Task Trainers, Patient Simulators, & EHRs: Oh My! Judith J. Warren, PhD, RN, BC, FAAN, FACMI Director, Nursing Informatics Mary N. Meyer, RN, MSN, ARNP-BC Director, Learning Lab April J. Roche, MBA, CPEHR Project Manager, Center for Health Informatics
Toto, I've a feeling we're not in Kansas any more. (Dorothy)
If I only had the nerve! (Cowardly Lion) Course Content Tools for simulation task trainers Simulators Clearly state learning objectives. Match the technology available with the objectives.
All you've ever need has always been right inside you. (Glinda the Good Witch) Or at least, inside your course and your lab!
Create a patient My! People have a way of coming and going so quickly here! (Dorothy)
Create a patient Find an appropriate patient Look in our library Use pre-developed case studies Create patient case
Algorithm Decision Chart You, my friend, are a victim of disorganized thinking (Oz to Lion) Maps out the expected student behaviors. Potential decision points Desired student performance outcomes.
Case Study Sam Jayhawk Trach patient Needs suction Assessment findings Trach shield: 30% Lung sounds: Rhonchi throughout Vital signs: Saturation: 86% You have order to suction prn. Call Physician Use SBAR Trigger to suction: Have you been suctioning much out of the trach? Suction patient Uses sterile technique Hyperoxygenates patient Returns patient to ordered amount of oxygen Orders: Titrate O2 to maintain sat of 92 or greater. Obtain sputum sample for culture and sensitivity Assessment findings Sats remain 88% Lung sounds: Clear but Diminished right base Call Physician Use SBAR Orders: Titrate O2 to maintain sat of 92 or greater; Call if Sats remain less than 92 on 60%. Suction patient Titrate O2 for sat < 92% Titrates oxygen up Monitors sats Assessment findings Sats rise to 93% Lung sounds: Clear TERMINATE scenario Uses sterile technique Hyperoxygenates patient Returns patient to ordered amount of oxygen and titrates monitoring sat.
Creating Clinical Data for EHR Case Study Spreadsheet Organizes all the patient s clinical data elements, including dates & times each occurs in the record. Helps ensure complete and accurate patient record is produced. Allows other members of your team to replicate chart(s) as necessary.
Creating Clinical Data for EHR
Pay no attention to that man behind the curtain. (Wizard of Oz) Dates & Times Build charts months in advance by future dating all data elements in the chart. Reveal data elements in a chart to users using date range searches limiting results to only relevant items. Trend results over time to illustrate important learning objectives. Dynamically interact with record and students during simulations Orders, Results, etc.
Importance of Timing EHR Data
It really was no miracle. What happened was just this... (Dorothy)
EHR Records Created
EHR Records Created
Dry Run Paper based chart Confirm the students workflow Identify missed details Equipment Information
Re-evaluate the EHR Do the students have what they need, when then need it? Detail review of the information Complete? Consistent? Doable?
Lights, camera, ACTION The simulation is a part of the course. EHR support during the initial run April available for questions & support in beginning In person By phone Independent
Keep the charts private Poppies...Poppies. Poppies will put them to sleep. Sleep. Now they'll sleep! (Wicked Witch of the West) When simulation is terminated Students complete documentation Faculty put the charts to sleep Example: zzzrobinson, James
Group Activity #1 (15 Minutes) Develop 2 simulation scenarios using task trainers and EHRs and/or patient simulators and EHRs. Identify a teaching strategy for each scenario. Groups Report 15 minutes
Group Activity #2 (15 Minutes) Develop a simulation workflow of the integration of selected technologies identified in the first activity. Pay attention to the particular activities required of the simulation team to create the details required for the programming of the EHR, task trainer, and patient simulators. Groups Report 15 minutes
Conclusions Details and facts not stories Sharing exercises Social networking tool(s) Points from the Group reports
Questions or comments?