Transcript Simulation Training for New Emergency Nurses

Simulation Training for New
Emergency Nurses
“SimMan”
Margaret M Miller FNP,BC
Introduction
• The Emergency Department (ED) is one of the
areas that is the forefront of Nursing. Since
the ED is both fascinating and challenging for
the new nurse, a comprehensive orientation
with high technology is warranted for success.
The use of Simulation in the orientation
process will set standards and guidelines for
various kinds of learning and assessments
Objectives
• Compare simulation technology to traditional
learning models
• Identify potential advantages and
disadvantages of simulation as a teaching
strategy
• Evaluate how simulation help the new nurse
transcend to the ED
The Role of Simulation as a Trend in
Nursing Education
• A teaching Strategy
• An evaluation tool
• Can be use to provide a more experiential
learning opportunity
• Provides increase use of learning technology
• It is more outcome based
• Provides more evidence-base education
Rationale for Incorporating the
SimMan in Orientation Program
• To promote better preparation of the new ED
nurse
• To simulate a patient safety environment
• To support innovative teaching strategies
• To have a better prepare nurse for the
Preceptors
• To create complicated patients presenting to
the ED, and implementation of Emergency
Care
Types of Simulation
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Screen-based/PC-based simulation
Virtual Patients
Partial task trainers
Human patient simulator
Standardized patients
Integrated models
Definition
• Wikipedia, the free encyclopedia defines
Simulation as the imitation of some real thing
• Simulation is widely used for educational
purposes. Such as Aviation, Military, Medical and
Transportation. A good example of this was seen
recently when the pilot landed the plane in the
Hudson River. A situation that was practice by
simulation for a long time and was eventually put
to use which save over 100 lives
Simulation
• In the Healthcare systems simulators are
increasingly being developed and deployed to
teach therapeutic and diagnostic procedures
• There are human simulators for every patient
we care for from birthing to the neonatal to
the adult
• One of the amazing features of simulation is
the see the real life reaction of the
mannequins
Type of Models
• Active models: Attempt to reproduce living
anatomy or physiology such as palpations,
electrocardiography and auscultation
• Interactive models: Responds to interactions
taken by a user. This has the advantage of
allowing a student to make judgments or
errors. The process of iterative learning
through assessment, evaluation, decision
making and error correction
Types of Models
• Computer Simulators: Simulators have been
proposed as an ideal tool for assessment of
student for clinical skills
Simulation
Simulation
Wooden mechanical horse during
WW1
What Is a SimMan
• Human simulator
• Computer controlled manikin that displays
physiologic data, such as heart rate, blood
pressure, respirator rate and prerecorded
sounds.
• Supports clinical decision making activities
• Preset scenarios available and the ability to
generate scenarios
SimMan
• Computer driven
• It provides highly realistic training experience:
To master decision making
Patient care skills
Simulate team work
Features of the SimMan
• Interactive manikin that responds
physiologically to interventions
• Examples are:
Defibrillation
Airway system: Its anatomically realistic
airways systems allows practice of all types of
difficult airway management
Difference in heart sounds and breath sounds
SimMan
Allow practice of IV insertions
Life threatening emergencies can be
simulation through the injections of drugs and
fluids
Improvement in patient’s safety and outcomes
Decrease in errors
Best standards use for care and training
SimMan in Education
• Helps health the providers to “think on their
feet”
• Provides feedback as they practice
• Ability to witness how quickly a patient can
become unstable
• Realize how important the application of their
assessment skills and response time can
improve a patient’s outcome
SimMan in Education
• The ability to recognize deviations from
expected baselines
• Refocusing for skilled nurses in their
assessment techniques
Advantages
• Offers opportunities to practice rare and
critical events
• Can be manipulated
• Allows for updates of new medications and
new calibrations
• Scenarios can be reproduced
• Offers opportunities to make and learn from
mistakes
Advantages
• The use of simulation saves lives and money
by reducing medical errors, training time
• Allows for the nurse to practice on a variety of
patients
• Each patient can present with a different case
history and unique symptoms
• Responds to user action with appropriate
physiological responses
Advantages
• The system is able to generate detail
evaluation after each session which helps with
feed back and the debriefing process
Limitations/Disadvantages
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Not real
Limited realistic human interaction
Students may not take it seriously
It is costly
Must have trained educators
Must maintain trained technical support
Summary
• We can conclude that simulation training for
the new ED nurse will increase both
productivity and creativity
• It will create patient safety
• It will increased and build on the new nurse
confidence
• And will help with nurse retention and
decrease in nursing turnover
References
• Donohue, A J., Durbin, DR., Nadel, FM.,
Stryjewski, GR., Kost, SI., Nadkami, VM.
(2010). Perception of realism during mock
resuscitations by pediatric house staff: The
impact of simulated physical features (1) 16 –
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• Hoyt, RE., Sutton, M., Yoshihashi, A., Practical
Guide for the Healthcare Professional 3rd
edition, 2009
References
• MCGonigle, D., Mastrian, K., (200). Nursing
Informatics and the foundation of Knowledge
• Ruesseler, M., Weinlich, M., Muller, MP.,
Byhahn, C., Marzi, I., Walcher, F. (2010).
Simulation training improves ability to manage
medical emergencies. Emergency J. (10) 734 8.
References
• Sutton, RM., Niles, D., Meaney, PA., Aplenc, R.
(2010) “Booster” training: Evaluation of
instructor led bedside cardiopulmonary
resuscitation skill training and automated
corrective feedback to improve
cardiopulmonary resuscitation compliance of
Pediatric Basic Life Support providers during
stimulated cardiac arrest.
http://www.ncbi.nln.nih.gov/pubmed/206053
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References
• Thomas, F., Carpenter, J., Rhoades, C.,
Holleran, R., Snow, G. (2010). The usefulness
of design of experimentation in defining the
effect difficult airway factors and training have
on simulation oral tracheal intubation success
rate in novice intubators. Academy of
Emergency Medicine (4) 460 - 3
References
• Weidman, EK., Bell, G., Walsh, D., Small, S.,
Edelson, P. (2010). Assessing the impact of
immersive simulation on clinical performance
during actual in hospital cardiac arrest with
CPR sensing technology: A randomized
feasibility study.
http://www.ncbi.nlm.nih.gov/pubmed/20724
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