Transcript ppt

Have Lucie, will travel:
Exploring in situ birthing simulation
Stacy Seay Capel MSN, RN, CHSE
Culver Nursing Education Lab
Novant Health Presbyterian Medical Center
Charlotte, NC
February 16, 2016
Making healthcare remarkable
With recognition,
great appreciation
and much affection:
Eileen Frager BSN, RNC-OB
Lindsey Horne MHA, BSN, RN-MNN
Allison Talbert BSN, RNC-OB
Teresa Shelton BSN, RNC-MNN
Objectives:
• Provide information and logistics regarding
mobile, in situ simulation.
• Share examples of rosters, audit tools, debriefing
reports and post simulation follow-up.
• Offer participation in preparation for maternal /
fetal emergency simulations.
Our history.
Serving since 1903.
Making healthcare remarkable
Novant
Health
Presbyterian
Medical
Center
School
of
Nursing
Margaret
Jean
Norwood
Culver
Background:
Novant Health (NH) is a regional healthcare
provider with:
• 25,000 team members
• 13 hospitals
• 100 outpatient facilities
• 350 physician practices
NH Greater Charlotte Market is located in
southern North Carolina and includes three
Magnet designated hospitals totaling > 8,300
births/ year:
• NH Presbyterian Medical Center:
620 beds
• NH Matthews Medical Center:
146 beds
• NH Huntersville Medical Center:
91 beds
NH Greater Charlotte Market has an established
simulation program, including:
• Mobile simulation unit
• High fidelity maternal / fetal simulator
• Multidisciplinary , in situ simulation
experience
Our plan.
Building on evidence and resources.
Making healthcare remarkable
Regional OB Simulation
Objectives:
• Create and implement a regional obstetric
simulation education plan
• Provide opportunities for women’s services
staff to experience high intensity, low
frequency simulated clinical emergencies in a
safe environment
• Utilize the planned experiences to promote
engagement, team building and process
improvement
Assesment:
In January of 2015 a needs assessment was
completed utilizing:
• risk management statistics
• review of the California Maternal Quality
Care Collaborative
• staff survey results
• physician input
Action:
Three OB emergencies were identified as events
that had high staff interest, could safely be
replicated through simulation, would impact
team practice and patient outcomes:
• prolapsed cord
• postpartum hemorrhage
• intrapartum maternal code
Education plans, scenarios and audit tools were
designed.
Nursing, MD’s, anesthesia, NNP’s, ICN, surgical
techs , public safety, chaplaincy services, house
supervision, respiratory care, rapid response
teams, administration, laboratory services and
pharmacy participated in the events.
Objectives for
Prolapsed cord Code:
• Identify risk factors for prolapsed cord
• Recognize actual event
• Initiate and demonstrate appropriate
interventions for a patient with a
prolapsed cord
Lucie Purple
28YO
168 lbs
5’8
S:The patient is a 28-year-old female being triaged for labor.
B: She has had regular prenatal care at her OB/GYN, and has had a
healthy pregnancy thus far. Primagravida
Allergies: No known drug allergies
Medications: None
Code Status: Full code
Social/Family History: Lives with husband, school teacher
A: You are entering the room to assess & complete the admission
Objectives for
Intrapartum Maternal Code:
• Recognize symptoms of cardiac arrest
• Demonstrate timely execution of OBLS
emergency skills in a safe environment
• Practice effective communication between
all team members
• Participate in timing and evaluation of
process
Lucie Purple
37YO
253 lbs
5’8
S:The patient is a 37-year-old female just admitted to L&D at 38
weeks, 12 hours with ruptured membranes and contractions
every 3 to 5 minutes.
B: Type I diabetes, has been on bed rest since 32 weeks due to
labile blood sugars and preterm contractions. Primagravida
Allergies: No known drug allergies
Medications: insulin pump
Code Status: Full code
Social/Family History: Lives with husband, school teacher
A: You are entering the room to assess & complete the admission
Objectives for
Postpartum Hemorrhage:
• Identify risk factors for PPH
• Recognize early S & S of post-partum
hemorrhage
• Perform appropriate management of and
initiate protocol for PPH
Lucie Purple
28YO
160 lbs
5’8
S:The patient is a 28-year-old female 4hrs postpartum
B: G4, P4 Had a 2 day induction and gave birth to a 9lb 12oz male.
One dose methergine given in L&D.
Allergies: No known drug allergies
Medications: Flonase & Singulair
Code Status: Full code
Social/Family History: Lives with husband and 3 other
children. She is a school teacher.
A: She has called out for assistance & You are entering the room.
References:
Clapper, T. C. (2013). In Situ and mobile simulation: Lessons learned… authentic
and resource intensive. Clinical Simulation in Nursing, 9(11), e551-e557.
Jeffries, P.R. (2007). Simulation in nursing education. New York, NY: NLN.
Kolb, D. A. (1984). Experiential learning: Experience as the source of learning and
development (Vol. 1). Englewood Cliffs, NJ: Prentice-Hall.
Rudolph, J., Simon, R., Dufresne, R. & Raemer, D. (2006) There’s no such thing as
“nonjudgmental” debriefing: A theory and method for debriefing with good
judgement. Simulation in Healthcare, 1(1), 49-56.
The INACSL Board of Directors (2015, June). Standards. Clinical Simulation in Nursing,
11(6), 309-315. doi:10.1016/j.ecns.2015.03.005
Contact Information
Stacy Seay Capel MSN, RN, CHSE
[email protected]
704.384.5597
Making healthcare remarkable