High-Fidelity Simulation as a Teaching Strategy for Oncology Nursing Education: Implications for Education and Practice

Trotter, Tanya

Saturday, 29 October 2011

Tanya Trotter, RN, MSN, CNS
Nursing Staff Development and Patient Education, The Ohio State University Comprehensive Cancer-The James Cancer Hospital and Solove Research Institute, Columbus, OH
Taletha Askew, MS, MBA, RN, CNS
9th Floor, Rm. 924, The Ohio State University-James Cancer Hospital, Columbus, OH
Stacey Vacchiano, MSN, CRNP
The James Cancer Hospital and Solove Research Institute, Ohio State University, Columbus, OH
Paula K. Garvey, MSN-ED, RN-BC
Department of Nursing & Patient Education, The Ohio State University Medical Center, Columbus, OH

Learning Objective 1: The learner will be able to create simulation scenario from actual patient documentation.

Learning Objective 2: Learner will be able to utilize high fidelity simulation as teaching tool for nursing clinical education.

Review of unit specific quality data identified failure to recognize increased oxygen requirement, mental status changes as early warning signs of acutely decompensating patient. Needed to asses, develop, implement, evaluate education plan to address RN learning needs.

Simulation provides nurses with realistic, hands-on practice with any patient care condition. Use of simulation in nursing education helps to improve self confidence, clinical judgment in addition to enhancing problem solving abilities, opportunities for unlimited practice of rare, critical events in a safe, controlled environment without risk to patients.

Goal: To equip the nurse to recognize, assess and manage the acutely decompensating patient.

Five-phase education plan utilizing high fidelity simulation:

Phase I (Assessment): Created simulation scenario with data from chart of actual Thoracic Surgery patient. Scenario implemented in OSU College of Nursing simulation lab. Groups of 2-3 RNs managed the “patient”. RNs given pre/post simulation surveys, evaluated by nurse manager, CNS and educators for (a) appropriate response to changes in patient’s condition (b) communicating up the chain of command (c) correct use of equipment (d) obtaining and following appropriate orders and (e) calling for additional resources as needed (ERT, Code Blue). After each session, debriefing occurred. Interventions for remaining phases designed based on the specific learning needs identified during Phase I.
Phase II (Implementation) 10 unit specific skills stations with both didactic and hands-on return demonstrations.
Phase III (Implementation) 8 hour didactic course. Topics: Failure to Rescue, Nursing Assessment, Respiratory Distress and ABG interpretation, Failure to Rescue Case Study focusing on the thoracic patient, Legal Aspects of Documentation, Preparing for Code Blue, second simulation exercise.
Phase IV (Implementation) 4 hour education “Care of the Thoracic Patient and pain management.
Phase V (Evaluation) 120 days after plan complete, third simulation exercise to evaluate knowledge, skill attainment.

Simulation is helpful to assess, address and evaluate unit-specific learning needs.

See more of: Poster Session I
See more of: Oral Paper & Poster: Evidence-Based Practice Contest