Medicine and Health Sciences Commons^™

Dnp Final Report: Developing Competence And Improving Patient Safety With Documentation Training In The Simulated Environment, Laura Zebreski

DNP Final Reports

With the advent of electronic health records, nursing documentation has declined in quality. Poor documentation exposes patients to safety risks. Nursing documentation is subject to legal standards set by the Texas State Board of Nursing. A DNP scholarly project was designed to create a learning and safety intervention to train student nurses to provide correct documentation before entering clinical settings. The goal of this project was to prepare nursing students to provide quality documentation that fulfills the legal standard to attempt to correct the current deficiencies seen in practice and promote patient safety. For this project, the students took a …

End-Of-Life Simulation Education, Lucas Farris

MSN Capstone Projects

In the current healthcare workforce, there exists a lack of comfort and knowledge about providing end-of-life (EOL) care that will only continue to worsen without prompt changes to the delivery of education (Jablonski et al., 2020). The lack of knowledge and comfort expressed in providing EOL care leads to a nurse’s moral and physical difficulty when a patient chooses palliative care or hospice. This is a detriment to patients and should be a consideration for schools of nursing when developing curriculum and clinical activities. By promoting changes in curriculum and the addition of an EOL simulation at the undergraduate level, …

Utilization Of A Multimodal De-Escalation Class To Improve Staff Confidence When Caring For Behaviorally Escalating Patients, Tara B. Neuner

Graduate Theses, Dissertations, and Capstones

Workplace violence is a common challenge seen in the healthcare settings across the world. This problem is steadily increasing in all types of hospitals, including a level one trauma center located in an urban area. There has been a steady rise in the number of assaults and workplace violence reported from bedside staff at this hospital. The leadership of the organization formed a work group to help combat the workplace violence and staff assaults that were occurring. In this process, a behavior response team was created to help nursing staff with escalating behavior in patients, and to help de-escalate the …

Unintended Consequences Of A Transition To Synchronous, Virtual Simulations For Interprofessional Learners, Tiffany Champagne-Langabeer, Samuel E Neher, Marylou Cardenas-Turanzas, Jennifer L Swails

Faculty and Staff Publications

The coronavirus pandemic shifted in-person environments to virtual environments. Little is known about the effectiveness of fully synchronous, virtual interprofessional education (IPE). This study aims to compare two IPE cases that occurred in-person pre-pandemic and virtual during-pandemic. Two cases are analyzed: a medical error care and a charity care case. Participants were students from various health science disciplines. Assessments were captured through The Interprofessional Collaborative Competency Attainment Survey (ICCAS). Effect sizes were calculated for the pre-and post-surveys and analyzed using Cohen's d for independent samples. From the in-person collection period, a total of 479 students participated in the medical error …

Best Practices For Implementing Critical Care Orientation Programs For Newly Graduated Nurses After Reduced Hands-On Clinical Experience Due To The Covid-19 Pandemic: An Integrative Review, Anne-Marie Hinish

Doctoral Dissertations and Projects

The academic-practice gap has been described in the literature for years. Poorly implemented transition to practice can negatively impact patient outcomes, newly graduated nurses, and the nursing profession. Abbreviated prelicensure clinical experiences due to the COVID-19 pandemic have exacerbated the academic-practice gap’s impact on new nurse confidence, competence, safety, and retention. This integrative literature review aimed to identify best practices for developing and implementing a standardized new graduate nurse orientation program in the critical care setting that addresses and supports the transition from student to practitioner in an era of reduced hands-on clinical experiences due to the COVID-19 pandemic. Evidence …

Amniotic Fluid Embolism During Cesarean Section: An Objective Structured Clinical Exam, Mackenzie Acosta, Morgan Self

Doctoral Projects

Amniotic Fluid Embolism is a rare obstetric event that has a high morbidity/mortality rate. It is imperative that the anesthesia provider be properly educated on how to recognize and treat an AFE. Prompt recognition and treatment, including the AOK regimen, increase the patient's chance of survival. The faculty for The University of Southern Mississippi’s Nurse Anesthesia Program acknowledged the need for an objective-based exam on Amniotic Fluid Embolism during the Cesarean section. The need for an educational tool on AFE prompted the creation of this doctoral project and resulted in an AFE OSCE which has been added to the OSCE …

Experiential Learning In Patient Safety: A Multi-Center Study Examining Emergency Medicine Residents' Situational Awareness Of Hazards Via Simulation, Kamna S Balhara, Nathan Olson, Jessica L Wilson, Rosemarie G Ramos, Harlan J Goode, Andrew E Muck, Adriana S Olson

Student and Faculty Publications

Introduction The 2016 Clinical Learning Environment Review established that experiential patient safety curricula for residents are uncommon. Moreover, these curricula do not incorporate non-technical skills linked to safety, such as situational awareness (SA). We developed an in-situ patient safety simulation exercise incorporating core SA concepts and subsequently assessed exercise feasibility and acceptability, and measured residents' safety SA. Methods A simulation scenario and mock chart were designed, incorporating 16 patient safety hazards. Residents at two institutions reviewed the chart and had 10 minutes in an emergency department room with the simulated scenario to document identified hazards, followed by a facilitated debriefing. …

The Application Of Computer-Aided Three-Dimensional Simulation And Prediction In Orthognathic Surgery (Caspos) For Treating Dento-Skeletal Patients, Yu-Jen Chang, Shiu-Shiun Lin, Te-Ju Wu, Wen-Ching Tsai, Wei-Yung Hsu, Jui-Pin Lai

Taiwanese Journal of Orthodontics

AIM: Computer-aided craniofacial reconstructions have been developed to allow surgeons to accurately simulate and predict the surgical outcome on complicated 3-D craniofacial structures. We have developed a new computerized method of 3-D simulation and prediction in orthognathic surgery (CASPOS) that not only enables clinicians to plan and simulate the surgical procedures, but also provides a bony "guiding splint" to allow surgeons to precisely position the bony segments into the planned location. This study is aimed for assessing the accuracy of simulation and prediction of our CASPOS protocol. MATERIALS AND METHOD: Fifteen adult patients with severe dento-skeletal discrepancies treated with orthodontics …

Implementing Immersive Virtual Reality Into A Nursing Curriculum, Sue A. Schuelke, Krystal Davis, Sue Barnason

Innovations in Health Sciences Education Journal

Due to workforce demands, new undergraduate nurses are hired directly into fast-paced units and are expected to manage complex patients with rapidly changing conditions and respond to time-sensitive situations. It is important for nurse educators to prepare undergraduate nurses for transition into clinical practice upon graduation. Simulation has been a valuable tool to provide experiential learning and promote clinical decision-making. The next iteration of improving clinical simulation as an experiential learning modality for nursing students is Immersive Virtual Reality (IVR): a realistic, immersive simulation in a 3-dimensional environment that is experienced by body movements and hand controllers. IVR can incorporate …

The Virtual Peripheral Nerve Academy: Education For The Identification And Treatment Of Peripheral Nerve Disorders, Erica B. Lee, Allison Podsednik, Kimberly Khoo, Amal Cheema, Raysa Cabrejo, Chen Shen, Joseph Rosen, A Lee Dellon

School of Medicine Publications and Presentations

Millions of people around the globe suffer peripheral nerve injuries caused by trauma and medical disorders. However, medical school curricula are profoundly deficient in peripheral nerve education. This lack of knowledge within the healthcare profession may cause inadequate patient care. We developed the Virtual Peripheral Nerve Academy (VPNA) as a reusable virtual learning environment to provide medical students with detailed education on the peripheral nervous system (PNS). Students are introduced to the PNS through virtual 3D rendering of the human body, wherein they visualize individual nerves through dissection and observe normal motor and sensory function associated with each nerve. PNS …

Integrated Simulations To Build Teamwork, Safety Culture And Efficient Clinical Services: A Case Study, Melanie J. Ferguson, Cassandra Sampson, Jed Duff, Theresa Green

Journal of Perioperative Nursing

Background: Simulation methodology and frameworks were used to build teamwork and a safety culture, and to establish efficient clinical services within the procedure centre of a newly constructed, stand-alone, fully digital greenfield hospital. Rapid ramp up of surgical services required significant recruitment, and onboarding necessitated training of nursing and other perioperative support staff.

Methods: A two-day, immersive integrated simulation activity was carried out with the interprofessional onboarding staff participating in their usual roles. During the simulation, staff had the opportunity to apply newly acquired skills and knowledge to all stages of a patient’s clinical journey through the procedure centre, including …

Debriefing For Meaningful Learning: Implementing A Train-The-Trainer Program For Debriefers, Aimee A. Woda, Jamie Hansen, Kristina Dreifuerst, Brandon Kyle Johnson, Anne Loomis, Nolan Cox, Cynthia Sherraden Bradley

College of Nursing Faculty Research and Publications

Debriefing for Meaningful Learning (DML) is a method of debriefing grounded in the theory of reflection used following a simulation or clinical learning experience to engage participants in an interactive dialogue aimed at examining and evaluating their thinking and decision-making processes. With increasing adoption of DML worldwide, a sustainable training program for nurse educators is needed. Attending conferences and workshops that provide training is challenging for many nurse educators because of time and cost constraints. One promising solution is the train-the-trainer (TTT) model. In this article, the development and implementation of a TTT model of DML debriefer training, adaptable to …

Quality Delivered: How A Pandemic Fostered Innovation And Creative Solutions In Clinical Education, Alice M. Davis, Laura Laporta, Nancy F. Mulligan, Stacy Carmel, Shelene Thomas, Denise O'Dell

Internet Journal of Allied Health Sciences and Practice

Background: Clinical education placements for students enrolled in healthcare programs were abruptly upended in March 2020 due to COVID-19. Programs were faced with decisions of how to mitigate substantive challenges due to an unforeseen pandemic within timeframes that would align with curricular sequences and graduation dates. Schools quickly modified curriculum formats, implemented alternative teaching and learning instruction and developed safety protocols to protect students, clinical faculty, and patients. Purpose: The aim of this study explored the strategies employed by one physical therapy school’s clinical education team, which resulted in successful completion of clinical course requirements and on-time graduation. Method: Data …

Staying Current: Developing Just-In-Time Evidence-Based Learning Objectives For A Maternal Cardiac Arrest Simulation Curriculum., Andrea D Shields, Jacqueline Battistelli, Laurie Kavanagh, Lara Ouellette, Brook Thomson, Peter Nielsen

Library Staff Publications

BACKGROUND: Our objective was to review the latest evidence on resuscitation care for maternal cardiac arrest (MCA) and gain expert consensus on best practices to inform an evidence-based curriculum.

METHODS: We convened a multidisciplinary panel of stakeholders in MCA to develop an evidence-based simulation training, Obstetric Life Support™ (OBLS). To inform the learning objectives, we used a novel three-step process to achieve consensus on best practices for maternal resuscitation. First, we reaffirmed the evidence process on an existing MCA guideline using the Appraisal of Guidelines for Research and Evaluation (AGREE II). Next, via systematic review, we evaluated the latest evidence …

Eagle Medical Tray Denesting & Debris Removal Process, Nicholas Allen Ungefug, Noah Chavez, Susana Shu-Lin Okhuysen, Michael Augustine Pennington

Industrial and Manufacturing Engineering

Eagle Medical Incorporated is a contract medical device packaging and sterilization company. The company purchases thermoformed medical packaging trays, which maintain the sterility of medical devices, from various manufacturers. To ensure packaging quality and to prevent cleanroom contamination, Eagle Medical inspects and sterilizes each blister tray that they order. This process is an essential non-value-added activity that creates a bottleneck. Cleanroom employees must stop packaging medical devices and attend to the processing of blister trays and packaging solutions. The blister trays arrive at Eagle’s facility in nested stacks. Vibration and movement during shipping further compresses the stacks, which makes separation …

Stop The Bleed And Seize Control: The Use Of Simulation And Video Modules In Educating Emergency Department Staff Regarding Maternal Hypertension And Hemorrhage, Jared Maxwell Talsky

Master's Projects and Capstones

In order to address shortcomings of the health care system within the United States surrounding the early recognition and response to preeclampsia (PreE) and postpartum hemorrhage (PPH) emergencies The Joint Commission (TJC) revised the accreditation requirements regarding implementing yearly maternal hypertension and hemorrhage simulation scenarios in emergency departments. A Quality improvement team of Clinical Nurse Leader (CNL) students at University of San Francisco, working alongside the emergency department and labor and delivery department nurse educators assisted a dual hospital system in the Bay Area of California to develop and implement training materials and simulations for the hospital system’s Emergency Department …

Nursing Students' Moral Courage Development Through Incivility Simulation Education, Melissa Madden

Nursing Theses and Dissertations

Objectives: The purpose of this study was to determine if the use of an incivility simulation intervention and incivility educational module would increase nursing students’ perceived moral courage more than an incivility educational module alone.

Hypotheses: Nursing students’ moral courage scores would increase more in response to an incivility simulation intervention and educational module than for those who received the incivility educational module intervention alone.

Methods: The NLN Jeffries Simulation Theory framed the proposed intervention using a quasi-experimental pre-test-post-test comparison group design. A convenience sample of 66 students was utilized from one university across two classes. The Moral Courage …

Implementing Uniform Curriculum To Increase Efficiency And Access To Simulation, Christine Mallar, Bethany Rocheleau, Shelly Chipman, Mike Shepherd, Erin Siebers

Costas T. Lambrew Research Retreat 2022

• Using Standardized Patients (SPs) is effective in improving communication skills.

• Conducting SP training can be cost prohibitive in terms of time and labor.

• Demands of current curriculum created a need for an innovative and more efficient approach to meet new CLER requirement.

Code Blue! When A Simulation Isn’T A Simulation Anymore, Bethany Rocheleau, Christine Mallar, Shelly Chipman, Leah Mallory, Mike Shepherd, Erin Siebers, Susan Lane, Tracie Knight

Costas T. Lambrew Research Retreat 2022

Objectives:

• To identify and remediate gaps responding to a medical emergency during a simulated event.

• To provide a safe working environment for standardized patients and clinical staff.

Exploring Gen Z Nursing Students’ Experience And Emotional Processing In Simulation: A Grounded Theory Study, Wendy Matthew

UNLV Theses, Dissertations, Professional Papers, and Capstones

Simulation is an integral teaching methodology used within current nursing curricula. The goal of simulation is to promote learning, develop clinical judgment and reasoning, and ultimately improve patient care. However, some factors can disrupt the goals of the simulation learning experience. Students may experience uncomfortable emotional responses, such as anxiety, during simulation events, which impairs students' thinking processes leading to decreased learning, poor performance, an inability to assess knowledge, and potentially prohibits the transfer of knowledge to practice. Over 90% of the general Generation Z (Gen Z) population report uncomfortable emotions such as stress and anxiety. Simulation is used in …

Use Of Ar To Bring Medical Simulation To Life, Zhenhua Yu, Richard L. Doolittle, Caroline J. Easton

Frameless

Use of simulation facilities and equipment in medical training has become the fabric of curricula across nearly all professions, most notably medical school, nursing, and related medical sciences programs. The gold standard for simulators is SimMan3G, Laerdal Inc., which offers a static electronic mannequin that affords the opportunity to create disease states, signs/symptoms, and real physiological/vital sign data complemented by voice interactions between faculty (within the control room) and student. All sessions are videotaped and, through a 15-30 minute debriefing, students exchange thoughts and impressions with faculty and engage in a deep reflective learning experience. The other option for medical …

Using Simulation To Develop Clinical Judgment In New-To-Practice Emergency Department Nurses: An Evidence-Based Benchmark Project, Moreno Divine Comiskey

MSN Capstone Projects

In the past 6 months, the Emergency Department at the George Washington University Hospital has onboarded over twice as many new-to-practice nurses as experienced emergency nurses. Studies suggest that these new-to-practice nurses often are deficient in clinical judgment, and our observations at our hospital support these findings. Researchers have found that onboarding programs that include simulation have success in improving clinical judgment, and advocate for its use. Simulation gives another angle to the onboarding program in addition to preceptorship and classroom learning, and allows participants to bridge the gap between theory and practice safely and without fear of harming a …

The Impact Of An Innovative Simulation On Prelicensure Nursing Student Empathy Levels, Annie Harrison

Articles, Abstracts, and Reports

Empathy is the ability to see oneself in the situation of another and to take actions on behalf of that individual based on that perception. However, empathy has been shown to decrease in nursing education and continues to do so in nursing practice. Importantly, aspects of empathy have been shown to be teachable. This scholarly practice project examined whether an innovative simulation would increase empathy in prelicensure nursing students. This study, guided by self-determination theory (SDT) and designed according to the Plan-Do-Study-Act (PDSA) change model, used a mixed-methods design. The instrument for quantitative data collection was the Toronto Empathy Questionnaire …

Cardiopulmonary Resuscitation Using High-Fidelity Simulators, Rebecca Walker

MSN Capstone Projects

Simulation and high-fidelity simulators (HFS) have become an important part of nursing education and its implementation into the curricula. It has become important in enhancing their knowledge and the development of competent nurses by reinforcement of skills that have been previously learned. HFS also increases students' confidence and reinforces their skills and knowledge while introducing cardiopulmonary resuscitation (CPR). The literature suggests that overall the students have greater retention of CPR skills if HFS is used instead of classical CPR training with low-fidelity simulators (LFS). However, some studies suggest that using HFS does not lead to retention of CPR skills or …

A Scaffolded Simulation Curriculum: Trnaslating Simulation With Standardized Patient Encounters Into Clinical Practice, Amy Graham, Andrea Knopp, Sarah Stowell, Carolyn Schubert

School of Nursing - Faculty Scholarship

No abstract provided.

Using The Unfolding Case Study To Improve Clinical Reasoning, Greg Williams, Sara L. Nottingham

Internet Journal of Allied Health Sciences and Practice

Context: When authentic clinical experiences are unavailable, instructors may need to consider alternatives for evaluating clinical reasoning. Objective: Describe an educational technique that simulates clinical experiences to allow students to demonstrate clinical reasoning. Background: The COVID-19 pandemic created a situation where providing clinical experiences became impossible. Yet, students still needed to exercise clinical judgement as part of their athletic training education program. The unfolding case study technique aligns well with Kolb’s Theory of Experiential Learning and can be used to help students improve clinical reasoning and critical thinking skills. Description: An unfolding case study was used to …

Observers Have Similar Improvements In Student Learning Outcomes As Participants In Athletic Training Simulation Education, Alma Mattocks

Graduate Theses, Dissertations, and Capstones

The use of standardized patient (SP) encounters in athletic training education programs have become more common; however, due to time and space constraints, it is possible that not all athletic training students will be able to directly participate in engaging with the SPs and instead some must be observers. The objective of this study was to determine if student participants who observe a simulation encounter, experience similar improvements in student learning outcomes as students who directly interact with SPs during the simulation encounter.

A pretest/posttest, randomized controlled trial was utilized. Nine athletic training students volunteered to participate in the research …

Evaluating The Military Medical Evacuation Dispatching And Delivery Problem Via Simulation And Self-Exciting Hawkes Process, Virbon B. Frial

Theses and Dissertations

The location, allocation, and utilization of military medical evacuation (MEDEVAC) resources significantly impact the quality and timeliness of medical care to injured troops. In 2009, Secretary of Defense Robert Gates introduced the Golden Hour mandate that entails the evacuation of critically-injured troops to military treatment facilities (MTFs) within an hour to prevent further complications. To develop high-quality policies that improve MEDEVAC system performance, several papers in the current literature assume that MTFs have both the capacity and capability of treating any patient, regardless of the type of injury. However, these assumptions are unrealistic when conducting high-intensity operations. While acknowledging MTF …

Comparative Study Of Knowledge Acquisition, Satisfaction, Self-Confidence And Perceived Support In Nursing Students Experiencing Simulation Versus Clinical Placement In Perinatal Care, Catherine Pépin, Marilyn Aita, Andréane Lavallée, Johanne Goudreau

Quality Advancement in Nursing Education - Avancées en formation infirmière

The aim of this study was to compare nursing students experiencing simulations (SIM group) (n=25) versus clinical placement (CPG) (n=55) in perinatal care. Questionnaires on satisfaction, self-confidence and perceived support were completed by both groups. Knowledge acquisition was assessed using standardized course evaluation. The Student’s t-test showed that differences between groups were not statistically significant for knowledge acquisition and satisfaction, while they were statistically significant for self-confidence and perceived support with higher scores in the CPG group. This study contributes to knowledge development since few have compared simulations as a learning method to replace totally clinical placement. Findings support the …

Improving The Competency Of Nurse Educators In The Use Of Simulation, Pricilla H. Wyatt

Electronic Theses and Dissertations

Simulation in nursing education programs is widely used as an active clinical learning strategy. This teaching methodology is a standard supplement to clinical experiences for nursing students to meet the requirements of clinical components within their degree program; however, the faculty of a small liberal arts-based Bachelor of Science in Nursing program was not using simulation to its fullest potential. Therefore, the purpose of this DNP project was to introduce the use of evidence-based practice simulation guidelines recommended by the National Council of State Boards of Nursing. The study sample of 16 included 10 full-time faculty, five part-time adjunct faculty, …