Simulation Training for New Emergency Nurses SimMan Margaret M
Miller FNP,BC
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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
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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
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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
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Rationale for Incorporating the SimMan in 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
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Types of Simulation Screen-based/PC-based simulation Virtual
Patients Partial task trainers Human patient simulator Standardized
patients Integrated models
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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
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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
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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
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Types of Models Computer Simulators: Simulators have been
proposed as an ideal tool for assessment of student for clinical
skills
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Simulation
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Wooden mechanical horse during WW1
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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
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SimMan Computer driven It provides highly realistic training
experience: To master decision making Patient care skills Simulate
team work
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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
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SimMan Allow practice of IV insertions Life threatening
emergencies can be simulation through the injections of drugs and
fluids Improvement in patients safety and outcomes Decrease in
errors Best standards use for care and training
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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 patients outcome
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SimMan in Education The ability to recognize deviations from
expected baselines Refocusing for skilled nurses in their
assessment techniques
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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
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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
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Advantages The system is able to generate detail evaluation
after each session which helps with feed back and the debriefing
process
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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
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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
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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 3
rd edition, 2009
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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.
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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/206053 36
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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
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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/20724 057