WEST VIRGINIA WESLEYAN COLLEGE SCHOOL OF NURSING

Student Simulation and Skills Lab Orientation Manual and Handbook

Revised 2015/SRB

SKILLS LABORATORY

The West Virginia Wesleyan College Skills Laboratory is located on the second physical floor of Middleton Hall. The Skills Lab is where you will be introduced to new skills, be expected to practice skills, and be evaluated on your skills. As you advance through the nursing program, you will spend time in the skills lab each semester. The nursing skills lab faculty and your course faculty will coordinate the nursing theory and clinical labs. Much of your success depends on how much time you dedicate to practice. You have the opportunity to practice independently, with your peers, with student lab assistants, and with faculty to help develop your skills. Currently there is no mandatory time requirements for practice. Therefore, it would be beneficial to include lab practice time into your weekly schedule. In the skills lab you will have the opportunity to overcome your own fears and insecurities while working with a variety of task trainers, manikins and hospital equipment. This allows you to learn and practice safely without the risk of causing harm to patients.

SKILLS LAB RESPONSIBILITIES AND GUIDELINES 1) The Nursing Skills lab is an extension of your clinical and academic programs. Therefore, all the same requirements for maintaining professional behaviors in both the clinical and academic settings apply. See your student nursing handbook for further detail on proper dress and behavior. 2) Respect lab personnel and equipment at all times. 3) Suggestion: Start a Skills Lab Notebook at the beginning of your nursing program. Organize all of your lab related information from each course for easy reference. 4) West Virginia Wesleyan College has adopted the use of the Elsevier Clinical Nursing Skills Collection. This is found in your Elsevier Evolve Account. It is mandatory for all students to purchase and use this reference material. Please familiarize yourself with the website and review the skills before attempting hands-on practice in the lab. www.evolve.elsevier.com 5) Review all Skills Lab Policies and Procedures in the Nursing Student Handbook, such as: Remediation, Absences, Skill Check-offs, and Competency Testing. 6) Please be reminded that West Virginia Wesleyan College School of Nursing holds its students to the highest standard and uses randomized drug testing. Students can be selected randomly during a semester, or be drug tested upon suspicion of drug use. Please see the Student Nursing Handbook for further detail. 7) Sign in and out of the lab at all times for both practicing and testing. Book is located inside the Skills lab on the bookshelf. (Blue Binder) 8) Please be mindful of supplies and create as little waste as possible. Save ALL supply pieces used and turn them into Director of Laboratories. Some supplies are reusable. 9) Do not move manikins or manikin parts without the help of lab personnel. 10) Do not use betadine (iodine) on manikins. 11) Make Course Faculty and Director of Laboratories aware of any latex allergies BEFORE scheduled lab times. 12) Use beds for practice and testing purposes only. 13) Individuals serving as patients are to remove their shoes when lying on the beds. 14) Report any malfunctioning, unsafe, or damaged equipment to the lab personnel via email. 15) Leave the Skills area tidy and trash free. Beds should be made, linens straight, personal trash removed when you leave. Page | 2

Student Skill Lab Assistants The School of Nursing strives to have the skills lab open as much as possible during the week to allow for student practice. These times will be posted after the beginning of the semester. Student assistants may be available to assist and guide you while you utilize the skills lab. These hours are called “Open Lab.” Please make sure to sign in and out of the lab. Please make sure to either print or bring your laptop to open the Elsevier Skill Checklist for the skill you are practicing. Remember, Lab assistants are NOT to do your work for you. They DO NOT have all the answers. Academic Integrity Violations of the principles of academic integrity can lead to dismissal from the School of Nursing. Forms of academic dishonesty include but are not necessarily limited to the following:    

Plagiarism – Submitting all or part of another’s work as one’s own in an academic exercise. Cheating – Using or attempting to use unauthorized materials on an examination or assignment. Facilitating Academic Dishonesty – Helping another to commit an act of dishonesty, such as substituting completing an assignment for someone else. Fabrication – Altering or transmitting, without authorization, academic information or records.

Nursing Skills Lab Academic Dishonesty:       

Utilizing unauthorized materials Changing Skills Laboratory Stations Altering sign-in forms without approval Assisting others during a competency Utilizing unauthorized calculators Utilizing unauthorized resources during competency Falsifying time spent in the Lab.

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Skills Taught It is at the discretion of the Course Faculty to decide which skills the students will cover hands on in the lab versus review via video and demonstrate in the clinical setting. The following is a list of skills and the course in which they are taught. Many skills are reinforced in several different courses, and students must be mindful that the nursing curriculum is cumulative from semester to semester. This list is also just to be thought of as a general guideline and may be altered by course instructors when needed. Nursing 220 Basic Hygiene  Bath: Shaving, Bedbath, Tub/Shower Bathing  Bedmaking  Bed positions/Specialty Bed/Mattress  Skin care, Nail and Foot Care  Oral/Denture Care: Conscious and Unconscious  Eyeglass/Hearing Aid Care  Back Massage  Incontinence Care  Urostomy/Colostomy Maintenance Standard Precautions  OHFLAC Long-term Care Standards  Handwashing  Clean Technique  PPE Use  Isolation Procedures Air/Food/Water  Feeding: Assist and Complete  Body Height and Weight  Oxygenation: IS & Cough/DB  Anti- Embolism Hose/SCD’s Elimination  Intake and Output  Bedpan/Urinal/ Foley Care  Specimen Collection: Urine/Stool  Enemas  Ostomy Bag changes and site care Safety/Activity/Rest  Bed Mechanics  Restraints/Protective Devices  Transfer Activities/Technique/Devices  Positioning/Turning: Abductor Pillows  ROM  Bed Cradles  Hoyer Lifts  Abuse: Recognition/Prevention Drugs and Solutions  Beginning theory of Drug Administration. Oral, topical, transdermal, rectal, optho, oto, vaginal, inhalations.  Oxygen Safety Nursing 222 Adult Physical Assessment  Evidence-based assessment (Nursing process)  Cultural competence  The interview/Health history  Mental Status assessment  Substance abuse, domestic violence assessments  Techniques=inspection, palpation ,percussion, auscultation

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Vital Signs/Pain/Nutrition Assessments Skin/Hair/Nails Assessments Head/Face/Neck/Eye Assessments Ear/Nose/Mouth/Throat Assessments Lymphatic/Breast Assessments Lung/Heart Assessments Peripheral Vascular Assessments Abdominal/Musculoskeletal Assessments Neurological Assessments Reproductive Assessments

Nursing 250  Pediatric medication calculations: Conversations/Safe dose  Pediatric Physical Assessments and Measurements  Immunizations  Growth and Development (6wk of age and up)  Pediatric Pain Assessment  Pediatric Fever Management  Pediatric Admission Procedures  Laboratory Testing and Range Values  Seizure Management  Pediatric Standards: Restraints, Cardiac Monitoring, Apnea Monitoring, Chest PT, Positioning, Specimen Collection, Lumbar Puncture, Isolation, Cast Care  Glucose Monitoring  Insulin Administration  Subcutaneous and Intradermal medication administration  Specimen Collection Nursing 310  Focused Assessment of the family  Antepartum Assessment  Focused Health Assessments  Childbirth education classes  Fetal Monitoring, NST, CST  Labor Monitoring Standards and Interventions  Concepts of Newborn Resuscitation Standards  Newborn Care  Newborn assessments  Gestational Age Assessment  Breastfeeding Assistance  Postpartum Assessments and care: Sitz bath, laceration care, hemorrhoid care, Breast Care, Emotional Support  Fundal Massage and hemorrhage control methods  Phototherapy  Pertinent Laboratory Values  Neonatal Glucose monitoring procedures  Transcutaneous Bili and Cardiac Testing Procedures  Newborn Hearing Screen  Post Cesarean Surgical Care Nursing 320  Neurological Assessments  Medication Administration Standards and Procedures  Therapeutic Communication Skills  Dysfunctional Group/Process/Communication  Client management techniques: Escalation  ECT care and Management  Aberrant Drug Use Behavior Management  Adolescent Suicide Risk Assessment and Precautions  Agitation and Disturbed Behaviors Prevention  Alcohol Withdrawal

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Anger Diffusion Assessment: Mental Status Assessment: Self-Harm and Aggression Assessment: Self-Harm and Aggression in Adolescent Patients Assessment: Suicide Risk Cognitive Stimulation Consent, Capacity, and Competency Issues Crisis Intervention De-escalation Elopement Family Education: Mental Illness Flashback Management Group Work Inappropriate Behavior Management Limit Setting Mental Health Issues Secondary to Medical Problems Mental Health Problems in Acute Care Patients Psychiatric Medications: Monitoring Effectiveness Psychiatric Medications: Recognizing Adverse Effects Quiet Room Rapport and Alliance Seclusion for Assaultive and Violent Behavior Management Staff-Splitting Patient Behavior Management Suicide Precautions Support Systems Trauma-Related Patient Management

Medical Surgical 330  Urinary Catheterization  Continuous Bladder Irrigation  Gastric Suctioning Techniques  Nasogastric Tube Placement  Enteral Nutrition  Wound Assessment  Dressing Techniques and Wound Vac. concepts  IM and IV Medication administration  IV pump use and troubleshooting  Medication Calculations pertinent to course content  Intravenous Fluid use and management  Sterile Field Techniques, surgical gowning  PCAs and related Care  02 devices  Pre, Post and Perioperative Care  Pertinent Lab Ranges and Values. Medical Surgical 340  Tracheal site care and suctioning, NT suctioning  Chest Tube Drainage systems  Transfer of immobilized patients, hip fractures, traction  Amputation care  Ostomy wafer changes and site care.  TPN administration  Central Line Dressing Change

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Community Health – 440  Assessment of Home Safety and Risk  Community Resource allocation and community assessment  Infectious Control Practices in Home Health Agencies  Assessment of Family Network and resources  Hospice Care  End of Life Care Critical Care - 455  ER Skills, defibrillator use  Emergency Medication Administration and Calculation  Care of Advanced Airways  Central Line Care  IV insertion and site care  Venipuncture  Arrhythmia care  Cardiac Monitoring  Ventilator and Aerosol Treatments  Hemodialysis  Hemodynamic Monitoring  Peritoneal Dialysis  CCRT  Care of patients with pacemakers and implanted defibrillators Leadership  Verifying and Implement Orders Safely  Giving and Receiving Report  Delegation and Supervision

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NAYLOR SIMULATION LABORATORY Welcome to the WVWC School of Nursing Simulation Lab. The lab was established in 2010 through a generous donation from the Howard D Naylor and Audrey Holden Naylor Family Fund. Both are WVWC alumni. Simulation-based education has become a part of healthcare educational programs across the United States, and other countries as well. Simulation provides a clinical learning environment using high-fidelity manikins and equipment. Students are introduced to a “scenario” that mimics a real patient situation (ex: asthma attack). Students respond using the level of clinical judgment that is appropriate for their place in the curriculum. After the scenario is over, students and faculty leave the area for a debriefing session. This is a time of reflection, and self-evaluation. The debriefing is always guided by a faculty member in a controlled environment immediately after the experience. After debriefing, the students will fill out an evaluation related to the simulation and their learning as well as completing an evaluation of the environment. The benefits of simulation include, but are not limited to, allowing the student to apply theories learned in the classroom and tasks learned and practiced in the skills lab. It is an attempt to allow students to use critical thinking and to practice clinical reasoning skills. It is not intended to replace the skills lab experience or the experience of caring for clients in a real healthcare setting. The lab here at WVWC utilizes several different high fidelity simulators. The CAE Metiman manikins are fully wireless with on-board fluid, pneumatic and electrical systems and is built tough to withstand a wide variety of real-life situations. It comes with extensive clinical features and capabilities designed specifically for nurses and emergency medical personnel. The simulator can be placed on a bed, on the ground or even in a vehicle. It can also be seated in an upright position (see cover picture). Our lab is also now equipped with a CAE BabySim, an interactive mannequin utilized for pediatric simulations, and CAE Lucina, a labor and delivery simulation model with neonate. Both additions promise to provide exciting educational opportunities for our students. In addition we will be welcoming “Hal,” a pediatric simulator with the body of a 7 year old child in fall of 2015. This is a product of the Gaumard Scientific Company. This new addition will allow even more realistic pediatric simulations for our students.

Revised 2015/SRB Page | 8

Guidelines for Simulation Lab Clinical Learners are expected to come to lab prepared and ready to participate. This can be accomplished by reviewing the lab objectives and completing the assignments prior to the scheduled lab. Faculty are responsible for submitting the objectives and assignments to the student prior to the sim lab experience. Students and faculty are to wear their clinical attire (as outlined in the Student Nurse Handbook). Students will bring standard equipment unless otherwise directed by their simulation clinical faculty. The students will be simulating the role of a licensed professional nurse, unless otherwise directed. Because of the high fidelity of the equipment in the lab, and the volume of students that will be utilizing the lab, it is necessary to adhere to the following general guidelines while in the lab. Also, in order to maintain realism, the manikins will be treated like “a real person”. Agreeing to the “fictional contract” is essential to learning success in the Simulation Laboratory. PLEASE LET THE CLINICAL INSTRUCTOR KNOW IF YOU ARE ALLERGIC TO LATEX. We attempt to provide a latex free environment, however, some parts of the manikin may contain small amounts of latex in their design.  

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Universal precautions will be implemented. HIPAA rules apply (learners should not share details and activities with learners who have not participated in the simulation experience except in faculty led conferences; students will be asked to sign a confidentiality statement prior to the sim experience ) During the simulation, learners must inform the computer operator of certain tasks they are completing so the operator can program the correct response (ex: “I am placing nitroglycerin under the tongue”). This should be relayed loudly and clearly. No food or drink is permitted in the Simulations area. Ink pens will stain the manikins. No ink pens near the manikins. Please bring a pencil and notebook. Only “manikin lubricating gel” will be used on the manikins (no betadine, iodine) Manikins are considered “real” patients and are to be treated with respect. All electronic devices (anything with an on/off switch) are to be turned off during simulation unless approved by faculty. Students should report any non-functioning equipment to the faculty. To maximize the learning experience, conversation and discussion will be limited to the simulation experience and related nursing topics. IF E UNABLE TO ATTEND ASSIGNED SIMULATION EXPERIENCE, please call or email simulation clinical faculty (contact information will be provided during orientation) Students will engage in and participate in the scenarios as a professional and treat simulation as a realistic patient care experience. Only persons authorized and crucial to the simulation experience are permitted in the Sim Lab and control room (i.e. nursing students, student actors, adult actors or any other authorized observers). Please realize that the manikins will speak, eyes will blink, and they will have realistic breathing movements. This can cause anxiety in certain individuals with diagnosed phobias. Students are responsible for informing the Director of Simulation prior to their scheduled simulation date if they believe they are not able to participate.

Revised August/2012; DP//Revised 2013/RDP: 2015 SRB Page | 9

QSEN

Students, please take time to review the QSEN competencies. You should strive to uphold them at all times in your profession. Quality and Safety Education for Nurses Competency Patient-Centered Care

Definition with Examples

Teamwork and Collaboration

Function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care. Examples: Recognize the contributions of other health team members and patient’s family members. Discuss effective strategies for communicating and resolving conflict. Participate in designing methods to support effective teamwork.

Evidence-Based Practice

Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. Examples: Demonstrate knowledge of basic scientific methods. Appreciate strengths and weaknesses of scientific bases for practice. Appreciate the importance of regularly reading relevant journals.

Quality Improvement

Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems. Examples: Use tools such as flow charts and diagrams to make process of care explicit. Appreciate how unwanted variation in outcomes affects care. Identify gaps between local and best practices.

Safety

Minimize risk of harm to patients and providers through both system effectiveness and individual performance. Examples: Examine human factors and basic safety design principles and commonly used unsafe practices. Value own role in preventing errors.

Informatics

Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making. Examples: Navigate an electronic health record. Protect confidentiality of protected health information in electronic health records.

Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs. Examples: Involve family and friends in care. Elicit patient values and preferences. Provide care with respect for diversity of the human experience.

2013 RDP Page | 10

WEST VIRGINIA WESLEYAN COLLEGE SCHOOL OF NURSING CONFIDENTIALITY AGREEMENT Dear Student, The WVWC School of Nursing supports HIPAA. HIPAA is binding to all members of the school community. This includes the Clinical Simulation Lab (CSL). Students are expected to keep all events, procedures, and information used in conjunction with the CSL strictly confidential. This includes patient history information obtained prior to the actual simulation Experience, as well as information obtained and used in the pre and post conferences. During your participation in a simulated clinical experience (SCE), you will be both an active participant in simulated scenarios and an observer. By signing this agreement, you agree to maintain strict confidentiality regarding both yours and others’ performance, whether seen in real time, on video or otherwise communicated to you. Failure to maintain confidentiality could result in a failing grade for the course and/or dismissal from the program. You will be discussing the scenarios during debriefing, however “All that takes place in the simulation environment stays in the simulation environment!” Due to copyrights, and to maintain optimal simulation experiences for the other learners who will be following, students must maintain strict confidentiality regarding the specific scenarios, as well as what happened during the simulation experience. _____ I agree to maintain strict confidentiality about the details of the scenarios, participants, and performance of any participants.

___________________________________ Signature

_______________________ Date

___________________________________ Witness

_______________________ Date

Revised 2013/RDP Reviewed 2015/SRB Page | 11

WEST VIRGINIA WESLEYAN COLLEGE SCHOOL OF NURSING CLINICAL SIMULATION LAB PHOTOGRAPHY AND PUBLICATION RELEASE I, (please print your name) _________________________________________________________________________ give West Virginia Wesleyan College of Buckhannon, WV the absolute right and permission to use my photograph. I understand that the photographs may be used in publications, print ads, and direct-mail pieces, electronic media (e.g. video, CD-ROM, Internet), or other forms of promotion. I release the College, the photographer, their offices, employees, agents and designees from liability for any violation of any personal or proprietary right I may have in connection with such use. I am 18 years of age. I, _________________________________________________________________________ have read the above statement and understand. I agree to give West Virginia Wesleyan College permission to record and/or photograph my performance in the CSL for primarily teaching purposes. _____ I authorize the School of Nursing staff/faculty to video record my performance during clinical simulation experienced (CSE). _____ I authorize the WVWC SON staff/faculty to use the video recording(s) for purposes including, but not limited to: debriefing, faculty review, educational, research, public relations, advertisement.

___________________________________ Signature

_______________________ Date

___________________________________ Printed name of student

Revised 2013/RDP Reviewed 2015/SRB Page | 12

THEORETICAL FRAMEWORK FOR NURSING EDUCATION SIMULATION     

Teacher factors: act as a facilitator and evaluator Student factors: accountable for own learning, need to be self-directed and motivated Educational practices: address active learning, diverse learning styles, collaboration, and high expectations Simulation design: incorporates objectives, high fidelity, problem solving, student support, and reflective thinking (debriefing) Expected student outcomes: knowledge, skill, critical thinking, confidence, learners satisfaction

Jeffries, Pamela R. (ED) (2007). Simulation in Nursing Education: From Conceptualization to Evaluation. National League of Nursing, 21-33.

STANDARDS OF PRACTICE West Virginia Wesleyan College strives to uphold the INACSL Standards of Simulation as outlined in the Journal of Clinical Simulation in Nursing (2013) 9, Sii-Siii. These 7 standards include: Standard I-Terminology, Standard II – Professional Integrity of Participants, Standard III – Participants Objectives, Standard IV – Facilitation, Standard V – Facilitator, Standard VI – The Debriefing Process and Standard VII – Participant Assessment and Evaluation. Meakin, C., Boese, T., Decker, S., Franklin, A.E., Gloe, D., Lioce, L., Sando, C.R., & Borum, J.C. et al., (2013, June). Standards of Best Practice: Simulation Standard I-VII: Clinical Simulation in Nursing 9 (6s), S3-S32. http://dx.doi.org/10.1016/j.ecns.2013.04.001.

Mission of the School of Nursing The mission of the School of Nursing is to provide accessible, high quality nursing education to a diverse group of undergraduate and graduate students, preparing them to be reflective healthcare leaders and scholars able to respond to the growing complexity in the healthcare system. This mission will be accomplished by offering innovative, nursing education programs that meet the needs of society and incorporate best-practice evidence and contemporary nursing science. Beliefs fundamental to the mission and the development and arrangement of the curriculum include an understanding of the fundamental dignity of human beings, the essence of nursing as science, art and service to humanity informed by the caring nature of the discipline, the perspective of health as a dynamic entity varying with time and life circumstances, and the lifelong process of education. Undergraduate and graduate study in nursing prepares women and men to promote human thriving in the care of diverse persons through culturally-sensitive, evidence-based practice, informed by an awareness of the unique meanings associated with knowledge, language and behavior.

2013 RDP Revised 2015 SRB

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Program Goals: Graduates of the program will: 1.

Demonstrate reflection and scholarly inquiry that exemplifies critical, creative thinking with the skills necessary to transform knowledge into evidence-based practice.

2. Possess the necessary knowledge and skill to manage human, fiscal, legal and regulatory processes as well as healthcare resources to improve nursing practice, education and nursing administration. 3. Use patient care technologies, information systems, communication processes and inter-professional collaboration in the provision of safe, efficient and effective nursing practice. 4. Assume the Baccalaureate Generalist role or the Master’s Level Advanced Practice role, demonstrating respect for the dignity and uniqueness of others, sensitivity to diversity and global health issues, and a commitment to providing excellent, evidence-based nursing care.

Student Learning Outcomes (Program Level) – BSN 1.

Translating and Integrating Scholarship into Practice: Integrate evidence, clinical judgment, inter-professional

perspective and patient preference in planning, implementing and evaluating outcomes of care. 2.

Background for Practice: Integrate theories and concepts from liberal education to build an understanding of the

human experience. 3.

Organizational and Systems Leadership; Quality Improvement and Safety: Use leadership skills and knowledge of healthcare to advance high quality, safe professional practice.

4.

Health Policy and Advocacy: Demonstrate basic knowledge of healthcare policy, financing, and regulatory

environments. 5.

Informatics and Healthcare Technologies: Manage information and technology to deliver quality patient care in a

variety of settings. 6.

Interprofessional Collaboration for Improving Patient and Population Health Outcomes: Demonstrate effective inter-

professional communication and collaboration to provide quality, patient-centered care. 7.

Baccalaureate Generalist Nursing Practice: Demonstrate evolving competence in professional role within a dynamic,

multicultural, global society. 8.

Clinical Prevention and Population Health for Improving Health: Assess protective and predictive factors that

influence the health of individuals, families, groups and populations. 9.

Advancing Professionalism and Professional Values: Demonstrate the professional standards of moral, ethical and

legal conduct.

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Student Learning Outcomes (Program Level) - MSN 1.

Translating and Integrating Scholarship into Practice: Integrate theory, evidence, clinical judgment, research and

inter-professional perspectives using translational processes to improve practice and associated health outcomes for patients. 2.

Background for Practice from Sciences and Humanities: Synthesize nursing science with knowledge from ethics,

biophysical, psychosocial, analytical, public health and organizational sciences to design advanced nursing care for diverse populations. 3.

Organizational and System Leadership; Quality Improvement and Safety: Operationalize safe, quality health care

services, applying leadership skills and ethical decision-making in the provision of culturally-responsive high quality nursing care. 4.

Health Policy and Advocacy: Analyze the impact of health policies on the structure and financing of health care,

healthcare practices and healthcare outcomes. 5.

Informatics and Healthcare Technologies: Analyze current and emerging technologies and develop strategies to

support safe practice environments and reduce risk while optimizing patient safety, cost-effectiveness and health outcomes. 6.

Interprofessional Collaboration for Improving Patient and Population Health Outcomes: Employ collaborative

strategies and leadership skills with intra-professional and inter-professional teams in the design, coordination, and evaluation of patient-centered care. 7.

Clinical Prevention and Population Health for Improving Health: Using culturally sensitive approaches, conduct a

comprehensive and systematic assessment of health and illness parameters in a complex situation. 8.

Master’s-Level Nursing Practice: Synthesize concepts including ecological, global and social determinants of

health, principles of genetics and genomics, and epidemiologic data to design, deliver and evaluate culturally relevant clinical interventions and strategies.

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Student Orientation and Preparation for Simulation

Within the first 2 weeks of the Fall Semester, a student focused open house will be held in the Simulation Lab. Students are responsible for attending this open house. During this time students will be offered hands-on opportunities to see the mannikans operating. Students will also have an opportunity to familarize themselves with the lab equipment. After the initial open house students will be responsible for scheduling further explorations in the lab with the Simulation Director. It is highly recommended that all entering sophomore students attend the open house, but all students are welcome. Notification of the date and time will be via electronic communication to the students at least 1 week prior to the event.

Students will be scheduled for course simulations by their theory professor. Simulation Faculty will strive to provide flexible hours for students, but the student must realize that their scheduled simulation is to be treated as a scheduled clinical. If they are unable to attend, they must notify the Director of Simulation in advance and must provide a sports excuse from their coach or a sick note from their care provider. Immediate family deaths will also be excused, but the student will need to speak with the Director of Simulation about required documentation.

Before a scheduled simulation, a preparation assignment will be given to the student. This assignment must be completed and return to the Simulation Faculty as their “ticket” to attend simulation. The student should arrive to the Simulation floor 15-20 minutes prior to their assigned time. This allows the student time to mentally prepare themselves with their team before entering the simulation. The Simulation Faculty will walk students through a “prebriefing” session. This prebriefing will include equipment updates, simulation objectives, and a review of the presimulation assignments. After prebriefing the students will receive report on their client and assume care. Once the simulation begins, it will not be disturbed until students have had enough time to complete the assigned objectives. In certain scenarios students may be asked to assume certain roles. The students are to remain in role until the completion of the scenario.

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During the Simulation

West Virginia Wesleyan College strives to provide students with realistic client encounters. This means that both the simulators and the simulation equipment is utilized regularly in the lab. Students are to speak and physically work with the simulation mannikans and equipments as they would in the “real world” clinical setting. While working in the simulation lab, students are to use the equipment to full function. For example, the client has been ordered by her care provider a breathing treatment and oxygen therapy. The student will: 1) Review the physicians orders in the Electronic Health Record (EHR) 2) Obtain the medication from the electronic medication cart 3) Safely and appropriately administer the medication to the client 4) Turn on the oxygen system 5) Apply the correct oxygen delivery system and regulate the oxygen flow 6) Question the clients comfort and provide therapuetic communication to the client. 7) Document all care given in the EHR As you can see it is essential that the students famalirize themselves with the equipment before entering the lab. When the simulation is completed, the control operator will announce on the overhead announcement system that the simulation has ended and provided further instruction for the students. Debriefing Debriefing is considered the most essentail part of the simulation experience. During debriefing the students will reflect on their teams performance during the simulation scenario. They may or may not watch a video of their perfromance. Debriefing can be emotional in certain situations. At all times the debriefing area is a professional “safe” area, meaning that students can share their thoughts and ideas without fear of humilation. Please be aware that at times the faculty may use constructive criticism to help guide student learning. However, students are not to be critical of their teammates, and are to view the scenario as a “team” approach with the performance of the whole more important than individual review. Documentation Expectations and Post Simulation Work During your simulation you will chart all care provided in your Elsevier Evolve SimChart. You are to document all care given by your team. Anything completed physically with the patient but not documented will be considered not completed. Under miscellanous nurses notes you are to also write a narrative nurses note for all care performed. This is to help you evolve your professional language and documentation etiquette. Always document professionally using proper medical terminology. Never place blame in a nurses note. All communication with providers must have a SimChart logged SBAR sheet. After Simulation a care map is to be turned in to the Simulation Director within 72 hours. Students are responsible for watching the SimChart tutoring videos on the Evolve website on their own time, and for talking with Elsevier Support if issues arise.

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Evaluation of the Simulation Simulation is considered a clinical day and is graded as pass/fail. To earn a passing grade, the student must: 

Follow the previously listed rules of the lab.

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All presimulation and post simulation work is to be completed on time.

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The student is to be respectful and courteous at all times.

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The student will perform all duties in the lab to the best of his/her ability.

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The student will fully participate in all debriefing activities

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If the course instructor has arranged additional acitivies, the student will fully participate to the best of their ability.

During the simulation, the faculty members responsible for observing the simulation will have checklists to ensure that the students are completing all needed tasks. For skills observations, the skills checklists from the Elsevier Evolve Skills for Nursing Collections. The faculty will also fill out the following performance evaluation.

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Simulation Experience Rubric West Virginia Wesleyan College

Student Name: _________________________________________________________________ Attributes/Skill

Accuracy, safety, and skillfulness in complete care

Communication

Excellent

Good

Needs Improvement

Performs ALL Critical Elements and ALL Learner Performance Measures, level appropriate HIPPA, side rails/call light, patient and room cleanliness, identifies patient at each encounter, full assessment, comfort measures performed. Performs ALL Critical Elements and ALL Learner Performance Measures. Speaks to patient and family members calmly and completely, speaks professionally with physician and members of all healthcare team. Uses SBAR

Performs MOST Critical elements and MOST Learner Performance Measures, level appropriate HIPPA, side rails/call light, patient and room cleanliness, identifies at least once, partial assessment

Performs minimal actions or misses critical elements: HIPPA, side rails/call light. Assessment attempted, not completed or inaccurate

Performs MOST Critical elements and MOST Learner Performance Measures. Speaks to patient and family professionally and with physician and members of all healthcare team. Partial SBAR report attempted Performs MOST Critical elements and MOST Learner Performance Measures. Follows some rights of medication administration, administer and follow up per institution protocol. Any errors are not life threatening. Performs MOST Critical elements and MOST Learner Performance Measures. Offers to assist classmates with tasks after prompting. Communicates with group minimally. Performs MOST Critical elements and MOST Learner Performance Measures. Arrives in clinical uniform, pressed and clean. Only 1 missing piece of equipment. Punctual to clinical site.

Performs minimal actions or misses critical elements: Follows institution policy for answering phone or electronic communications. SBAR not utilized, poor report.

fully

Medications

Teamwork

Professionalism

Performs ALL Critical Elements and ALL Learner Performance Measures. Gathers all necessary supplies, follows 6 rights of medication administration, administer and follow up per institution protocol. No medication errors Performs ALL Critical Elements and ALL Learner Performance Measures. Offers to assist classmates with tasks. Good communication.

Performs ALL Critical Elements and ALL Learner Performance Measures. Arrives in clinical uniform. Has all equipment and is in working order. Has pleasant disposition. Accepts constructive criticism. Follows institution policies. Punctual to simulation.

Essential Observations Checklist

Performs minimal actions or misses critical elements: No or very poor attempt to follow 6 rights of medication administration. Unsafe administration.

Performs minimal actions or misses one or more critical elements. No teamwork or very poor teamwork. Poor communication or team blaming. Performs minimal actions or misses critical elements: Tardy, incomplete uniform. Unapproachable. Has some equipment, not all equipment functional. May appear sloppy.

Comment Area:

Washed hands appropriately _____ Greeted Patient and used 2 identifiers_____ Used side rails appropriately _____ Lifted Bed to working height_______ Did not worked over side rails _______ Did not contaminate medications (if applicable) ____ Safely donned and removed gloves_____ Did not contaminate hallway or nursing desk______ Administered safe dosages of medications______ Explained all procedures to patient________ Safety check of room, call bell and bedside stand in reach_______ Lowered bed before leaving room______

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Overall Performance: Excellent_________ Good__________ Needs Improvement_________ Simulation Topic/Course: _______________________________________________________________ Notes:

Simulation Observer Signature: ___________________________________________________________

Student Comment area if needed:

Student Signature: ___________________________________________________________________________

FOR INSTRUCTOR USE AFTER SIMULATION: All Simulation documentation received and meets standards? ________________________________________ Care map completed and is adequate? ___________________________________________________________ If applicable, remediation scheduled and completed? _______________________________________________ Further comments if needed:

Signature: _________________________________________________________________________________

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Care Map Rubric Care maps help to make clinical experiences better by allowing you to organize and prioritize your care. The following rubric will be used when looking at your simulation care map.

Care Map Grading Rubric Criteria

Met/ Not Met

Uses NANDA approved Nursing Diagnosis Uses 3 part Nursing Diagnosis Goal is present and complete, measureable Interventions are tailored to the patient and not generic. Incorporates current Laboratory findings and medications into map Expected Outcomes are direct results of proposed interventions Center of Map provides adequate information about the patient Links are used to show connections between (if applicable):  Interventions that assist with more than one diagnosis  Medications to diagnosis  Medications to diagnostic tests  Interventions that relate to other interventions  Diagnostic test to nursing diagnosis.

If more than 2 criteria are not met, student will receive an unsatisfactory grade for the assignment, and the work will be submitted to the course coordinator for further discussion. If an item is not met, the student may be asked to redo the map to meet the satisfactory criteria. If a student finds themselves struggling with care maps, a recommended text is: Wittman-Price, R. A., Thompson, B., Sutton, S. & Eskew, S. (2012). Nursing concepts care maps for safe patient care. Philadelphia: F. A. Davis. Please refer to the following example. Be mindful that this is a simple example, and you may be asked to add more to your assignment.

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Nrg Dx: 1 – Decreased Cardiac Impairment R/T Congestive Heart failure AEB Shortness of breath, swelling of the extremities, fluid overload Goal: Resident will maintain a pulse oximetry reading of >89% on 2L O2 via N/C for next 24 hours.

Interventions: 1) 2) 3) 4)

Oxygen at 2L via N/C on at all times Daily weight. Report if weight gain of 2 pounds Lasix 20 mg p.o. bid Vital Signs daily. Report Abnormal Results

Ordered Labs and Diagnostic Tests

Interventions

E.M. 88 yo Fe Cauc. Widowed, Methodist, MPOA Daughter. No Code. Former Police Officer. Has 3 children. Lives alone. Smoker. No Drugs. No alcohol

Interventions

Med DX: CHF Nrg Dx 2

Diabetes Hypertension

Nrg Dx 3

Goal

Goal

Pre-Simulation Worksheet Before each Simulation the students will be presented with a topic area. Once they are aware of the topic area, the students are to fill out and submit the following form to help them prepare themselves for the simulation: Please note the plagiarism of any form will make you receive an automatic unsatisfactory for the simulation. Please cite all sources using APA format both with in work and end citations. All work is checked for plagiarism.

Student Name: _______________________________________________________________ Date: _________________ Topic Area: ________________________________________________________________________________________ Pathophysiology of condition:

Physical/Clinical Manifestations (symptoms) of condition:

What laboratory assessments and diagnostic tests are often ordered for this condition? Why?

Name 3 medications that are often prescribed for this condition. What action does this medication cause in the body and how does it work? List most common side effects from the medication.

What are your 3 priority education topics for the client and the family? Explain why.

Please list 3 priority (in order of priority) Nursing Diagnosis for this condition and explain why you picked those 3 diagnosis.

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Remediation West Virginia Wesleyan College School of Nursing has chosen to utilize their lab as a formative tool for improvement. Students are observed and evaluated to help them improve their skills or to further refine them. Students will be given their evaluation rubric to review after the simulation. This rubric is to be given back to the instructor BEFORE the student leaves the simulation area. Remediation of a skill may be assigned and this may be in the form of a skills tutoring session in the lab, or a written assignment. This remediation can only be rescheduled ONE time. If the student fails to complete the remediation, the simulation will be considered an unsatisfactory clinical day. Cases of extreme circumstances will be reviewed on an individual basis. Sickness If the students finds themselves to be too ill to participate in simulation, they must contact faculty prior to the simulation experience. An excuse from the campus Health Center or selected health care provider must be provided upon return. They are to notify the Simulation Director that they will be absent BEFORE the simulation. The best way to protect the population from illness is by prevention of the spread of the virus or bacteria. The following is a list of symptoms that warrant approval from a health care provider to attend simulation: Fever, more than one episode of diarrhea, active vomiting, draining wounds, burns, and rashes that appears shiny or are of unknown origin. Chain of Command Please feel free to contact the Director of Simulation if you have a question, comment, or concern. The best way to schedule a meeting is via e-mail. Please allow 24 business hours for a response. The current Director if Simulation is Shannon Bosley MSN, RN. Email [email protected]. Extension 8221. If further assistance is needed, the WVWC School of Nursing Chain of Command will be implemented according to the student handbook.

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