A Delphi Study On The Use Of Simulation In Undergraduate Nursing Education, Diana L. Bailey

Walden Dissertations and Doctoral Studies

AbstractThe lack of traditional clinical sites for nursing students has prompted a surge in simulation as an innovative teaching strategy in undergraduate nursing education. The International Nursing Association for Clinical Simulation and Learning (INASCL) developed the INACSL Standards of Best Practice: SimulationSM to direct schools of nursing in implementing high-quality simulations. As simulated experiences replace traditional clinical experiences, it is imperative that simulated experiences replicate real-life patient scenarios. The purpose of this Delphi study was to establish consensus on the use of the INACSL Standards of Best Practice: Simulation in undergraduate nursing education. The conceptual frameworks guiding this study were …

Introducing A New 12 Week Education & Simulation Program To Optimize Financial Performance Of Nurse Managers, Melissa Hathcoat

Master's Projects and Capstones

Problem: Several nurse executives (Waxman 2018; Massarweh, 2017; Hunt, 2018) agree that in today's increasingly complex health care environment, the reality of decreasing reimbursements and increasing focus on value-based metrics reflects a crucial knowledge base for nurse managers. Therefore, it is imperative for unit-based nurse leaders to receive education and support to attain and maintain the requisite business competencies to achieve both fiscal and quality targets in their microsystem (McFarlan, 2020). In an integrated managed care delivery system in northern California, no education curriculum exists for nurse managers and assistant nurse managers that addresses gaps in financial knowledge, skills, and …

Debriefing: A Place For Enthusiastic Teaching And Learning At A Distance, Cynthia Sherraden Bradley, Brandon Kyle Johnson, Kristina Dreifuerst

College of Nursing Faculty Research and Publications

The current pandemic has required a quick response to the unprecedented suspension of face-to-face instruction in higher education worldwide. The rapid conversion of didactic, laboratory, and clinical courses to distance learning has been challenging, requiring integration of screen-based virtual simulations and other innovative learning activities. The importance of a robust debriefing of these learning opportunities is often neglected, which could be to the detriment of the students. Debriefing is based on strong narrative pedagogy, requiring an engaging and enthusiastic dialog. Despite long days of screen time, it is even more imperative to connect with students to create meaningful learning through …

Simulation: An Effective Tool For Mentoring The Novice Nursing Faculty, Charlene B. Smith, Jeanne Hamner, Carol Hession, Cari Granier, Travis "Pete" Lewis, Ashley Thibodeaux

Journal of Interprofessional Practice and Collaboration

Abstract

The American Association of Colleges of Nursing (AACN) (2019) reported in 2018-2019, U.S. nursing schools turned away more than 75,000 qualified applicants from baccalaureate and graduate nursing programs due to insufficient numbers of faculty and clinical sites. Two-thirds of the nursing schools related a shortage of nursing faculty and/or clinical preceptors as a reason for not admitting qualified applicants (AACN, 2019).

There is a triad of challenges facing nursing today. The evolving triad is a nursing shortage, a lack of clinical facilities and nursing faculty. Nursing education must increase enrollment to fulfill the upcoming nursing shortage. Nursing schools are …

Improving The Detection Of Rheumatic Heart Disease In Children Residing In Samoa, Shay Harding

Student Works

Improving the Detection of Rheumatic Heart Disease in

Children Residing in Samoa

Shay Harding

College of Nursing, BYU

Master of Science

Rheumatic Heart disease (RHD) is the most common cause of heart related illness in individuals under 25 years of age and is a major health concern on the Pacific Islands of Samoa (Saxena et al., 2017). RHD related mortality among Samoan children is disproportionally high relative to the rest of the world; it is estimated to impact 10 out of every 1000 children there (Allen et al., 2017). The health care system in Samoa is limited in its resources, …

Measuring Learning And Engagement During Debriefing: A New Instrument, Shelly Jensen Reed

Faculty Publications

Background: Debriefing is considered to be where the bulk of learning takes place. Examination of debriefing is needed to help determine if facilitation methods effectively contribute to the learning process. More instruments are needed to evaluate all key debriefing elements, and no tools exist that evaluate participant engagement in the learning process.

Method: Kolb’s experiential learning theory was used to inform tool development. The focus of the new instrument is behaviors that indicate engagement with the learning process as the learner moves through Kolb’s learning cycle. A qualitative study of debriefing facilitators was performed, and a behaviorally anchored instrument was …

Impact Of A Modified Early Warning Score Tool On Nurses’ Ability To Recognize And Respond To Clinical Deterioration, Talecia Y. Warren, Leslie C. Moore, Sterling L. Roberts, Laura Darby

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Timely recognition of signs of impending clinical deterioration in acute care hospitalized patients can prevent an unexpected illness from becoming a fatal event. Failure to recognize the precursors of impending doom can have many factors, but the most influential of these is the role of the bedside nurse in detecting the subtle signs of decline. The Modified Early Warning Score (MEWS) has been used successfully to detect clinical deterioration in hospitalized patients, while simulation has been used successfully to provide an environment to test reaction to acute patient decline without harm to actual patients. A translational research project implemented the …

Pilot Project: Developing A Standardized Evidence-Based Education Process For Nurses To Enhance New Medication Eduction Of Hospitalized Patients With Heart Failure, Michele Ann Crotteau

Doctor of Nursing Practice Projects

Problem Description: Research has shown that health information is difficult for the average adult to understand while clear communication helps patients feel involved and increases adherence to treatment. The Joint Commission recommends Health Literacy (HL) assessment and the use of the Teach Back Method (TBM). Medication errors that occur between the RN and elderly patient are preventable when the RN communicates effectively about the patient’s medications. A paucity of research exists evaluating TBM for nurse-patient communications. This Quality Improvement (QI) Pilot Project (PP) took place over 3-months, aimed to improve new medication education to elderly patients with Heart Failure (HF). …

The Development, Implementation, And Evaluation Of A Sexual Assault Nurse Examiner Training Program, Shantee Henry

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Sexual assault is a growing concern in the United States. Appropriate care of its survivors is essential to controlling the short and long-term effects of this trauma. A sexual assault nurse examiner (SANE) is a registered nurse that acquires additional training specializing in the comprehensive care of sexual assault survivors. Research indicates that there are not enough SANEs to provide coverage for the increasing number of sexual assaults, especially in rural areas. To increase the number of certified SANEs in rural areas, the Health Resources and Services Administration (HRSA) of the U.S. government provided funds through a grant that was …

Preparing For Obstetrical Emergencies In The Emergency Department, Tracy Littlehale

Doctor of Nursing Practice Projects

Emergency Department nurses must maintain the skills to manage OB emergencies in the ED, especially in hospitals with no OB unit. Limited contact with OB patients diminishes the self-confidence, knowledge and skill of ED nurses, which may minimize their ability to recognize OB problems in a timely manner. As increasing numbers of patients with OB emergencies are expected to seek care in rural EDs due to closure of rural OB units and rising OB risk factors, maintenance of OB skills by ED nurses is critical. Simulation has been identified in the literature as an effective strategy to help nurses advance …

Using Simulation To Improve Skills, Confidence, And Satisfaction Related To Diabetes Education, Greshin M. Markwell

Doctor of Nursing Practice Projects

Diabetes mellitus is the seventh leading cause of death in the U.S. and affects 30.3 million people (Centers for Disease Control and Prevention [CDC], 2019). Research suggests that patients often have a limited knowledge and insight into self-management of diabetes mellitus (DM). Acceptance of the disease, insufficient knowledge, and noncompliance are the examples of key factors that affect the progress of the disease. Nurses play a key role in the delivery of diabetes education which can improve compliance. Simulation can be used to improve the nursing skill sets for diabetes education. The purpose of this project was to implement evidence-based …

Simulation Impact On Medication Administration Safety: A Simulation Quality Improvement Project, Stacy Simpson

Doctor of Nursing Practice Projects

Background: Two medication simulations increasing in rigor, patient acuity, and distractions were implemented among undergraduate nursing students.

Objectives: To increase nursing student confidence, knowledge, and competence when administering medications.

Design: Two medication administration simulations were implemented and data was collected from students via a pre-simulation quiz, observation during the simulation via a Clinical Simulation Evaluation Tool, and student evaluation of the simulation with a modified version of the Simulation Evaluation Tool Likert scale.

Settings: Gaston Community College nursing simulation lab.

Participants: 53 undergraduate nursing students enrolled in NUR 101 and 42 students in NUR 102 …

Enhancing Teamwork In Nursing Students, Heather Rawson

Doctor of Nursing Practice Projects

Abstract

The purpose of this project was to equip senior practical nursing students (n = 11) with the skills needed to increase their feelings of preparedness to join an intradisciplinary team in the workplace after graduation. This project utilized a pre-test/post-test design using TeamSTEPPS^® Teamwork Attitudes Questionnaire (T-TAQ) to determine if participation in TeamSTEPPS^® training and a simulation exercise enhanced perception of teamwork in senior practical nursing students. A paired t-test was performed to analyze the data collected from the questionnaires acquired before and after the TeamSTEPPS^® training. The results showed a t-value of 8.49, greater than …

Examining Instructional Methods In End-Of-Life Nursing Education: Lecture Vs. Simulation, Jonathan M. Benson

Electronic Theses and Dissertations

Undergraduate nursing programs have historically glossed over end-of-life care, if their curricula addressed it at all. This lack of instruction can leave practicing nurses feeling poorly prepared to deliver this specialized care. Feeling incompetent and lacking confidence may lead to poorer attitudes regarding this nursing specialty. Thus, effective continuing education activities are paramount in equipping nurses to provide this care and improve attitudes towards caring for terminally ill patients and their families. The purpose of this study was to examine how registered nurse attitudes towards end-of-life care are impacted using a simulation-based learning experience compared to a traditional face-to-face lecture …

Nurse Educator Perceptions Of Using Simulation For Evaluation Of Nursing Competencies, Angela Elizabeth Horton

Walden Dissertations and Doctoral Studies

Over the past 10 years, simulation technology has been increasingly used in clinical settings to evaluate nursing competencies and ensure safe patient care. However, not all simulation laboratories are used consistently by hospital nursing education departments to support learning. The purpose of this qualitative case study, framed by constructivist theory, was to identify nurse educators’ perceptions of the value of using simulation to evaluate nurse competence. Research questions addressed how nurse educators decided what teaching methods to use when evaluating nursing competencies. The participant sample included 8 nurse educators responsible for the education of new and practicing nurses in the …

Effectiveness Of A Structured Online Prebriefing Activity On Prelicensure Students’ Clinical Judgment, Elizabeth M. Delavan

Nursing Theses and Dissertations

Significance of the Problem: Today’s healthcare environment requires new nurses to have strong clinical judgment skills upon entry to practice. Contributing to this problem are the challenges faced by prelicensure nursing programs that include faculty shortages and the decreasing availability of clinical spaces. Simulation activities offer hands-on clinical learning opportunities in the place of traditional clinical experiences. However, simulation labs are costly to develop and maintain, which impacts student learning opportunities. Prebriefing, an understudied area of simulation, provides educators with another clinical exercise to facilitate students’ growth in clinical judgment.

Objective: The purpose of this study was to explore the …

A Simulation To Improve Nursing Students’ Understanding Of The Experience Of Middle Eastern Refugees, Ibtisam Matta

Honors Projects

A simulation was constructed with the aim of improving nursing students’ understanding of the needs of Middle Eastern refugees.

The research questions were: what are student nurses’ perceptions on the unique culture of the Middle Eastern refugee population after participating in a simulation of this populations’ experiences, and how will these influence the students’ interactions with this population in their nursing career?

Approval was granted from the Grand Valley State University (GVSU) Internal Review Board (IRB) to conduct the research. Student nurses were recruited through GVSU Kirkhoff College of Nursing (KCON) Student Nursing Association (SNA); the event was one of …

Local Anesthesia Before Intravenous Cannula Insertion: Recommendations For Registered Nurses In Practice, Vera Campbell-Jones

Electronic Theses and Dissertations

Abstract

Administering local anesthetics, such as intradermal, should become standard practice for RNs in pretreatments for pain control prior to intravenous insertion. Peripheral venous cannulation has provoked the most fear and anxiety in adult patients about everyday practice in hospitals. Adult patients often state that this procedure causes considerable discomfort. Local anesthesia for cannulation is usually not offered to adult patients who are on general medical units. Evidence has indicated inconsistency in the use of pain management strategies during these procedures. The researcher’s goal in this project was to educate RNs about the intradermal pretreatment procedure, provide education on the …

The Impact Of Simulation On Knowledge And Performance Gain Regarding Diabetic Patient Care, Aimee A. Woda, Jamie Hansen, Kristina Dreifuerst, Polly Anderson, Theresa Marie Hardy, Mauricio Garnier-Villarreal

College of Nursing Faculty Research and Publications

Background

It is essential that nurses be prepared to provide quality care for patients with diabetes, a common condition today. The purpose of this study was to evaluate the impact of a high-fidelity simulation on traditional prelicensure nursing students' knowledge and performance related to care of the diabetic patient.

Methods

This multisite, multimeasure study used a purposive, quasiexperimental [sic] pretest-posttest design.

Results

Simulation positively impacted performance change scores. Pretest scores were positively associated with simulation scores and posttest scores.

Conclusions

The findings from this study support the use of high-fidelity simulation to improve care of the diabetic patient.

The Use Of Simulation And Experiential Learning To Practice Prenatal Care Management Within A Doctor Of Nursing Practice Program., Heather J. Locke

Doctor of Nursing Practice Papers

Background: Many barriers have been identified that affect patient-provider gestational weight gain (GWG) counseling, including lack of time, insufficient training, concern about the sensitivity of the topic, and the provider perception that the advice is ineffective (Ronnberg et al., 2015; Stotland et al., 2010). Simulation-based learning (SBL) is an evidence-based clinical education strategy that mimics real-life situations as a high-quality interactive experience that complements clinical experiences to develop entry into practice competency (SSH, 2015).

Aims: The purpose of this project was to implement an educational program that incorporated a combined teaching method of a didactic module and a standardized patient …

Regulation Of Simulation Use In United States Prelicensure Nursing Programs, Cynthia Sherraden Bradley, Brandon Kyle Johnson, Kristina Dreifuerst, Patti White, Susan Kata Conde, Colleen H. Meakim, Kim Curry-Lourenco, Reba Moyer Childress

College of Nursing Faculty Research and Publications

Background

Simulation usage has proliferated throughout nursing education. Although nursing programs have sought integration of simulation to substitute traditional clinical learning hours, the variability of regulations between states raises questions about consistency of learner outcomes.

Methods

The Boards of Nursing (BONs) of the United States and the District of Columbia were queried by internet, phone, and email to discover regulations and guidelines for the use of simulation in nursing education.

Results

More than half of the BONs reported regulations for simulation use, but they varied greatly. Some had regulations defining a percentage of traditional clinical hours that could be replaced …

Cultivating Self-Confidence: Integrating Simulation Into Hospital Nursing Orientation, Martha Richey

Doctor of Nursing Practice Projects

Background: Simulation provides a safe environment for newly hired nurses at all levels to learn and practice new skills in a safe and structured approach. Simulation allows nurses the opportunity to increase self-confidence at the bedside without placing a patient at risk for harm.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) project is to evaluate the effectiveness of implementing a simulation program during hospital orientation to increase self-confidence with newly hired nurses.

Design Method: A quasi-experimental design using a pre-test-post-test data collection method.

Conclusion: The rapidly changing healthcare environment requires that nurses are prepared to provide patient …

Utilizing Simulation To Implement Cognitive Aids In The Operating Room, Kaitlyn Brown

Doctor of Nursing Practice Projects

Background: Operating room crises require prompt, efficient action to avoid detrimental outcomes. Research shows that crisis checklists or other cognitive aids assist anesthesia providers in taking prompt action while improving efficiency by decreasing treatment steps missed during critical events.

Objectives: The purpose of this project was to evaluate the effectiveness of incorporating cardiac arrest and malignant hyperthermia crisis checklists into the operating room using high-fidelity simulation-based education.

Methods: Researchers implemented the Stanford Emergency Manual Cognitive Aids for cardiac arrest and malignant hyperthermia to anesthesia staff at a community hospital in southern Illinois with 18 participants. Implementation consisted of an education …

Simulation As Replacement For Traditional Clinical In Pre-Licensure Nursing Education: Outcomes Of Different Ratios Of Replacement Time For Traditional Clinical With Simulation, Tiffany Zyniewicz

Dissertations

The use of simulation in nursing education has grown over the last 30 years. The National Council of State Boards of Nursing National Simulation Study indicated that up to 50% of traditional clinical hours can be replaced with simulation at a 1:1 replacement ratio and produce the same outcomes. A review of the literature indicated that there is no standard replacement ratio for simulation time to traditional clinical time being used in pre-licensure nursing education in the United States. The purpose of this study was to explore the outcomes of utilizing a 1:1 simulation-to-traditional clinical time replacement ratio and a …

Prevalence And Use Of High-Fidelity Simulation In Family Nurse Practitioner Programs, Christina Rosa Pendrak Pepin

UNLV Theses, Dissertations, Professional Papers, and Capstones

Family nurse practitioner (FNP) programs represent almost 60% of all accredited primary-care NP programs in the U.S. in 2015. Increased enrollments and creation of new NP programs has led to a shortage of appropriate clinical sites and the increased competition for quality clinical sites. FNP programs have turned towards utilizing innovative ways to address this shortage including the use of high-fidelity simulation. However, a lack of literature supports substituting traditional clinical hours with high-fidelity simulation. Only 45 articles were found over a 35-year period describing the use of high-fidelity simulation in an FNP program and of those published since 2014, …

Evaluation Of A Simulation-Based Nurse Residency Program, Cheri A. Van Wyngarden

Doctoral Projects

Upon completion of nursing school, new graduate nurses sit for licensure examination to demonstrate the minimal knowledge necessary to practice safely as an entry level nurse. Despite satisfactory completion of this examination, many new graduate nurses lack the competency and confidence to safely practice (Jung, Lee, Kang, & Kim, 2016 & Liaw, Palham, Chan, Wong & Lim, 2014). Traditional models of preceptorship with orientation are not adequately preparing new graduate nurses for practice. Nurse residency programs narrow the gap between demonstrated knowledge and competent practice. Varying types of nurse residency programs have successfully replaced traditional nursing orientation methods across the …

In Situ Pediatric Mock Codes: The First Five Minutes, Josephine N. Ruiz

Doctoral Projects

The purpose of this quality improvement project was to use in situ simulation-based mock codes to evaluate the effectiveness of participants’ actions and perceived confidence, and to potentially reinforce and improve knowledge retention, skill acquisition, and confidence levels of nursing staff with regards to pediatric emergencies. Simulated drills were evaluated with a tool focused on high-performance teams and team dynamics as outlined by American Heart Association Pediatric Advanced Life Support 2016. Twenty-four simulated drills were conducted from January to February 2019. Each hour-long session was composed of pre-briefing, simulated drill or scenario, and debriefing and took place in empty patient …

Infection Control Of The Anesthesia Workspace – Double Glove Technique, Debra Farida, Megan E. Callow

College of Science and Health Theses and Dissertations

Background: Current infection control practice has proven to be inadequate and pathogen transfer from anesthesia provider to patient is well established in literature, especially pertaining to contamination during direct laryngoscopy (DL), which exposes both surface and patient to disease, viruses, and bacteria.

Objectives: The purpose of this study was to evaluate the acquisition of confidence and perceived knowledge of proper handling of potential contaminants during induction and DL utilizing video simulation among junior level (second year) nurse anesthesia trainees (NAT-2s) enrolled at NorthShore University HealthSystem (NSUHS).

Method: Eighteen NAT-2s were evaluated using single group, pre-test post-test design, …

Collaborative Care Best Practices Model (Ccbpm) Development For Nursing And Occupational Therapy Assistant Interprofessional Simulation, Carrie M. O'Reilly, Lisa P. Simmons, Mary L. Romanello

The Open Journal of Occupational Therapy

The use of simulation as a teaching and learning stratagem is well supported in the professional literature. The development of a collaborative care best practices model (CCBPM) was undertaken to help the creation and implementation of an interprofessional education (IPE) learning strategy between occupational therapy assistant (OTA) and pre-licensure nursing students at a private liberal arts college. The project goals and outcomes involved faculty development, CCBPM development, and OTA and nursing novice student competency acquisition in their respective professions. Twenty-three students (10 OTA and 13 nursing) completed the IPE learning simulation exercise. A mixed-method approach to data analysis was used …

Active Shooter Awareness Education And Training Using Best Practices For Nurses In Acute Care Facilities, Amanda Carol Dean

Nursing Theses and Capstone Projects

The thought of having an active shooter at your place of work is unimaginable. The thought of having an active shooter at a place of healing is terrifying and distressing for patients, families, and nursing staff. An active shooter event, as defined by Hauk (2018), is when at least one person is actively killing or trying to kill people in a confined populated space. If an active shooter event were to take place in an acute care facility, nurses must be educated on best practices of responding to an active shooter, including identifying the situation, notifying the appropriate personnel of …