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College of Nursing Critical Care Nursing

2011

Critical Care Skills Laboratory

Prepared By Dr. Radwa Hamdi

Assistant Professor of Critical Care College of Nursing

University of Dammam

2015

UNIVERSITY OF DAMMAM COLLEGE OF NURSING

CRITICAL CARE NURSING SKILLS & SIMULATION LAB

1. OBJECTIVES

2. STUDENT CODE OF CONDUCT

3. SCHEDULES

4. LIST OF PROCEDURES

5. DOCUMENTS

6. WORKSHOPS AND TRAINING

7. CHECKLISTS

8. SIMULATION

9. INVENTORIES



Critical Care skills Laboratory

Objectives The critical care laboratory in the college of nursing is a fully equipped state-of-the-art

laboratory designed to recreate the atmosphere of the critical care unit, the latest in

laboratory and simulation technology such as high fidelity human patient simulators,

digitalized video, bedside computer charting, and electronic supply and static mannequins

are all included within the lab. The lab also provides a space for debriefing and reflective

thinking exercises that allow the students time to review their decisions and actions with

the instructor and their classmates.

Mission:

Preparing graduate nurses qualified for caring for critically ill patients according to the

universal standards of nursing practice.

Objectives:

x Enhance learning using simulation technology and related resources.

x Provide educational materials for students, faculty, and staff.

x Provide hands-on learning experiences specific to critical care nursing course

objectives as directed by the nursing curriculum.

x Provide a safe environment for students to practice critical care nursing skills

x Bridge the gap between theoretical learning and clinical training

x Encourage independent student learning opportunities

x Integrate Clinical Simulation into critical care Nursing curriculum

x Increase preparedness of nursing students before introduction to hospital training

x Introduce physiology/ pharmacology/health assessment, etc. into cases critical care

students

x Increase preparedness for dealing with high acuity and critical cases

x Enhance communication skills

x Demonstrate the value of team-work and collaboration



RESPONSIBILITIES AND CONDUCT OF STUDENTS IN

CLINICAL SIMULATION LAB

� Review the skills to be practiced and/or demonstrated as well as having read the assigned chapters by your instructor prior to lab attendance.

� Gather and return the equipment used for skill performance.

� Inform instructor when unable to locate equipment, supplies or resources

� Approach situations and scenarios as if they are actual patient interactions

� Handle simulators and equipment with care and respect

� Follow safety measures at all times

� Maintain cleanliness of the area

� Dispose of sharps appropriately

� Demonstrate respect and consideration for self and others.

� All students should display professional conduct.

� Allow others the opportunity to practice

� Alert the instructor of allergies including latex

� Inform instructor if supplies are running low.

� Any damage or malfunction of mannequins or equipment should be reported to the lab faculty immediately.

� Inform the instructor of any particular learning needs.



Clinical Master in Critical Care Nursing Second Semester Schedule

Critical Care Nursing

ACADEMIC YEAR 2015-2016

Date / Time

8-10 10-12 12-12:30

12:30-2:30

Sunday

Clinical (Hospital) Dr. Radwa H. Bakr Dr. Fatma Mokabel Dr. Omnia H.Salem Dr. Rima Algarni

Pr

ayer

Tim

e

Clinical (Hospital) Dr. Radwa H. Bakr Dr. Fatma Mokabel Dr. Omnia H.Salem Dr. Rima Algarni

Monday

Tuesday

Wednesday Advanced Health

Assessment Dr. Radwa H. Bakr*

Dr. Abeer Ali Dr. Rima Algarni

Applied Pharmacology

Dr. Fawzia Noshine*

Advanced Health Assessment

Dr. Radwa H. Bakr* Dr. Abeer Ali

Dr. Rima Algarni

Thursday Critical Care Nursing I Dr. Fatma Mokabel* Dr. Radwa H. Bakr Dr. Omnia H.Salem Dr. Rima Algarni

Pathophysiology of critical illness

Dr. Omnia H.Salem* Dr. Fatma Mokabel

* Course Coordinator

Program Coordinator Dr. Radwa Hamdi



MASTER OF SCIENCE IN CRITICAL CARE NURSING

LABORATORY ROTATION SECOND SEMESTER

ACADEMIC YEAR 2015- 2016

Date Activity Staff member

1st week

Saturday Examination of the

critically ill patient : simulated clinical experience

Dr. Radwa Hamdi

Sunday Vascular access

Dr. Radwa Hamdi

Monday Clinical skills revision : ECG, ABG, XRAY, redominstration and screening

Dr. Radwa Hamdi

2nd week

Saturday Assessment of the trauma patient : simulated clinical experience

Dr. Radwa Hamdi

Sunday NGT insertion , gavage, lavage , feeding

Dr. Radwa Hamdi

Monday Tracheal suctioning Insertion of an indwelling catheter

Dr. Radwa Hamdi

Program Coordinator

Dr. Radwa Hamdi



CRITICAL CARE NURSING POSTGRADUATE COURSES

Course Simulated clinical

experience (SCE)

Objectives Duration Logistics

CRITICAL CARE NURSING

Care of the patient who develops cardiopulmonary resuscitation ACLS protocols

- Recognizes and responds appropriately to a crisis situation - Correctly identifies cardiopulmonary arrest , calls for help and responds to the code leader’s orders for interventions - Adheres to ACLS protocols and algorithms - Correctly administers cardiovascular medications - Correctly defibrillates the patient using safety precautions - Documents interventions and the patient’s response

Six

sessions

Critical

Care Lab II

ADVANCED HEALTH ASSESSMENT

Assessment of the cardiovascular system Assessment of the respiratory system

- Correctly takes history from simulated patient - Inspects the chest and identifies findings - Palpates for excursion, TVF, and pulsations - Percuses the chest over MCL and MAL, back - Auscultates the chest over MCL and MAL -Identifies normal and abnormal breath sounds and adventitious sounds and heart sounds and their significance - Documents findings - Communicates effectively with patient and team members

Four

sessions

Critical

Care Lab II



Clinical Skills& Simulation Lab Schedule 2015-2016 First Semester

Nursing Labs SUN MON TUE WED THUR

Medical & Surgical

Nursing Lab

Medical Surgical Nursing


Fundamentals of Nursing


Maintenance

Health Assessment Bridging

Fundamental Nursing Lab





Maintenance


Obstetric & GYNE Nursing

Lab



Fundamental Nursing

Fundamental Nursing

Maintenance

OB/GYNE Nursing Bridging


Pediatric Nursing

Lab



Maintenance Pediatric Nursing

Pediatric Nursing


New Born Nursing Lab

Fatat Al khaleej Program

OB/GYNE Nursing Bridging

Maintenance Pediatric Nursing

Pediatric Nursing


Critical Care Nursing lab 1

Post graduated Medical Surgical Nursing



Maintenance Post graduated Medical Surgical Nursing


Critical Care Nursing Lab 2



Maintenance

Operating Room Lab



Fundamental Nursing

Fundamental Nursing

Maintenance

Emergency Room Lab



Fundamental Nursing

Fundamental Nursing

Maintenance

Home Care Nursing Lab

Nursing Management

Nursing Management

Maintenance Fatat Al khaleej Program

Fatat Al khaleej Program Fatat Al khaleej

Program Computer lab

(Big) Nursing Management

Nursing Management

Maintenance

Computer Lab (small)

Post graduated Statistics

Maintenance

Clinical Skills & Simulation Lab Coordinator Dr. Radwa H Bakr



CRITICAL CARE I

LABORATORY OCCUPANCY

ACADEMIC YEAR 2015-2016 FIRST SEMESTER

Course Year Semester No of students Total (per/session)

Days occupying lab

Duration Description

Medical /

Surgical

Nursing I

Third

Year

First

Semester

50 (8

per

session)

Sunday and

Monday

16 weeks Students will

practice procedures

and simulation as

part of their clinical

training

Clinical

Master in

Medical

surgical

nursing

Master

progra

m

Third

semester

3

Sunday and

Monday

Tuesday


practice procedures

and simulation as


training

Fundamentals

of nursing

2nd

Year

First

Semester

50 (8

per

session)

Wednesday

and

Thursday


practice procedures

and simulation as


training



CRITICAL CARE II

LABORATORY OCCUPANCY

ACADEMIC YEAR 2015-2016 FIRST SEMESTER

Course Year Semester No of students Total (per/session)

Days occupying lab

Duration Description

Medical /

surgical

nursing I

Third

Year

First

Semester

50

(8 per

session)

Sunday and

Monday


practice procedures

and simulation as


training

Fundamentals

of Nursing

2nd

Year

First

Semester

50 (8

per

session)

Wednesday

and thursday


practice procedures

and simulation as


training



Critical Care Nursing Laboratory Rotation

LIST OF PROCEDURES

SYSTEM PROCEDURE

Cardiovascular System Drawing blood from a vein

Insertion of an IV line

Assiting insertion of a central venous line

Central venous line care

CVP measurment

Drawing an arterial sample

Inserting an arterial line

Cardiopulmonary resuscitation

Defibrillation

Respiratory System:

Maintaining patent airway

Inserting an oropharyngeal airway

Bag valve mask ventilation

Suctioning the airway

ETT care

Tracheostomy care

Managing ventilator emergencies

Gastrointestinal and Genitourinary System

Feeding via NGT

Inserting a urinary catheter

Caring for a patient with an indwelling

catheter

Inserting a nasogastric tube



STUDENT EVALUATION OF SIMULATED CLINICAL EXPERIENCE

Student name: ………………………... Student Number…………….………………… Program:………………………………. Year……………….. Semester ……………… Simulated clinical experience:……………..……………………………………………. Instructor:………………………………........................Date:…………………………...

Serial Strongly Agree

5

Agree 4

Uncertain 3

Disagree 2

Strongly Disagree

1 1. The instructor prompts guided

me I thinking critically

2. I feel more confident in my ability to deal with real patients

3. I developed better understandings of drugs used in the simulated clinical experience

4. I feel more prepared for decision making

5. My physical examination and assessment skills have improved

6. I feel more able to predict what pathophysiological changes may occur in a real patient

7. The simulated clinical experience has reinforced my theoretical knowledge

8. The simulated clinical experience has challenged me to think and make decisions

9. I have learned a great deal from observing my colleagues

10. I have learned ways to improve my communication skills with patients and colleagues

11. Debriefing sessions and discussions were valuable

Comments : ………………………………………………………………………..…………………………………………………………………..............................................................................................................................................................................................................



Simulated Clinical Experience Evaluation Sheet

Simulation: ………………………………………………… Instructor: ……………... Student Name: …………….……… Student Number: …………..……………………. Date : ……………………………..…Group: ………………………………………..….. Serial Theme Done

2 Incomplete

1 Not done

0 Comments

ASSESSMENT : (TOTAL 12 grades) 1. x Proper equipment used 2. x Systematic approach 3. x Appropriate techniques 4. x Identifies significance of findings 5. x Refers to appropriate personnel 6. x Evaluates after intervention COMMUNICATION : ( TOTAL 8 grades) 1. x Communicates effectively with

members of healthcare team

2. x Uses appropriate verbal and non- verbal communication

3. x Communicates effectively with patient and family members

4. x Uses terms appropriate to patient’s level of education

NURSING MANAGEMENT : (TOTAL 14 GRADES) 1. x Uses best practices 2. x Prioritizes interventions 3. x Uses appropriate protocols /

procedures/ treatments /interventions

4. x Uses Critical thinking / problem solving

5. x Delegates appropriately 6. x Proper Fluid/ blood /drug

administration

7. x Coordinates appropriately with

interdisciplinary team

KNOWLEDGE AND COGNITIVE SKILLS (TOTAL 6 GRADES) 1. x Post SCE written exam PSYCHOMOTOR SKILLS (TOTAL 10 GRADES) 1. x Procedure checklist TOTAL GRADE (50) Instructor’s signature:______________________________ Date:_________________



CLINICAL SIMULATION LABORATORIES PHOTOGRAPHY RELEASE

I , ___________________________________ hereby agree to allow

___________________________________ to record or photograph my

performance in the clinical simulation lab , for use in simulation sessions for

teaching purposes or for use in educational materials , brochures, manuals

and presentations.

Date : _____________________________________________________

Name : ____________________________________________________

Signature : _________________________________________________



Clinical Skills & Simulation Laboratory

Confidentiality Agreement

As a nursing student enrolled in the College of Nursing University of Dammam .I

will be actively participating in clinical nursing simulations. I understand that the

content of these simulations will be kept confidential in order to maintain the

integrity of the learning experience for me and my fellow students. It would be

unethical for me to share any information regarding simulation scenarios with my

fellow students. I will also be observing fellow students within the clinical

simulation laboratory, and I will not discuss their performance with anyone

outside of the simulation laboratory.

I fully understand and acknowledge that the unauthorized release, mishandling of

confidential information or inappropriate exchange of information is prohibited,

and serious consequences may occur if I violate this agreement. I will exemplify

the College of Nursing University of Dammam values of integrity, respect for

human dignity, and confidentiality.

Student name : ___________________________________________________

Student signature: _________________________________________________

Date: ___________________________________________________________

Year/ Level __________________________Course:______________________

Instructor:________________________________________________________



Clinical Skills & Simulation Laboratory

Injury/Incident Report

Accident/Date: _________________ Time: _________ Today’s Date: ____________

Name/Address: _______________________________________________________________________

_______________________________________________________________________

Age: ______ Sex: ________ Telephone # _____________________________________

Details of Incident: ________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Nature of Injury:

________________________________________________________________________

________________________________________________________________________

Treatment Rendered:

________________________________________________________________________

________________________________________________________________________

Referred to: ________________________________________________________________________

CSL Faculty Signature : ____________________Date: _________________________



CRITICAL CARE LABORATORY

SCHEDULED TRAINING ACTIVITIES & WORKSHOPS

ACADEMIC YEAR 2015 – 2016 FIRST SEMESTER

Workshop / training

Date Instructor Location Duration

Pediatric ECS (CAE )

Maintenance and training

Saturday September 12TH

2015

Dr. Rashad (CAE-

Imanco)

Critical Care Lab II

1 day

ECS Maintenance and

training

Saturday October 10th

2015

Dr. Manan (CAE-Leader)

Critical Care Lab II

1 day

SIMMAN 3G Maintenance and Technical training

October 11th October 31st

Dr. Ashraf (Laerdal-

Beta)

Critical Care Lab I

1 day

AV System Maintenance and Technical training

November 14th 2015

Dr. Ashraf (Laerdal-

Beta)

Critical Care Lab I

1 day



high fidelity simulation workshop

with : pedia sim by meti®

INSTRUCTOR : DR. RADWA HAMDI

Participants : Pediatric Nursing Academic Staff and Demonstrators

Duration: One day

Timing: Tuesday October 13th 2015

Venue: College of Nursing - Critical Care II Skill Lab



Workshop Rationale: This workshop is designed to acquaint pediatric nursing faculty with the

high fidelity simulator designed by METI ; Pediatric Emergency care

simulator (PEDIA SIM), as well as the educational modules of the Program

of Nursing Curriculum Integration (PNCI) , a four-semester guide which

provides simulated clinical experiences (SCE). That are integrated within the

nursing curriculum. Human patient simulation provides an innovate

learning environment where nursing students can practice clinical and

critical thinking skills without fear of harming a real person, the result is

increased self-confidence, and ultimately competence. Simulation offers

multiple opportunities for student training and clinical experience that help

overcome the limitations of clinical areas, However simulators are often

under- utilized due to insufficient staff training.

The aim of this workshop is to train paediatric Nursing academic staff on

the use of high fidelity simulators to prepare them for the use of simulation

in undergraduate and postgraduate student clinical training .

Workshop objectives: As a result of successful completion of the workshop, participants will be

able to:

x Identify the parts of the high fidelity simulator

x Familiarize with simulator software and applications

x Demonstrate how to operate the high fidelity simulator Familiarize

with educational modules of the Program of Nursing Curriculum

Integration (PNCI)



x Demonstrate how to run a scenario on the high fidelity simulator

x Demonstrate how to write new scenarios by editing existing ones

x Demonstrate how to create new scenarios

x Demonstrate how to conduct a clinical simulation session

x Demonstrate how to conduct a debriefing session



High fidelity Simulation Workshop

Pedia Sim by METI® Instructor : Dr. Radwa Hamdi

Program

Day : Time: Activity:

Tuesday 13/10/15

8.00-8.30: x Identify the parts of the high fidelity simulator

8.30-9.30: x Familiarize with simulator software and applications

x Demonstrate how to operate the high fidelity simulator

9.30-10.00: x Familiarize with educational modules of the

Program of Nursing Curriculum Integration (PNCI)

10.00 - 10.30: x Practical application : how to run a scenario on the high fidelity simulator

10.30- 11.00 x Writing new scenarios by editing existing ones

x Creating new scenarios 11.00 – 12.00 Practical application : conducting a clinical

simulation session x Demonstrate how to conduct a debriefing session

12.30 – 1.30: Prayer break

1.30 – 2.00: x Practical application : Conducting a debriefing session



simulation training

workshop with : simman 3g ®

Instructor : Dr. Ashraf Al-Riyati -- BETA COMPANY

Participants : College of Nursing Academic Staff and

Demonstrators

Duration:

One day

Timing:

Saturday October 10th 2015, to be repeated Saturday 17th Oct 2015

Venue:

College of Nursing - Critical Care I Simulation Laboratory

2015



Workshop Rationale: This workshop is designed to acquaint nursing faculty with the most recent

high fidelity simulator designed by SIMMAN ; SIMMAN 3G. Human

patient simulation provides an innovate learning environment where nursing

students can practice clinical and critical thinking skills without fear of

harming a real person, the result is increased self-confidence, and ultimately

competence. Simulation offers multiple opportunities for student training

and clinical experience that help overcome the limitations of clinical areas,

However simulators are often under- utilized due to insufficient staff

training. The aim of this workshop is to acquaint Nursing academic staff on

the use of SIMMAN 3G high to prepare them for the use of simulation in

undergraduate and postgraduate student clinical training .

Workshop objectives: As a result of successful completion of the workshop, participants will be

able to:

x Identify the parts of the high fidelity simulator

x Familiarize with simulator software and applications


x Familiarize with educational modules

x Demonstrate how to run a scenario on the high fidelity simulator

x Demonstrate how to write new scenarios by editing existing ones

x Demonstrate how to create new scenarios

x Demonstrate how to conduct a clinical simulation session



Simulation Training Workshop With :

SimMan 3G ®

Instructor : Dr. Ashraf Al-Riyati -- BETA COMPANY

Program


Saturday 10/10/2015

8.00-8.30: x Identify the parts of the high fidelity simulator SIMMAN 3G

8.30-9.30: x Familiarize with simulator software and applications


9.30-10.00: x Familiarize with educational modules

10.00 - 10.30:

x Practical application : how to run a scenario on the high fidelity simulator

10.30- 11.00 x Writing new scenarios by editing existing ones

x Creating new scenarios 11.00 –

12.00 x Practical application : conducting a

clinical simulation session

12.30 – 1.30:

Prayer break

1.30 – 2.00: x Practical application : conducting a clinical simulation session



Hands on Workshop Simulation-Based training to Improve Quality of Care During Cardiac Arrest Team Response

With : ECS by METI®

INSTRUCTORS : Dr. Radwa Hamdi Ms. Zeinab Alsaba, Ms. Heba Massoud Target : This workshop will be of interest to nurses, physicians, Health care

professionals, medical and nursing students

Duration: One day

Timing: Tuesday 1/1/2015

Venue: College of Nursing - Critical Care II Skill Lab

2015



Workshop Rationale: This workshop utilizes high fidelity simulation to refresh participants

knowledge on the practice of a rapid response to a cardiac arrest situation in

a high acuity unit. The cardiac arrest simulation workshop will begin with a

presentation reviewing key elements of response to a code blue that enhance

the chances of survival and also a review of the importance of each team

member's role in a resuscitation attempt. Following this presentation,

attendees will be confronted with a sudden cardiopulmonary arrest scenario.

The critical care skill lab is set up with state-of-the-art equipment in the form

of a simulated ICU suite, where participants will be allowed to participate

firsthand in a resuscitation code. The event will allow attendees to observe

an unexpected collapse of an individual and the ensuing response.

Participants will undertake CPR, airway management and the

administration of drugs according to ACLS protocols using a highfidelity

simulator (ECS , METI ®).After a session of orientation on the simulator the

cardiac arrest scenario will be started participants will be divided into two

groups the first group of students will participate in the simulation while the

other group will be asked to sit and observe the group in action while noting

comments on management, teamwork and communication skills, roles will

be reversed subsequently. Then both groups will join together for a

debriefing session. The aim of this workshop is to allow participants the

chance to make mistakes without hurting patients and to debrief regarding

both medical, nursing, and teamwork principles in an effort to bridge the gap

between theoretical principles and active application.



Workshop objectives:

x Apply ACLS guidelines to manage a cardiac arrest situation in a high acuity unit

x Discuss the importance of each team member's role in a resuscitation attempt.

x Practice CPR, airway management, defibrillation and the administration of drugs according to ACLS protocols using a high fidelity simulator

x Reinforce management, teamwork and communication

Content of the workshop:

x Introduction to simulation

x Orientation to the simulator

x Advanced cardiac life support : a review

x Basic arrhythmia : a review

x Teamwork in cardiac arrest response

x Simulated clinical experience : management of the patient who develops sudden cardiac arrest in a high acuity unit

x Debriefing and evaluation



Simulation-Based training to Improve Quality of Care During Cardiac Arrest Team Response INSTRUCTORS : Dr. Radwa Hamdi , Mrs. Rana Alamry, Ms. Zeinab Alsaba, Ms. Heba Massoud

Program


Tuesday 11/1/11

1.00-1.15: Introduction to simulation

1.15 -1.30: Orientation to the simulation

1.30-2.00: Advanced cardiac life support : a review

2.00 – 2.15:

Teamwork in cardiac arrest response

2.15– 2.45 Group 1 : Simulated clinical experience : management of the patient who develops sudden cardiac arrest in a high acuity unit

2.45 – 3.15:

Group 2 : Simulated clinical experience : management of the patient who develops sudden cardiac arrest in a high acuity unit

3.15-3.30: Video viewing

3.30 – 4.00:

Debriefing and evaluation



Round Table Discussion

High Fidelity Simulation : Observation of a Course Instructor: Dr. Radwa Hamdi The use of simulation is an expanding domain in medical, nursing, and allied medical, Education. Many faculty and staff members wish to introduce simulation in their colleges but are reluctant due to the novelty of the experience. Some have already acquired the simulators but are not clear on how to incorporate it in student teaching. This workshop is designed to acquaint faculty, staff members or directors of training centers on how to use simulation in teaching by observing a course in action. Participants will attend the orientation session and will observe the hands on simulation training and then attend the debriefing session. Once the course is over a round table discussion will take place, during which the participants will have a chance to take part in an interactive discussion, ask questions and get explanations on the practical issues related to the use of clinical simulation in student teaching. Objectives :

x Acquaint faculty, staff members or directors of training centers on how to use simulation in teaching by observing a course in action.

x Identify approaches utilized in conducting a debriefing session

x Discuss practical issues related to the use of clinical simulation in student teaching.



Emergency Care:

The Golden Hour and Beyond

HANDS ON WORKSHOP:

Simulation-Based training to Improve Quality of Care

during Cardiac Arrest Team Response

This workshop utilizes high fidelity simulation to refresh participants’

knowledge of the practice of rapid response to a cardiac arrest situation in

a high acuity unit. The cardiac arrest simulation workshop will begin with

a hands-on review session of the key elements of response to a code blue

that enhance the chances of survival and also a review of the importance

of each team member's role in a resuscitation attempt.

Following this session, attendees will be confronted with a sudden

cardiopulmonary arrest scenario. Participants will be allowed to

participate firsthand in a resuscitation code. The event will allow attendees

to observe an unexpected collapse of an individual and the ensuing

response. Participants will undertake CPR, airway management, and the

administration of drugs according to ACLS protocols using a highfidelity

simulator (SimMan3G®).

After a session of orientation on the simulator the cardiac arrest scenario

will be started.Participants will be divided into two groups the first group

of students will participate in the simulation while the other group will be

asked to sit and observe the group in action while noting comments on

code management, teamwork, and communication skills. Roles will be



reversed subsequently, then both groups will join together for a debriefing

session.

The aim of this workshop is to allow participants the chance to make

mistakes without hurting patients and to debrief regarding both medical,

nursing, and teamwork principles in an effort to bridge the gap between

theoretical principles and active application.

Objectives:

x Apply techniques and protocols learned in ACLS training.

x Review the importance of each team member's role in a resuscitation

attempt.

x Undertake CPR, airway management, and the administration of

drugs according to ACLS protocols using a high fidelity simulator.

x Enhance management, teamwork, and communication skills.

x Debrief regarding strengths and areas for improvement.

Venue:

x Preconference workshop:College of Nursing - Clinical Skill Labs

x Conference :University of Dammam main campus- Building 11

Duration:Two days Target audience: The symposium and workshop are directed toward nurses, physicians, surgeons, and health care professionals committed to acute care, trauma, and emergency medicine and nursing. Number of Participants:

x Symposium: Open attendance

x Hands-on workshop: 30 participants



Emergency Care:

The Golden Hour and Beyond PROGRAM

Preconference Workshop Wednesday, February 4th, 2015

Hands on Workshop: Simulation-Based training to Improve Quality of Care During Cardiac

Arrest Team Response 8:00- 9:00

Registration

9:00- 11:30 Session (1): THE BASICS Instructors: x ACLS algorithms

x ECG interpretation x CPR x AED x Airway management

Dr. Ahmed Aljlaoud Mrs. BadreyaAltaleb Mrs. HebaMassoud

11:30- 12:00 Prayer and Coffee break Session (2):

SIMULATION BASED TRAINING Instructors:

12:00- 2:00 High fidelity simulation session: Management of cardiopulmonary arrest

Dr. RadwaBakr Ms. ZainabAlsabaa Mrs. BothaynaFathy

2:00- 3:00 Session (3):

DEBREIFING Facilitator

Debriefing session Dr. RadwaBakr 3:00- 4:00 Lunch break

4:00 End of program



Training Workshop Evaluation Form

Please provide feedback regarding the training session that you attended. Your opinion is valuable to us and will guide us in planning future training workshops . Workshop: ……………………………………………………………………………………………… Instructor(s): ……………………………………………………………………………………………… Please check the box corresponding to the degree to which you believe the training workshop achieved its goals: SN Strongly

Agree 5

Agree 4

Uncertain 3

Disagree 2

Strongly Disagree

1 1. Objectives for the workshop were met

2. Questions were answered to my satisfaction

3. I better understand the components of the simulator

4. I better understand how to operate the simulator

5. I better understand how to run a simulation scenario

6. I received guidance on how to use simulation in my course

7. I better understand how I can integrate simulation into my curriculum

8. I am better prepared to assume the role of facilitator in a simulation setting

9. I am better prepared to make the simulator and its environment more realistic

10. I better understand the importance of debriefing

11. I feel confident in my ability to use the simulator with my student

12. Overall I am satisfied with the workshop/ training

Comments : ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………



Training Workshop Attendance Sheet

Workshop/Training Session:………………………………………………. Instructor :………………………………………………………………….. Date :…………………………………………………………………………

Attendance

Serial Name Signature

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

Lab manager s:………………………………………………………..

Lab coordinator: Dr. Radwa Bakr



INTRAVENOUS CATHETER INSERTION

STUDENT’S NAME:…………………………………… STUDENT’S NUMBER: …………………………………………

PROCEDURE CHECKLIST Done (2)

IC (1)

Not Done

(0)

COMMENTS

1 Explains the procedure and obtains consent.

2 Observes universal precautions

3 Applies local anesthetic

4 Places tourniquet above the intended site and palpates the vein.

5 Cleanses skin and fixes vein

6 Inserts catheter, bevel up, parallel to the vein at a 30 degree angle to the skin.

7 Advances into the vein.

8 Decreases angle when flashback occurs.

9 Advances 0.5 then retracts needle from catheter.

10 Advances catheter until port is flush with the skin.

11 Occludes the distal end of the catheter and connects IV tubing

12 Checks flow through catheter.

13 Secures the catheter

Grade : …………………………………………………………………………………………………………………………..

Date of evaluation: ………………………………………………………………………………………………………….

Clinical supervisor: …………………………………………………………………………………………………………..



UNIVERSAL PRECAUTIONS FOR INVASIVE PROCEDURE


Grade : ……………………………………………………………………………….………………………………………………………..

Date of evaluation: ………………………………………………………………………..…………………………………………….

Clinical supervisor: …………………………………………………………….………………………………………………………..


IC (1)

Not Done

(0)

COMMENTS

1 Checks Patient identity

2 Checks relevant documents

3 Obtains informed consent

4 Marks procedure site

5 Positions patient correctly

6 Displays Images and results properly

7 Prepares blood products, implants, devices, or special equipment

8 Administers required antibiotics or fluids

9 Observes safety precautions based on history and medications



ARTERIAL LINE INSERTION ( Radial artery )



IC (1)

Not Done

(0)

COMMENTS

1 Explains procedure and obtains consent.

2 Observes universal precautions.

3 Positions limb for arterial cannulation: supinates the arm and dorsiflexes the wrist

4 Follows aseptic technique

5 Palpates the artery.

6 Infiltrates the insertion site with 1% lidocaine.

7 Uses Catheter-over-needle technique: Inserts needle and catheter at a 20- to 40-degree angle to the skin. When a flash of blood appears in the hub, drops angle to near 0 degrees and advances about 1 mm. Slides the catheter off the needle into the artery. Puts pressure on the artery and removes the needle from the catheter.

8 Connects the catheter to the transduction system and observes arterial waveform and pressure.

9 Secures the catheter with sterile dressing and tape.

Grade : …………………………………………………………………………………………………………………………..

Date of evaluation: ………………………… Clinical supervisor: ………………………………..



SUCTIONING A PATIENT WITH AN ENDOCTRACHEAL TUBE (ETT)


Grade : ………………………………………………………………………………………………………………………….. Date of evaluation: ………………………………………………………………………………………………………….



IC (1)

Not Done

(0)

COMMENTS

1 Explains the procedure to the patient.

2 Observes aseptic technique

3 Opens sterile gloves and suction catheter.

4 Places clean Latex glove on non-dominate hand.

5 Monitors oxygen saturation during procedure.

6 Pre-oxygenates patient with AMBU bag on a 100% O2 for 2 minutes

7 Turns on suctioning equipment with suction tubing and places near head of patient.

8 Places sterile gloves on dominate hand and connects suction catheter to suction tubing.

9 Using aseptic technique, passes suction catheter , while occluded , through ET tube until patient coughs.

10 Applies suction and withdraws suction catheter with a rotating motion at 5 second intervals.

11 Ventillates patient with ambu bag using 100% oxygen

12 Cleans out patient oropharyngeal airway with suction catheter .

13 Discards suction catheter

14 Rinses suction tubing with water.

15 Monitors patients breathing and oxygen saturation.

16 Notes amount, colour and consistency of tracheal aspiration



SUCTIONING A PATIENT WITH A TRACHEOSTOMY TUBE



IC (1)

Not Done

(0)

COMMENTS

1 Explains the procedure to the patient.

2 Observes aseptic technique

3 Opens sterile gloves and suction catheter.

4 Places clean Latex glove on non-dominate hand.

5 Monitors oxygen saturation during procedure.

6 Pre-oxygenates patient with AMBU bag on a 100% O2 for 2 minutes

7 Turns on suctioning equipment with and places near head of patient.

8 Places sterile glove on dominate hand and connects suction catheter to suction tubing.

9 Using aseptic technique, passes suction catheter through connector down into tracheal tube entering the patients upper airway until patient coughs.

10 Applies suctioning while withdrawing suction catheter with a rotating motion at 5 second intervals.

11 Ventilates patient with AMBU bag on a 100% 02

12 Clean out patient oral pharyngeal airway with either suction catheter

13 Discards suction catheter

14 Rinse suction tubing with water.

15 Monitors patients breathing and oxygen saturation.

16 Notes amount, colour and consistency of tracheal aspiration

Grade : …………………………………………………………………………………………………………………………..

Date of evaluation: …………………………… Clinical supervisor: ………………………………………..



DRAWING AN ARTERIAL SAMPLE (radial artery)


Grade : …………………………………………………………………………………………………………………………..

Date of evaluation: ………………………….. Clinical supervisor: ….……………………………….


IC (1)

Not Done

(0)

COMMENTS

1 Explains the procedure to the patient

2 Observes universal precautions for invasive procedures

3 Applies local anesthesic if appropriate

4 Prepares skin with antiseptic solution

5 Uses sterile technique.

6 Performs modified Allen test.

7 Positions patient supine and extends wrist to 30 to 45 degrees.

8 Palpates artery distal to the radial styloid

9 Holds the syringe like a dart with the lumen of the needle facing the flow of blood.

10 Enters the skin at a 45-degree angle, at a point 2 to 3 cm proximal to the volar wrist crease.

11 Slowly advances the needle toward the point of maximal arterial impulse.

12 Allows blood to fill the syringe.

13 Collects sample then withdraws the needle.

14 Expels air bubbles in the syringe,caps and labels.



BAG MASK VENTILATION


Grade : …………………………………………………………………………………………………………………………..




IC (1)

Not Done

(0)

COMMENTS

1 Provides O2 supplementation and monitoring


3 Opens the patient's airway with head-tilt or jaw-thrust.

4 Chooses a proper size face mask and connects to oxygen

5 One-handed technique: (C E ) Holds the mask with the thumb and forefinger in a "C" shape and hold the jaw with the other fingers (E )

6 Two-handed technique: Places thumb and of one hand on one side of the mask and places other hand similarly on the other side of the mask. Uses remaining fingers to pull the mandible into the mask

7 Uses correct sized bag to ventilate: 250 mL for neonates, 500 mL for pediatric , 1000 to 1500 mL for adults



BASIC AIRWAY MANAGEMENT


Grade : ……………………………………………………………………………………………………………………………..




IC (1)

Not Done

(0)

COMMENTS

1 Uses universal precautions.

2 Head-tilt chin-lift maneuver : Applies downward pressure on the forehead and uses fingers to lift mandible.

3 Jaw-thrust maneuver : Places heels of hands on sides of the patient's head and grasps angles of mandible with fingers and push jaw anteriorly.

4 Oropharyngeal airway (OPA) insertion : Selects correct size OPA (from mouth to the angle of the mandible).

5 Inserts OPA inverted, then rotates 180 degrees at the posterior pharynx.

6 Nasopharyngeal airway (NPA) insertion : Selects correct size NPA (from tip of nose to angle of mandible).

7 Lubricates NPA and inserts along floor of the nasal cavity.

8 Bag-valve mask ventilation : Opens airway, then applies mask using either one- or two-handed technique ventilates at rate of 10 to 12 breaths per minute, at a tidal volume of 8 to 10 mL/kg.



DRAWING BLOOD FROM A VEIN


Grade : ………………………………………………….…………………………………………………………………………..

Date of evaluation: ……………………………………….………………………………………………………………….



IC (1)

Not Done

(0)

COMMENTS

1 Explains procedure and obtains consent.


3 Positions the patient supine and places all supplies within reach.

4 Places tourniquet 5 to 10 cm proximal to selected venipuncture site.

5 Cleanses overlying skin with antiseptic solution.

6 Applies traction distal to the vein.

7 Holds butterfly needle with bevel facing upward.

8 Inserts needle into vessel and observes for flash of blood.

9 Inserts vacuum tube into the vacuette tube and collects sample.

10 Releases tourniquet and removes needle.



VENTILATOR EMERGENCY



IC (1)

Not Done

(0)

COMMENTS

1 Problems Associated With Mechanical Ventilator: Detaches patient from ventilator and manually ventilate patient using Resuscitator (attached to endotracheal tube) and high flow oxygen.

2 If the patient is "easy" to manually ventilate and settles once removed from the ventilator – identifies ventilator as primary source of the emergency.

3 While one nurse manually ventilates the patient, second nurse inspects ventilator and performs performance check

4 If problem cannot be identified and rectified, replaces ventilator with another.

5 Orders malfunctioning ventilator to be sent to biomedical engineering for review.

6 Problems Associated With The Endotracheal Tube: If patient is "easy" to manually ventilate but an audible air leak is present, checks cuff pressure with manometer.

7 If leak persists or is unsealable, checks tube position, length and air entry.

8 Reinserts tube to correct length if necessary

9 Checks for absence of cuff leak and equal air entry.

10 Documents event.

11 If patient is "difficult" to ventilate, attempts to pass asuction catheter.

12 If the suction catheter cannot be passed further than 5 cm - verifies that patient is not biting on tube.

13 Inserts oropharyngeal airway and attempts to suction patient again.

14 If the suction catheter cannot be passed further than 10-15 cm, positions patient's head in neutral position and attempts suction again.

15 If suction catheter cannot be passed further than the tip of the endotracheal tube: Deflates cuff and passes suction catheter.



PROCEDURE CHECKLIST Done

(2) IC (1)

Not Done

(0)

COMMENTS

16 Reinflates cuff to pressure of 15 to 25 cm H2O and attempts to pass suction catheter again.

17 If passage of catheter is impossible and ventilation is absent: removes tube.

18 Calls for assistance of ICU physician immediately.

19 Manually ventilates patient using Resuscitator and appropriately sized mask.

20 Prepares for reintubation.

Grade : …………………………………………………………………………………………………………………………..





TRACHEOSTOMY DRESSING


Grade : …………………………………………………………………………………………………………………………..

Date of evaluation: …………………………Clinical supervisor: …………………………………………………………


IC (1)

Not Done

(0)

COMMENTS

1 Explains procedure to patient

2 Aseptically prepares equipment

3 Prepares dressing pack at bedside

4 Suctions patient

5 Removes old dressings and ties

6 Swabs around tracheal stoma with normal saline

7 Folds sterile gauze squares in half and place on under each wing of tracheostomy tube.

8 Attaches cotton tape to tracheostomy tube by passing doubled cotton tape up through opening then threading loose ends up through loop.

9 Passes two long portions of cotton tape behind patients head.

10 Ties long end to short leaving a two finger space between patient and tie tapes.

11 Measures cuff pressure



SET UP AND INSERTION ENDOTRACHEAL TUBE


EQUIPMENT: Oxygen Suction 10ml syringe Laryngoscope Magills forceps Lubricant Airway Resuscitation bag and mask Suction Catheter Drugs as ordered Stethoscope Leucoplast tape

STANDARDS: * Emergency intubation to be undertaken by the medical officer skilled in this procedure. Persons warranting E.I. must have a registered nurse in constant attendance. IV access made available. Cricoid pressure to be applied prior to intubation and removed only after cuff inflation. Cuff inflated to 200mmHg and no more than 30mmHg. Positioning of the ETT is verified by observing chest movement. - Auscultation of the chest and stomach. Chest x-ray (reviewed by medical officer). ETT sizes ranging from 2.5mm to 9.5mm. Selection appropriate to patient size. Necessary drugs are prescribed and administered at medical officers request. OUTCOMES: Patient airway available with means to maximise respiratory function.




IC (1)

Not Done

(0)

COMMENTS

1. Removes Excess secretions/foreign bodies from oropharynx prior to procedure.

2. Pre-oxygenates patient with 100% oxygen

3. Places patient in supine position with adequate access to the head.

4. Keeps prepared drugs available close to IV access

5. Starts Manual ventilation once ETT IS INSITU

6. Records size of ETT and placement at the lips.

7. Observes and records respiratory observations.

Grade : …………………………………………………………………………………………………………………………..





CENTRAL VENOUS CATHETER CHANGE

STUDENT NAME :………………………………….. STUDENT NUMBER; ………………………………………………. PROCEDURE CHECKLIST Done

(2) IC (1)

Not Done

(0)

COMMENTS

1 Explains the procedure and obtains consent.


3 Prepares dressing pack at bedside prior to positioning patient.

4 Hangs new IV solution and new IV set ( protecting distal end from contamination by placing it on open dressing pack).

5 Primes IV line with appropriate solution

6 Stops infusion pump and clamps IV line, with roller clamp on CVC lumen extension being changed

7 Clamps off line of CVC pigtail being changed with slide clamp.

8 Places new IV administration set and IV solution into Infusion Pump.

9 Places CVC pigtail and IV line on sterile towel from dressing pack and allows solution to dry

10 Starts Infusion Pump and allow fluid to run into sterile field of dressing pack.

11 Connects new IV line too CVC pigtail and removes slide clamp from CVC pigtail.

12 Labels IV administration set with time and date of change.

13. Documents the procedure

Grade : …………………………………………………………………………………………………………………………..


Clinical supervisor: ………………………………………………………………………………………………………….



Critical Care Nursing Laboratory Rotation

Simulated Clinical Experience

Objectives

During their laboratory rotation critical care master students will be exposed

to several simulated clinical experiences tailored to mimic situations to

which they will be exposed in the ICU environment , this will provide an

opportunity for students to practice skills and interventions in a safe risk free

environment as well as implement teamwork leadership, and communication

skills.

The simulated clinical cal experience will be followed by a debriefing

session during which strengths and areas for improvement will be discussed

with the instructor. As a result of each simulated clinical experience students

will be expected to:

x Integrate theoretical knowledge to practice

x Utilize evidence base, critical thinking and the nursing process as

afrme work for nursing care

x Determine the priorities for nursing utilizing individualized plans of

care

x Evaluate the effectiveness of therapeutic interventions implemented

x Document nursing and medical interventions

x Implement best nursing practices for the simulated patient

x Apply interdisciplinary collaboration

x Communicate effectively with healthcare providers regarding patient

progress



Integration of simulation in Critical Care Nursing curriculum

Human patient simulation is one such strategy to address the multiple issues

faced in teaching critical care nursing today. Patient simulation allows teach

multiple objectives while brings learning alive in a multidimensional

environment, and increases the confidence of the learner, which leads to

competence. This is of particular importance for nurses who will be working

in a high acuity environment where skill and self confidence are of utmost

importance .

The Program for Nursing Curriculum Integration (PNCI) by METI provides

an answer to assist faculty with this transition and make more efficient use

of their time as they embark on the use of patient simulation to facilitate

learning and to assess competency.

Areas of practice Critical Care Nursing: Selected topics of the critical care curriculum will be chosen to be taught

using human patient simulation in an effort to bridge the gap between theory

and knowledge while enhancing skill, knowledge and self confidence.

The following is a list of the critical care topics included in the program of

nursing curriculum integration , the high lighted items are presently being

used in postgraduate teaching

x Assessment of the cardiovascular system



x Assessment of the respiratory system

x Traumatic Brain Injury

x RSV Bronchiolitis

x Meningitis

x Fluid and Electrolyte Imbalance

x Cystic Fibrosis

x Chronic Heart Failure and COPD

x Bioterrorism

x End-of-Life Care

x Sickle Cell Crisis

x Chronic Osteomyelitis on Home Antibiotic Therapy

x Acquired Immune Deficiency Syndrome

x Cardiac Rehabilitation

x Dementia and UTI

x Intentional Overdose of a Hypnotic

x Cardiopulmonary Arrest

x DIC

x Acute respiratory distress syndrome

x Mechanical ventilation

x Acute Coronary Syndrome and AMI

x COPD Exacerbation with Respiratory Failure

x Postoperative Pulmonary Embolism

x Closed Head Injury with Increasing ICP

x Multiple Patient Care Management



ROADMAP FOR INTEGRATION

PROGRAM OF NURSING CURRICULUM INTEGRATION

CRITICAL CARE NURSING

Concept

Simulated clinical experience

x Changes in Vital Signs in Relation to Critically Ill Patients

x Interventions and Treatment of Abnormal Vital Signs in Life Threatening Disorders: ECG, Pulse Oximetry, Arterial Lines, Respiratory and Temp. Monitoring

x Acute heart failure exacerbation x Basic dysrhythmias recognition and

management

x Suctioning; Endotracheal Tubes, Artificial Airways

x Oxygen Delivery Systems; Mechanical Ventilation

x Acute Respiratory Distress/ Failure Secondary to Trauma,

x Post-Anesthesia and pneumonia

x Glasgow Coma Scale; Trauma Patient

x Gunshot wound x Herniation syndrom x Motor vehicle collision with abdominal

injuryy and internal bleeding and hypovolemic shock

x ICP monitoring , arterial lines , pulmonary artery cathters

Pulmonary artery catheter

x Cardiac pacemakers x Syncope Secondary to Bradycardia Requiring Transthoracic Pacing Prior to the Insertion of a Permanent Pacemaker

x Inclusion of pertinent pharmacology in critical care

x Antidysrhythmic Agents Thrombolytic Agents; Vasopressors; Blood products

x Cardiopulmonary arrest x Brain attack with thrombolytic therapy

x Adult Drug Overdose and Poisoning x Neurologically Compromised Patient

x Intentional Overdose of a Hypnotic x Cocaine Overdose with Cardiac Arrest x Spinal cord injured patient with

neurogenic shock x Ventilator Dependent Patients

x Postoperative pulmonary embolism



Simulated clinical experience

Debriefing guide

Simulation: ………………………………………………………………. Instructor : ………………………………………………………...…….. Objectives :

x Enhance learning through reflection

x Self evaluate knowledge and abilities

x Assess of teamwork and communication skills

x Enhance critical thinking and problem solving

Process of debriefing : x Explore personal reactions

x Assess and analyse interventions

x Discuss prioritization of care

x Discuss communication and collaboration

x Discuss safety

x Review documentation

x Link to clinical and real world

x Video playback

x Review what went well and what did not

x Identify areas for improvement

x Evaluate simulated clinical experience



Clinical Master in Critical care nursing

Edited Cases for Simulation Case 1:

History: x Mrs Gamela is a 29 year old Saudi woman x She is 7m pregnant x Complains of dizziness, palpitations and easy fatigability x also complains of being out of breath x (gets breathless on doing light housework) x The condition started about 1 month ago but has markedly

worsened over the last two days x The condition worsens by effort and improves when she lies

down x She sleeps on two pillows x This is her first pregnancy she is on irregular antenatal care x The patient also complains of indigestion, heart burn and

constipation Past history :

x Received monthly shots for one year when about 12 does not know for what

x Tonsillectomy at age 13 x no DM , HTN x No allergies x medication : only takes vitamins prescribed by her

obstetrician Family History

x Mother is diabetic x Father and mother are first cousins



Clinical Master in Critical Care Nursing Edited Cases for Simulation

Case 2:

Mr Amar is a 87 year old Saudi man who lives in a nursing home his wife died 1 year ago, he has two children who live abroad and call him once a week The patient experiences shortness of breath and palpitation when he gets up from bed to go to the bathroom this has been going on ever since his last surgery, he sleeps sitting up in bed and feels more dyspnic when he lies down Over the last two weeks the patient has lost 4 pounds Past history: DM type II of 20 years duration The patient had two CABG surgeries one of three vessels ten years ago and the second of four vessels 3 months ago. His current medications include: (The patient does not know the name of the drugs but has them with him) Metformin 1000mg X 2 Furosimide X 2 Lisinopril X1 Nadolol X 3 Digoxin X 1 except Friday Family history: DM, HTN , heart disease two of his brothers died of a heart attack



Clinical Master in Critical care nursing Edited Cases for Simulation

Case 3:

Noora is a 45 year old Saudi female she is married and has four children The patient complains of abdominal pain and diarrhea for the last couple of days, diarrhea (8/ day) with nausea but no vomiting she reports that this has happened since she had eaten a meal at a local restaurant she also reports feeling frequently as if her heart is missing a beat The patient also complains of tingling and numbness in the fingers of her right hand that is increased by cold weather this has been going on for the last few years The patient is obese and is diabetic on insulin for the last 15 years Past history: Hysterectomy 2 years ago, for bleeding Arthritis for the last 5 years

Her current medications include: Insulin Prednisolone tablets x 1 for arthritis Family history: DM (mother) HTN (mother) 2 of her children havesickle cell disease



Clinical Master in Critical Care Nursing Edited Cases for Simulation

Case 4:

SAID is a 27 year old Egyptian male who works in a ceramic factory he is married and has two children the patient complains of severe fatigue and weakness that has been going on for the last month, two days ago the patient experienced two attacks of fainting from which he recovered by lying down, the patient also complains of palpitations the patient has had bronchial asthma for the last 6 years but recently his attacks were exacerbated by dusty weather Past history: The patient has a history of scarlet fever at the age of 10 He recalls having several attacks of arthritis during his childhood He was dispensed from military service for having a bad heart

His current medications include: Simbicort inhaler x3 or as needed Family history: Irrelevant



Simulated Clinical Experience Evaluation Sheet

Simulation: ………………………………………………… Instructor: ……………... Student Name: …………….……… Student Number: …………..……………………. Date : ……………………………..…Group: ………………………………………..….. Serial Theme Done

2 Incomplete

1 Not done

0 Comments

ASSESSMENT : (TOTAL 12 grades) 7. x Proper equipment used 8. x Systematic approach 9. x Appropriate techniques 10. x Identifies significance of findings 11. x Refers to appropriate personnel 12. x Evaluates after intervention COMMUNICATION : ( TOTAL 8 grades) 5. x Communicates effectively with

members of healthcare team

6. x Uses appropriate verbal and non- verbal communication

7. x Communicates effectively with patient and family members

8. x Uses terms appropriate to patient’s level of education

NURSING MANAGEMENT : (TOTAL 14 GRADES) 8. x Uses best practices 9. x Prioritizes interventions 10. x Uses appropriate protocols /

procedures/ treatments /interventions

11. x Uses Critical thinking / problem solving

12. x Delegates appropriately 13. x Proper Fluid/ blood /drug

administration

14. x Coordinates appropriately with

interdisciplinary team

KNOWLEDGE AND COGNITIVE SKILLS (TOTAL 6 GRADES) 2. x Post SCE written exam PSYCHOMOTOR SKILLS (TOTAL 10 GRADES) 2. x Procedure checklist TOTAL GRADE (50) Instructor’s signature:______________________________ Date:_________________



Simulated clinical experience:

care of the patient who develops respiratory

failure

Description of the activity:

Students will be exposed to a simulated clinical experience involving a 26 year old

patient who develops ARDS and progressive respiratory failure following exposure to a

motor vehicle accident causing bilateral lung contusions. One student will assume the

role of nurse in charge while the others will as observers and the roles will be reversed

subsequently .Students will be expected to :

x Perform initial assessment

x Evaluate data and document findings

x Assess surgical wounds, drains

x Assist healthcare provider in endotracheal intubation

x Check ventilator settings

x Evaluate effecyiveness of ventilator settings

x Monitor pumps and infusions and check for patency

x Assess vitals , ABG and xray and report to healthcare provider

x Administer oral care

x Do cuff pressure checks

x Document assessment, interventions and response to treatment

The objectives of this simulated clinical experience are: x Identify the pathophysiology and causes of ARDS

x Perform assessment of the critically ill patient

x Prioritize interventions for a mevchanically ventilated patient

x Describe the nursing management of a person to be weaned from mechanical

ventillation

x Discuss the modes of ventilator settings for a mechanically ventilated patient

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x A

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x A

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SIMULATED CLINICAL EXPERIENCE

OBSERVATION RUBRICS

SCE:ASTHMA ATTACK IN THE PEDIATRIC PATIENT:

II. ADMISSION AND MANAGEMENT IN THE PICU

Group B students:

………………………..……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….…………………………………………………………………………………..

Serial

Minimal Expected Behavior


Areas for improvement Done

Incomplete

Not done

State#4: Admission to PICU 1. x Completes assessment

2. x Evaluates data

3. x Documents findings

4. x Obtains and interprets oxygen

saturation

5. x Identifies worsening condition

6. x Endorses PICU nurse

7. x Provides age appropriate

communication to and reassurance to patient

8. x Allows child to remain in position of comfort

9. x Arranges for arterial blood gases and lab work to be drawn

10. x Obtains chest XRAY 11. x Notifies respiratory therapist of

continuous nebulizer treatments

12. x Maintains correct IV flow rate 13. x Notifies healthcare provider of

findings

State #5:no Improvement in PICU

1. x Repeats assessment

2. x Evaluates data



5. x Uses bag valve mask device to administer oxygen

6. x Provides age appropriate communication and reassurance to patient


8. x Arranges for ABG to be drawn 9. x Requests and interprets results 10. x Maintains correct IV flow rate 11. x Correctly draws and administers

medication according to the 5 rights

12. x Notifies health care provider of the deteriorating condition

13. x Prepares for endotracheal tube insertion

14. x Assists physician in endotracheal tube insertion

Group : ………………………….. Date of simulation: ……………………………………

Clinical supervisor: ……….……………………………………………………………

SIMULATED CLINICAL EXPERIENCE

OBSERVATION RUBRICS

SCE:ASTHMA ATTACK IN THE PEDIATRIC PATIENT:

II. ADMISSION AND MANAGEMENT IN THE PICU

Group B students:

………………………..……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….…………………………………………………………………………………..

Serial

Minimal Expected Behavior


Areas for improvement Done

Incomplete

Not done

State#4: Admission to PICU 14. x Completes assessment

15. x Evaluates data


17. x Obtains and interprets oxygen

saturation


19. x Endorses PICU nurse

20. x Provides age appropriate

communication to and reassurance to patient


22. x Arranges for arterial blood gases and lab work to be drawn

23. x Obtains chest XRAY 24. x Notifies respiratory therapist of

continuous nebulizer treatments

25. x Maintains correct IV flow rate 26. x Notifies healthcare provider of

findings

State #5:no Improvement in PICU

15. x Repeats assessment

16. x Evaluates data



19. x Uses bag valve mask device to administer oxygen

20. x Provides age appropriate communication and reassurance to patient


22. x Arranges for ABG to be drawn 23. x Requests and interprets results 24. x Maintains correct IV flow rate 25. x Correctly draws and administers

medication according to the 5 rights

26. x Notifies health care provider of the deteriorating condition

27. x Prepares for endotracheal tube insertion

28. x Assists physician in endotracheal tube insertion

Group : ………………………….. Date of simulation: ……………………………………

Clinical supervisor: ……….……………………………………………………………

Critical Care Nursing Skills Laboratory 1

(CC1)

Inventory May 2015

Cabinet #

Equipment/Supplies Quantity Remarks

3

VHS Tapes x Suctioning x Oxygenation

1 1

CDs x Simulaids x Touch Tools x DELL

1 1 1

6

Towels 2 Patient’s Gown 2 Face Towel 2 Pillow 1 Pillow Cases 1 Blanket 1 Blue Linens 2

7

Tracheostomy Care Simulator

1

Ostomy Care Simulator

1

Manikin Accessories 8 Hungry Manikin 2

Cabinet #


Interchangeable Catheterization/ Enema Trainer

1

Pocket Masks 2 10

Buttocks Wound Care Model/Gluteal Ulcer

1

11 Tracheostomy Simulator 1 Chester Chest

2

12

Little Anne Manikin

1

NGTube & Tracheo Care Trainer/Respiratory & Wound Care Task Trainer

1

Cabinet #


Choking Charlie 1

13

Arterial Puncture Arm w/ Accessories

1

Airway Management Trainer 1 Central Venous Simulator 1 IV Arm Accessories

14

Nebulizer 1 Laryngoscope 1 Otoscope/Ophthalmoscope 1 Extension Wire 1

15

Littmann Stethoscope 5 Aneroid Sphygmomanometer 3 Screw Driver 2 Pliers 1

16

Venatech Trainer 3 Pulse Oximeter 1 Accu-Check Glucometer 1

External Equipments Quantity Remarks

Electronics Monitor 1 Computer Dell CPU Optiplex 1 Use for lecture Computer Dell Monitor 1 Use for lectrue Computer Dell CPU Optiplex 1 Inside control room Computer Dell Monitor 1 Inside control room Smartboard 1 Data Show w/ Remote 1 Printer 1 Sony Bravia Plasma w/

Remote 1

Simulators 3G Manikin (Laerdel) in bed 1 Instructor & Patient Monitor

Laptop 2

Inside the vault

Furnitures Computer Table 2 1-inside lab Conference Table 1 Swivel Chairs 20 Wall Painting 2 Vault 1 IV Stand 1 Yellow Back Strap 1 Shifted to ER Orange Stretcher 1 Suction Machine 1 (Laerdel) Inventory done by: Mrs. Lilibeth V. Reyes Lab Manager Critical Care Lab-l Noted by: Dr. Omnia Salem Dr. Radwa Hamdi Bakr Coordinator Overall Coordinator Critical Care Lab-1 Nursing Skills Laboratory

CRITICAL CARE NURSING SKILLS LABORATORY 2

(CC2)

Inventory May 2015

Cabinet #


2

Pulse Oximeter 1

Venatech IV Trainer 2 Nebulizer 1 Rebreather Mask (White & Blue) 2 Pocket Masks 2

3 Nursing Education /Meti Modules 5 6

Chester Chest

2

Adult Sternal Intraosseous Infusion Simulator

1

Central Venous Simulator 1 7

Arterial Puncture Arm 1 Arterial Stick Arm 1 VATA-Peter PICC (Peripherally Inserted Central Catheter) Line

1

Auscultation Trainer 1 9

Linens 9 Blankets 2

Towels 2 Face Towels 2 Pillow Cases 2 Patient’s Gown 1

10 Central Venous Simulator 1

Cabinet #


Little Anne 2 AED-Advance External Defibrillator

2

11

Choking Charlie Manikin 1 Abdominal Aortic Aneurysm Simulator

1

12

Tracheostomy Care Simulator 2 Catheterization/Enema Model 1

13

Laryngoscope 2 1-With CC1 Ophthalmoscope/Otoscope 1 Omron Fat Loss Monitor 1

14

Littmann Stethoscope 5 Accu-Check Glucometer 2 Vascular Dopplex 1

15 Accu-Check Glucometer 1

External Equipment Quantity Remarks

Electronics Meti-Laptops (Adult) 2 New (silver MacPro)

Old (white MacBook) Meti-Laptops (Pedia) 2 Meti-MSI Touchscreen

Monitors 2 Adult &Pedia

Meti-MSI keyboards w/ mouse

2 Inside the vault

Computer Dell CPU Optiplex 1 Inside the control room Computer Dell Monitor with

keyboard & mouse 1

Computer Dell CPU Optiplex 1 Inside the Glass door exclusively used for the virtual IV

Computer Dell Monitor with keyboard & mouse

1

Computer Dell CPU Optiplex 1 For lecture purposes Computer Dell Monitor with

keyboard & mouse 1

Smartboard 1 Data Show w/ Remote 1 Printer 1 LG DVD Player 1 LG VCR Player 1 Sony Bravia Plasma w/

Remote 1

External Equipment Quantity Remarks

Simulators Airway Management Trainer 1 Meti-Adult Manikin in bed 1 Meti-Pedia Manikin in bed 1 Servo-Ventilator 1 Arterial Puncture Wrist

with Circulation Pump 1

Tracheostomy Simulator 1 Portable Suction Machine 2 1-yellow(Laerdel) – no seal

rubber 1-white(New Aspiret)

Digital Weighing Scale 1 ECG Machine with leads 1 Furnitures Computer Table 3 Multipurpose Cart w/ 4

drawers 1

Multipurpose Cart w/ 7 drawers

1

Medicine Cart 3 1-shifted to ER 1-shifted to MS

Conference Table 1 Swivel Chairs 20 Wall Painting 2 Vault 1 Crash Cart 1 New – no division IV Stand 1 Yellow Back Strap 1 Shifted to ER Inventory done by: Mrs. Lilibeth V. Reyes Lab Manager Critical Care Lab-2 Noted by: Dr. Radwa Hamdi Bakr Coordinator-Critical Care Lab-2 Overall Coordinator-Nursing Skills Laboratory