IV push medications
4. Use of oxygen adjuncts for changing assessment findings
5. ECG rhythms
6. Abnormal lab values
7. Variety of IV infusions and rates
8. Focused patient assessment
9. Blood administration
10. Chest tube drainage system and correct set up
11. Assessment of ABCs
Sim Memorial Hospital: Description and Criteria

• Established groups of 5-6 students will participate in the simulation scenarios.

• This is an environment where students will act as RNs in a patient care situation.
• Each scenario will be introduced through nurse to nurse report.
• Each student in the group will be assigned a patient or patients. There may be other
participants playing various roles (i.e.: family, lab, pharmacist, etc.)
To be able to participate in Simulation Scenarios the student must*:
• Approach the simulation experience as an actual clinical situation.
• Wear student uniform (this is a clinical rotation)
• Have appropriate equipment (stethoscopes, resource information/ smart phone/tablets,
calculators, calipers, etc). There will be drug books and other resource material as indicated
available
*Students who are unprepared, inappropriately attired and/or come without the above noted
equipment cannot participate and will forfeit points for the session.
During the Simulation scenario the students must:
• Maintain standard precautions (use of gloves and other personal protective equipment)
• Review the patient’s chart and MAR
• Check arm band for identification
• Check labels on all IV fluids
• Respond appropriately and professionally to the patient, significant others, or other staff
• Utilize all equipment at the bedside appropriately (IV fluids, pumps, oxygen adjuncts,
bed, etc.)
• Read and interpret data on the cardiac monitor
• Communicate effectively to coworkers, supervisor, physician, and others
In addition to the responsibilities noted above, RN (student) must:
• Perform initial assessment of the patient, but may delegate activities as appropriate
• Initiate or delegate appropriate interventions
• Follow up on all assessments, evaluate interventions, reassess as indicated by the scenario
• Be prepared to provide report to the oncoming nurse/supervisor/physician
The following key concepts must be incorporated into the simulation experience:
• Communication
• Patient Safety
• Patient Care Management
• Safe Medication Administration
• Pain and symptom management
• Early intervention
• Patient handoff/report
Debriefing: there will be a debriefing session at the break and after clinical experience. Each
student will reflect on what happened during the scenario and give report. The session will be
facilitated by your instructor.

Some questions to consider during the debriefing session:

• What was my experience during the simulation?
• How did I perceive my own responses during simulation?
• What thoughts did I have during the simulation?
• What did I do well?
• What did my team mates do well?
• Did I feel supported by my team mates?
• What would I do different next time?
• How would this improve my clinical performance?

Learning from the Simulation Experience

• Recognize that you are a Novice and may make mistakes.
• In the words of Van Helsing “We learn from failure, not from success!”
• Utilize your resources – co-worker, pharmacist, lab, etc.
• Instructor feedback is intended for personal growth, not an attack on your character.

Clinical Tips for Success

• Use the IV pump and IV fluids as you would in clinical
• Keep ABC’s in mind
• Be prepared to perform CPR
• Know your oxygen adjuncts and when the situation requires something else
• Know how to use the bed, don’t just push buttons
• Remember the patient! Don’t just stare at the monitor!
• Communicate aloud! State clearly what you observe and what you want.
• Think the nursing process! OK…if you can’t do that then….
1) Assess…what is happening?
2) Set a goal… what do you want to happen?
3) Intervene…don’t just stand there….do something!
4) Evaluate/Reassess….Did it work? What’s happening now? Do I need to do something
else? Talk to your teammates and access resources!

Sim Faire/Sim Eval

• Sim Eval is an hour long simulation experience done three times during the semester
• You will be assigned a time to attend each and receive a grade for your clinical
performance.
Students will individually care for a patient and be evaluated by an instructor according to
Simulation Evaluation Rubric (A & B). Be sure to bring your calipers and calculator, and wear
scrubs