Navigating a Disaster: A Capstone Simulation Integrating Leadership Skills, Ethical Principles, and Clinical Reasoning

Transcription

1 The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based nursing materials. Take credit for all your work, not just books and journal articles. To learn more, visit Item type Format Title Presentation Text-based Document Navigating a Disaster: A Capstone Simulation Integrating Leadership Skills, Ethical Principles, and Clinical Reasoning Authors Wiles, Lynn L.; Isibel, Denise B. Downloaded 4-May :49:47 Link to item

2 Navigating a Disaster: A Capstone Simulation Integrating Leadership Skills, Ethical Principles and Clinical Reasoning Lynn L. Wiles, PhD MSN RN CEN Director of Technology & Simulation Role Transition Course Coordinator Denise Isibel, MSN RN CNE Leadership Course Coordinator

3 Presentation Objectives: 1. The learner will explain how simulation provides an opportunity to develop the clinical reasoning and leadership skills needed to respond to disasters. 2. The learner will summarize how structured debriefing is used to analyze clinical reasoning, leadership and ethical principles, and patient outcomes in response to a disaster. The authors did not receive any employer or commercial support for this project, nor are there any conflicts of interest to report. Lynn L. Wiles & Denise Isibel Old Dominion University

4 Simulation Format Background CCNE AACN Capstone Simulation Graduating Seniors Last week of semester Groups of 8 Wiki sign-up Confidentiality agreement Don t bring supplies or uniforms!

5 Participant Roles Students- random role assignment Nurse Bystander Triage Nurse Incident Commander Patients Simulation Equipment Live Actors Faculty Role Transition, Leadership course, & simulation faculty Voice of the patient (simulation equipment) Command center voice

6 Simulation Scene Set-up Sim Lab prep Simulation Equipment Prep Moulage Faculty / Actor prep Moulage Scripts Only provide information if asked Simulation Recording Static Video

7 Student Preparation & Deliverable Preparation 2 Journal of Emergency Nursing articles Nursing Process and Critical Thinking Linked to Disaster Preparedness Ethical Decision Making and Disaster Triage Role Transition seminar class time Disaster Triage Deliverable 1-2 page reflective log Bulson, J. A. & Bulson, T. (2011). Nursing process and critical thinking linked to disaster preparedness. JEN 37(5), Good, L. (2008). Ethical decision making in disaster triage. JEN 34 (2),

8 Student Learning Objectives 1. Assess patients and integrate the impact of the patient s health history with current health problems. 2. Recognize respiratory failure, cardiac ischemia, hypoglycemia and shock. 3. Prioritize and implement nursing interventions using the available equipment. 4. Demonstrate effective leadership, teamwork and communication. 5. Discuss ethical considerations of mass casualty triage and disaster response.

9 Scene

10 Patient Scenarios Patient 1 Young adult male with significant head and neck trauma, unresponsive, gurgling respirations, cyanosis Patient 2 Young adult male with open forearm fracture and leg laceration Patient 3 Adult female s/p abdominal surgery with wound dehiscence

11 Patient Scenarios Patient 4 Teenage female with hypoglycemia that progresses through altered LOC if DM / insulin dose not detected Patient 5 Adult female retired military nurse with PTSD Patient 6 Adult female with glass shard protruding from her eye and large leg laceration

12 Patient Scenarios Patient 7 Adult male with chest pain and SOB after helping extricate / carry patient 1 to lab Patient 8 Young adult female with large facial laceration and other minor injuries Patient 9 Non-English speaking young adult female in labor Patient 10- the baby!

13 Debriefing Assessment Basics (PMH, meds, allergies) Situation specific Clinical Reasoning Triage tag decision Supplies requested Interventions Standard precautions!! Creative use of supplies Communication Clarity / SBAR

14 Organizational & Ethical Challenges Leadership Opportunities Random roll assignment When a non-leader gets the lead role & vice versa Decision Maker Communication Scope of Practice Let s intubate! Lack of Resources Basic supplies No meds Triage Decision Advocating for the patient Everyone s a red! Black tag

15 Emotional Response Varied based on the overall effectiveness of the group activity Chaos We nailed this We were a disaster I couldn t walk away We need more practice Hospital disaster plan prep discussions

16 Next Steps Collaboration ODU Theater Department Expansion Duplicate patients live actors and simulators Do triage categories change? Can students black tag a live person?

17 References Alim, S., Kawabata, M., & Nakazawa, M. (2015). Evaluation of disaster preparedness training and disaster drill for nursing students. Nurse Education Today, 35(1), Beach, M. (2010). Disaster preparedness and management. F. A. Davis: Philadelphia. Halstead, J. A. (2013). When disaster strikes: Are you and your nursing students prepared? Nursing Education Perspectives, 34(4), Hutchinson, S. W., Haynes, S., Parker, P., Dennis, B., McLin, C., & Welldaregay, W. (2011). Implementing a multidisciplinary disaster simulation for undergraduate nursing students. Nursing Education Perspectives, 32(4), Jose, M. M., & Dufrene, C. (2014). Educational competencies and technologies for disaster preparedness in undergraduate nursing education: An integrative review. Nurse Education Today, 34(4), Kaplan, B. G., Connor, A., Ferranti, E. P., Holmes, L., & Spencer, L. (2012). Use of an emergency preparedness disaster simulation with undergraduate nursing students. Public Health Nursing, 29(1), Loke, A. Y., & Fung, O. W. M. (2014). Nurses competencies in disaster nursing: Implications for curriculum development and public health. International Journal of Environmental Research and Public Health, 11(3), National League for Nursing (2013). Emergency! Educating nurses and nursing students to handle disaster. The NLN Report, 19, 2-4. Schmidt, C. K., Davis, J. M., Sanders, J. L., Chapman, L. A., Cisco, M. C., & Hardy, A. R. (2011). Exploring nursing students' level of preparedness for disaster response. Nursing Education Perspectives, 32(6), Weiner, B., Irwin, M., Trangenstein, T., & Gordon, J. (2005).Emergency preparedness curriculum in nursing schools in the United States. Nursing Education Perspectives, 26 (6),

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