Objectives Following this lab session the student will be able to o make appropriate basic assessments on a patient, using

skills learned in the lab; o identify most of the errors set up in the clinical simulation; o perform skills learned in the lab; o perform head-to-toe assessments (as much as is possible using a mannequin); o critically think through and develop a basic plan of care for one of the patients using the nursing process. Instructor Preparation 1. Set up 34 mannequins (depending on the number of students in class) so that groups of three students have a chance to work on at least two scenarios. 2. Write up a nursing kardex for each patient with name, age diagnosis, nursing treatments, etc. (If you can use a kardex from the hospital where students will be having clinical, it would help them prepare for clinical). 3. For each scenario, identify which assessments and skills students will have the opportunity to practice. 4. Have some errors set up so that students can practice critical thinking skills and troubleshooting. (For example, Mr. Smith has a fractured hip and had a surgical repair done 2 days ago. He is also a diabetic. Set up Mr. Smith with a hip dressing for students to change, a foley catheter to be cared for and measured, a fingerstick, (students could do one on themselves for practice), and an I.V. of D5LR. Have the nursing kardex read I.V.: D51/2NS. Student will need to check orders or at least report the discrepancy.) 5. Examples of skills that can be utilized: isolation (have a patient with MRSA), Dressing change, I.V. bag change, medications administration (if you use this procedure, be sure and have an MAR sheet and providers orders available), foley catheter (for catheter care and measuring intake and output), N/G tube that isnt working properly, tube feeding, TEDs, etc. If mannequins have working parts, you can have specific vital signs, lung sounds, bowel sounds, and heart sounds preset. 6. Examples of simulations: melted chocolate kisses or chips or chocolate pudding on the sheets or in diapers, red tinged urine in a foley bag by using red dye, and oatmeal and water makes a good emesis. Be creative! The possibilities are endless! 7. Have available at each station: Nursing kardex with all necessary information, MAR sheet, providers order sheet, appropriate pieces of the chart to document (I & O, V/S, etc. (Again, using the actual chart copies from the hospital where students will practice will help them learn to be more comfortable with documenting assessments. Lecture Outline 1. Review directions for the simulations. This can be set up however the instructor wishes. The time spent at each scenario should be equal to the amount of work that the student is expected to do. 2. Explain how you want the students to work in groups (i.e., one student will be the main nurse and plan the care, one student will be her helper, third student will be silent observer and record areas for improvement and what was done correctly). 3. Give the nurse and helper time to review the nursing kardex and formulate a plan. 4. When the set time is close to being up, students should clean up their work space and place the mannequin in original setup. 5. Then have students rotate to another scenario and rotate their roles in the group. 6. If each simulation is 45 minutes and each group does three simulations, this will leave enough time to process the experience. 7. After the simulations have been completed, bring all the students together and discuss the experience. The recorders can read their observations: what they observed being done well and what they saw as areas for improvement. They can also talk about the errors their group found and what they did about them. No names should be used for this exercise. 8. After processing, have the students identify one particular scenario and, as a group, formulate a care plan using each part of the nursing process. Teaching Guidelines o Present this lab day as a day of fun and an opportunity for the students to put together what they have learned. This will help reduce stress! o The amount of time spent on each simulation should be in proportion to what you want the students to actually do. Have longer simulations if they have to change dressings, get someone out of bed, measure intake and output, and document. If you want them to only verbalize some skills (such as the bed bath) but do others i.e., dressings, N/G feedings, vital sign, documentation, etc., be clear with directions so that they will be less frustrated. o The instructor could be the nurse on the unit so that the students can learn that its appropriate to ask questions when they are unsure of something. A nursing treatment that they havent learned could be added to the kardex for this purpose. o Each simulation should present different learning opportunities so that the students get a variety of skills and assessments to practice. o Have fun! This is a very rewarding experience for students AND instructors!

Skills Lab Teaching Plan Week 13: Lab Simulations