Simulation Training for New Emergency Nurses “ SimMan ”

1. Simulation Training for New Emergency Nurses“SimMan” Margaret M Miller FNP,BC

2. Introduction • The Emergency Department (ED) is one of the areas that is the forefront of Nursing. Since the ED is both fascinating and challenging for the new nurse, a comprehensive orientation with high technology is warranted for success. The use of Simulation in the orientation process will set standards and guidelines for various kinds of learning and assessments

3. Objectives • Compare simulation technology to traditional learning models • Identify potential advantages and disadvantages of simulation as a teaching strategy • Evaluate how simulation help the new nurse transcend to the ED

4. The Role of Simulation as a Trend in Nursing Education • A teaching Strategy • An evaluation tool • Can be use to provide a more experiential learning opportunity • Provides increase use of learning technology • It is more outcome based • Provides more evidence-base education

5. Rationale for Incorporating the SimManin Orientation Program • To promote better preparation of the new ED nurse • To simulate a patient safety environment • To support innovative teaching strategies • To have a better prepare nurse for the Preceptors • To create complicated patients presenting to the ED, and implementation of Emergency Care

6. Types of Simulation • Screen-based/PC-based simulation • Virtual Patients • Partial task trainers • Human patient simulator • Standardized patients • Integrated models

7. Definition • Wikipedia, the free encyclopedia defines Simulation as the imitation of some real thing • Simulation is widely used for educational purposes. Such as Aviation, Military, Medical and Transportation. A good example of this was seen recently when the pilot landed the plane in the Hudson River. A situation that was practice by simulation for a long time and was eventually put to use which save over 100 lives

8. Simulation • In the Healthcare systems simulators are increasingly being developed and deployed to teach therapeutic and diagnostic procedures • There are human simulators for every patient we care for from birthing to the neonatal to the adult • One of the amazing features of simulation is the see the real life reaction of the mannequins

9. Type of Models • Active models: Attempt to reproduce living anatomy or physiology such as palpations, electrocardiography and auscultation • Interactive models: Responds to interactions taken by a user. This has the advantage of allowing a student to make judgments or errors. The process of iterative learning through assessment, evaluation, decision making and error correction

10. Types of Models • Computer Simulators: Simulators have been proposed as an ideal tool for assessment of student for clinical skills

11. Simulation

12. Simulation

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14. What Is a SimMan • Human simulator • Computer controlled manikin that displays physiologic data, such as heart rate, blood pressure, respirator rate and prerecorded sounds. • Supports clinical decision making activities • Preset scenarios available and the ability to generate scenarios

15. SimMan • Computer driven • It provides highly realistic training experience: • To master decision making • Patient care skills • Simulate team work

16. Features of the SimMan • Interactive manikin that responds physiologically to interventions • Examples are: • Defibrillation • Airway system: Its anatomically realistic airways systems allows practice of all types of difficult airway management • Difference in heart sounds and breath sounds

17. SimMan • Allow practice of IV insertions • Life threatening emergencies can be simulation through the injections of drugs and fluids • Improvement in patient’s safety and outcomes • Decrease in errors • Best standards use for care and training

18. SimMan in Education • Helps health the providers to “think on their feet” • Provides feedback as they practice • Ability to witness how quickly a patient can become unstable • Realize how important the application of their assessment skills and response time can improve a patient’s outcome

19. SimMan in Education • The ability to recognize deviations from expected baselines • Refocusing for skilled nurses in their assessment techniques

20. Advantages • Offers opportunities to practice rare and critical events • Can be manipulated • Allows for updates of new medications and new calibrations • Scenarios can be reproduced • Offers opportunities to make and learn from mistakes

21. Advantages • The use of simulation saves lives and money by reducing medical errors, training time • Allows for the nurse to practice on a variety of patients • Each patient can present with a different case history and unique symptoms • Responds to user action with appropriate physiological responses

22. Advantages • The system is able to generate detail evaluation after each session which helps with feed back and the debriefing process

23. Limitations/Disadvantages • Not real • Limited realistic human interaction • Students may not take it seriously • It is costly • Must have trained educators • Must maintain trained technical support

24. Summary • We can conclude that simulation training for the new ED nurse will increase both productivity and creativity • It will create patient safety • It will increased and build on the new nurse confidence • And will help with nurse retention and decrease in nursing turnover

25. References • Donohue, A J., Durbin, DR., Nadel, FM., Stryjewski, GR., Kost, SI., Nadkami, VM. (2010). Perception of realism during mock resuscitations by pediatric house staff: The impact of simulated physical features (1) 16 – 20 • Hoyt, RE., Sutton, M., Yoshihashi, A., Practical Guide for the Healthcare Professional 3rd edition, 2009

26. References • MCGonigle, D., Mastrian, K., (200). Nursing Informatics and the foundation of Knowledge • Ruesseler, M., Weinlich, M., Muller, MP., Byhahn, C., Marzi, I., Walcher, F. (2010). Simulation training improves ability to manage medical emergencies. Emergency J. (10) 734 -8.

27. References • Sutton, RM., Niles, D., Meaney, PA., Aplenc, R. (2010) “Booster” training: Evaluation of instructor led bedside cardiopulmonary resuscitation skill training and automated corrective feedback to improve cardiopulmonary resuscitation compliance of Pediatric Basic Life Support providers during stimulated cardiac arrest. http://www.ncbi.nln.nih.gov/pubmed/20605336

28. References • Thomas, F., Carpenter, J., Rhoades, C., Holleran, R., Snow, G. (2010). The usefulness of design of experimentation in defining the effect difficult airway factors and training have on simulation oral tracheal intubation success rate in novice intubators. Academy of Emergency Medicine (4) 460 - 3

29. References • Weidman, EK., Bell, G., Walsh, D., Small, S., Edelson, P. (2010). Assessing the impact of immersive simulation on clinical performance during actual in hospital cardiac arrest with CPR sensing technology: A randomized feasibility study. http://www.ncbi.nlm.nih.gov/pubmed/20724057