Nursing Commons^™

Simulation Strategies For Safer Student Medication Administration: A Quality Improvement Project, Rochelle D. Beaver

Doctor of Nursing Practice Projects

Medication administration is an essential skill for nurses, but there are few opportunities for students to practice this skill to prepare for clinical practice. Literature shows that best practice to bridge the gap is simulation. The purpose of this quality improvement project is to implement an evidence-based simulation activity for students. The problem is that not all faculty are trained to teach via simulation. The aim of the project is to increase the nursing faculty’s competence in facilitating a medication administration simulation activity focusing on pre-briefing and debriefing utilizing evidence-based standards from International Nursing Association for Clinical Simulation and Learning. …

Utilizing Simulation Training To Understand Maternal Cardiac Arrest Precipitated By Amniotic Fluid Embolism: A Quality Improvement Project, Erica L. Wright, Megan L. Tiernan, Michael W. Neft, Paige Spagiare, Erica Coffin

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Background and Problem: Maternal cardiac arrest precipitated by amniotic fluid embolism is among the leading direct causes of death among laboring women (Enomoto et al., 2022). Because it presents suddenly without any immediate apparent cause and lacks specific diagnostic tests, frontline obstetric caregivers must be vigilant, competent, and prepared to handle this potentially catastrophic emergency. Coordination among multiple disciplines is paramount since two lives, not just one, are at risk. Unfortunately, the rarity of maternal cardiac arrest significantly limits opportunities for staff to learn how to identify and manage these events successfully. Method: This quality improvement project established a simulation-based …

Quality Improvement Project Implementing A Structured Communication Program For Academic Clinical Nursing Education, Ashley Daniel

Doctor of Nursing Practice Projects

Effective communication between healthcare professionals is a critical component of safe and high-quality patient care. Structured tools like SBAR (situation, background, assessment, and recommendation) provide a framework to enhance clarity and reduce miscommunication. This quality improvement project implemented SBAR as a structured communication program in debriefing after simulation to improve communication confidence among practical nursing students. The purpose of this project was to evaluate whether the integration of SBAR into debriefing would increase students’ self-reported communication confidence. The problem addressed was the lack of confidence in clinical communication among nursing students, which can impact patient safety and team collaboration. The …

Enhancing Adherence To Oxytocin Administration Guidelines To Reduce Postpartum Hemorrhage Rates In A Labor And Delivery Unit, Maya Denny

Master's Projects and Capstones

Abstract

Background: Postpartum hemorrhage (PPH) remains a critical challenge in maternal care. It shows a 13% PPH incidence rate in a high-risk labor and delivery unit in a northern California medical center, exceeding the national benchmark of 5%–10% based on 2021 ACOG data from 150 patient records.

Problem: There is inconsistent adherence to oxytocin administration guidelines, with only 60% of 100 audited charts documenting fetal and uterine activity, contributing to the elevated rate. The team is looking for a target rate of 90%.

Intervention: This involves implementing a checklist, providing training for 25 clinicians, and conducting two 30-minute simulation scenarios …

Quality Improvement Project Nursing Lab Instructors’ Experiences Using A Structured Prebriefing Tool In Simulation Education, Avion Smith-Samms

Doctor of Nursing Practice Projects

The International Nursing Association for Clinical Simulation and Learning (INACSL) endorses the inclusion of prebriefing as a Standard of Best Practice to enhance psychological safety, clarity, and engagement in simulation; without a structured approach, nursing students often experience anxiety, reduced confidence, and a lack of preparedness. At the project site, a university’s simulation learning lab, nursing lab instructors reported inconsistent prebriefing practices, leading to suboptimal simulation experiences. This Quality Improvement (QI) project aimed to evaluate the impact of implementing the INACSL prebriefing tool on nursing lab instructors’ perceptions of preparedness, confidence, and student performance. A quasi-experimental design was used over …

Quality Improvement Project Educating Nursing Faculty On The Lasater Clinical Judgment Rubric In Simulation, Tiffany Shivers

Doctor of Nursing Practice Projects

This quality improvement project aimed to enhance nursing faculty preparedness in simulation-based education by increasing knowledge and self-efficacy using the Lasater Clinical Judgment Rubric (LCJR). A quasi-experimental, one-group pre-/post-intervention design was used to evaluate outcomes among ten faculty participants. The intervention consisted of an educational session introducing the LCJR and structured debriefing techniques. Data were collected using a knowledge assessment and the General Self-Efficacy Scale. Descriptive statistics and the Wilcoxon Signed-Rank Test were used to analyze changes in scores. Results demonstrated statistically significant improvements in both knowledge (Z = –2.805, p = .005) and self-efficacy (Z = –2.666, p = …

Measuring Nursing Student’S Performance, Attitude And Psychological Impact Of Different Evaluation Approaches In Simulation Education At Arab American University- Palestine, Mohammad Asia, Maysa Kassabry

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

This study aimed to compare the competency and psychological impact of using the objective structured clinical examination (OSCE) to the traditional evaluation methods (TEM) in evaluating cardiology skills among nursing simulation students. Thirty-two students were initially assessed using TEM, and one week later using the OSCE. Scores of the student competency were compared using paired sample t-tests, while semi-structured interviews were used to expand on qualitative measures. Students' mean scores were significantly higher in using OSCE than in TEM (p< 0.001). Students' attitudes and perceptions of both approaches showed favorable attitudes towards OSCE on most of the items. The qualitative data showed that students with lower GPAs and utilizing the OSCE approach experienced higher anxiety. The psychological impact of evaluation approaches requires additional investigation.

Ageism From The Perspectives Of Diploma Program Nursing Students After An Aging Simulation: A Phenomenological Reflection, Melissa Suzanne Jones

Doctoral Dissertations and Projects

Ageism in the healthcare system creates a challenge for nurses and their patients. Knowledge is needed regarding sensory changes that occur with normal aging. This knowledge gap leads to stereotyping and missed opportunities for age-appropriate care. Nurses must recognize that hearing loss and naturally occurring vision changes can lead to poor outcomes and social isolation in older adults. In addition, caring for older adults becomes less desirable to nurses entering practice because of negative perceptions about older adults. However, nursing programs can address ageism by augmenting the curriculum with a geriatric sensitivity simulation. Through a series of exercises that simulate …

Accelerating Initial Cardiac Arrest Response In Medical-Surgical Nurses Through Virtual Reality Training, Carissa A. Hernandez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Through their limited exposure, non-critical care nurses may feel unprepared to respond when faced with a sudden emergency such as cardiac arrest. This Quality Improvement (QI) project employed virtual reality (VR) technology to improve nurse confidence, adherence to the American Heart Association (AHA) basic life support (BLS) algorithm, and documentation accuracy among medical-surgical nurses in a Veterans Affairs hospital in Nevada. The project addressed their ability to react promptly and effectively during these high-stakes emergencies. Methods: Following a scoping literature review from the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PubMed databases, this Evidence Based …

Enhancing Advanced Practice Nursing: Implementing A Simulation-Based Point-Of-Care Ultrasound Training Program, Brandy Younge, John Chovan, Bonnie Fagan, Joy Shoemaker

Doctor of Nursing Practice Scholarly Projects

Nurse practitioners (NPs) are advanced practice nurses entrusted with diagnosing and treating illnesses, managing acute and chronic diseases, and engaging in continuous education to remain knowledgeable of evidence-based advancements. NPs offer a comprehensive range of healthcare services, catering to patients from wellness check-ups to those requiring complex care, such as individuals hospitalized with sepsis. One technological advancement that can support NPs in delivering optimal patient care is point-of-care ultrasound (POCUS). In the United States, over 385,000 NPs practice in patient care settings that may use POCUS. Numerous medical societies have issued position statements supporting the use of POCUS in the …

Development Of An Evidence Based Orientation Model For The Newly Graduated Nurse, Sandra L. Takach

Doctor of Nursing Practice Scholarly Projects

Healthcare in the acute hospital setting experienced a significant increase in highly acute patients with multiple comorbidities requiring competent, experienced clinicians who can provide high quality, safe care. The nursing shortage paired with the post pandemic hospital environment has altered the landscape of nurses entering the workforce and created a gap in competency of the bedside nurse. A loss of tenured nurses who typically onboard and mentor the novice nurse coupled with less than adequate clinical preparation of those graduating college led to elevated levels of stress and staggering turnover rates for the newly graduated nurse. Research validates efficient orientation …

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Effect Of Multiple Simulation Exposures On Nursing Students' Critical Thinking In First Direct Patient Care Practice, Dawn Veltre

Doctoral Dissertations and Projects

Critical thinking is a core competency essential for nursing practice, and nursing students must develop these skills to become competent nurses. The purpose of this quantitative quasi-experimental pretest-posttest design is to determine the effect of multiple simulation exposures on nursing students' critical thinking during their first direct patient care practice. A convenience sample of 39 first-year nursing students enrolled in an associate degree nursing program in the western United States participated in this study. Participants completed a demographic survey and the Health Sciences Reasoning Test (HSRT) to measure critical thinking skills before multiple simulation exposures, two exposures, or four exposures …

The Importance Of Feedback With An Asynchronous Online Training Program When Learning Debriefing For Meaningful Learning, Aimee A. Woda, Brandon Kyle Johnson, Jamie Hansen, Kristina Chen, Kristina Thomas Dreifuerst

College of Nursing Faculty Research and Publications

Background

Despite knowing the importance of debriefing, there is insufficient evidence to guide the best way to train and provide formative feedback to develop competent debriefers.

Method

This multi-site, experimental, repeated measures study was used to test the impact of different intervals of expert feedback on a debriefer's competence implementing debriefing after participating in an asynchronous, online, distributed modular training program.

Results

Training and early feedback facilitated rapid improvements in a debriefer's ability to implement a debriefing method correctly. Regular feedback improved competence over time.

Conclusion

A well-developed, asynchronous online training program is an effective way to train debriefers.

Implementing Standardized Patients In Simulation In Undergraduate Nursing Education, Taylor A. Murray

SACAD: Scholarly Activities

Abstract

The integration of standardized patients (SPs) in simulation-based learning has emerged as a transformative approach in undergraduate nursing education. By providing nursing students with the opportunity to engage with trained actors simulating real-life patient scenarios, SPs offer a safe and controlled environment to develop essential clinical skills. This research explores the impact of SPs on promoting student confidence and enhancing their practical skills in nursing practice. Implementing SPs into nursing education not only supports students in refining their assessment and communication abilities but also prepares them for the complexities of patient care in real-world settings. Ultimately, this study aims …

A Descriptive Case Study: Exploring The Impact Of Practicing The Role Of The Registered Nurse Throughout A Simulation Curriculum From Graduates Of A Midwest Associate Degree Nursing Program, Mindy J. Ritter

Sabbatical Projects

The researcher sought to learn the impact of participating in a repetitive, immersive, high-fidelity simulation curriculum on graduates' nursing practice.

The literature has highlighted the gaps in graduates’ practice readiness and transition to practice. This gap is coupled with the decreased opportunities for students in the clinical setting, increased patient acuity, and rapid acceleration in the use of technology in healthcare organizations. The implementation of simulation pedagogy can help bridge these gaps; however, its implementation, frequency, and curricular integration vary across nursing academia.

This qualitative descriptive case study explored the perceptions of graduates from a midwest associate degree nursing program …

Student Expectations And Outcomes In Virtual Vs In-Person Interprofessional Simulations: A Qualitative Analysis, Padmavathy Ramaswamy, Abbey M Bachmann, Tiffany Champagne-Langabeer, Chasisty L Gilder, Samuel E Neher, Jennifer L Swails

Faculty, Staff and Student Publications

Background: Health-related programs frequently integrate interprofessional education (IPE) into their training. The COVID-19 pandemic transitioned many IPE programs online, making it essential to assess student expectations and perceived learning outcomes across virtual simulations and in-person settings.

Methods: This qualitative study compared student expectations and self-reported outcomes across in-person and virtual case scenarios at a Texas health science center. Responses to open-ended questions from two data collection periods were analyzed using inductive coding and thematic analysis.

Results: Students from nursing, medicine, dentistry, public health, and informatics participated in each group. Three major themes emerged from this study: communication, teamwork, and …

The Benefits Of Implementing Medication Administration Simulation In The Undergraduate Nursing Pharmacology Course, Ogulbagt Narova

SACAD: Scholarly Activities

Medication administration is one of the most critical tasks for nurses. Yet, it can also be a source of anxiety and errors, especially for nursing students who are still building their skills. Many new nursing students struggle to feel confident and competent when administering medications in real clinical settings. Simulation-based learning offers a powerful way to address this challenge. Using realistic, hands-on scenarios, students can practice medication administration in a safe environment without harming patients. This approach helps students build critical skills, gain confidence, and reduce the likelihood of medication errors. Incorporating medication administration simulations into nursing pharmacology courses will …

The Integration Of Video Recording In Health Assessment Simulation To Improve Feedback Quality, Stephanie Bork, Meredith Deegan, Allison Gregory

School of Nursing Publications

Introduction

Simulation-based learning is integral in preparing nursing students, especially graduate-level nurse practitioner (NP) students. Simulation bridges the gap between theory and practice, providing a safe space for students to practice clinical skills, communication, and develop appropriate clinical judgment and reasoning before delivering care to patients in healthcare settings. Video recording in the simulated environment enhances educators’ ability to assess student competency and performance. During a faculty-observed simulation, it can be challenging to deliver consistent, meaningful, and competency-based feedback to each student. This project aims to integrate Echo360 video recording in graduate health assessment simulation to enhance the quality of …

Building An Interdisciplinary Simulation Orientation For The Mobile Health And Wellness Program, Meredith Deegan, Lauren Goeke

School of Nursing Publications

No abstract provided.

Roadmap To Developing Clinical Competency For Novice Nursing Students, Meredith Deegan, Lauren Goeke

School of Nursing Publications

No abstract provided.

Enhancing Simulation Debriefing In Nursing Education: A Quality Improvement Project, Rebecca L. Ray

Doctor of Nursing Practice Projects

This quality improvement (QI) project is of utmost importance as it aims to significantly enhance the debriefing process after simulations in an Associate Registered Nursing Program. The project is designed to equip nursing instructors with a comprehensive guide to facilitate debriefing after simulations, thereby improving student learning outcomes, fostering reflection, and enhancing clinical practice. The lack of consistent and practical guidance during the debriefing process after simulation exercises has been identified as a critical challenge in the nursing program. Without proper guidance, the debriefing process may not achieve its intended outcomes, underscoring the necessity of this project. The intervention at …

Evaluation Of A Quality Cpr Coach Simulation-Based Competency Training: From Learning Outcomes To Patient Outcomes, Katie L. Mcdermott, Kari L. Rajzer-Wakeham, Jennifer M. Andres, Christine A. Schindler

College of Nursing Faculty Research and Publications

Background

Variability in cardiopulmonary resuscitation (CPR) quality and skill decay result in suboptimal application of CPR, which impacts patient outcomes following an arrest. Quality CPR Coach is a supplementary code team role that provides real time, verbal feedback directly to chest compressors to cognitively offload the team leader and ensure high-quality, goal-directed CPR delivery.

Methods

Design, implementation, and evaluation of a simulation-based Quality CPR Coach competency curriculum. Multi-modal assessment and evaluation methods were used.

Results

Statistically significant increase in confidence, perceived ability to verbalize Coach responsibilities, and knowledge. Participants demonstrated accurate Coach role performance across progressively scaffolded simulated compression event …

The Role Of Game-Based Learning Simulation To Enhance Leadership In Pandemic Preparedness For Nursing Students, Scott James Andrews

Theses: Doctorates and Masters

During the COVID-19 pandemic, nurses around the world suffered with the impact of resource scarcity on the provision of quality nursing care to patients. Nursing staff were at higher risk of infection than all other healthcare workers, with working conditions during the pandemic resulting in significant staffing pressures. The challenges faced by staff during the pandemic inevitably influenced the quality and delivery of clinical education, highlighting the need for innovative solutions such as digital learning to address emerging training needs. Further, the impact of COVID-19 restrictions on clinical education has highlighted the benefits of digital learning environments as alternatives to …

Nursing Simulation For Pediatric Communication: An Integrative Literature Review, Jayla R. Call

Honors Undergraduate Theses

The aim of this thesis is to explore literature focused on enhancing nursing students' communication skills with pediatric patients through simulation. Effective communication is key to building rapport and trust, which are essential for improving patient outcomes. However, nursing students may experience anxiety when interacting with pediatric patients due to limited training in communication techniques. Simulation offers a valuable opportunity for students to practice and refine their skills in a risk-free environment, allowing them to build confidence and competence. An integrative literature review was conducted, utilizing three databases and PRISMA guidelines (Page et al., 2021) to gather relevant studies for …

Examining The Relationship Of Simulation To Nursing Communication Competency: A Quantitative, Causal-Comparative, Retrospective Study, Patresha Pamella Pearson

Doctoral Dissertations and Projects

This quantitative, causal-comparative, retrospective study investigated the impact of simulation-based education on nurse communication competence by evaluating communication skills between two groups of recently graduated and licensed registered nurses while controlling for total experience hours. Though nursing communication competence significantly impacts patient care outcomes, few studies have addressed the impact of simulation on the communication competence of licensed nurses practicing in the clinical setting. The study was conducted in the clinical setting with 78 participants divided between two categorical groups of recently graduated and licensed registered nurses depending on the proportion of simulation-based education received during clinical experience requirements. The …

Cultivating Nursing Student Competency Through Serious Gaming Simulation-Enhanced Prebriefing, Shopha M. Tserotas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Problem: Simulation is an effective teaching strategy for undergraduate nursing students, providing a safe environment for learning in a low-risk setting. However, students are not fully prepared to take full advantage of high-fidelity simulation activities. The purpose of this study was to examine the impact of serious gaming simulation-enhanced prebriefing on student competency and simulation effectiveness. Methodology: The study employed a quantitative, cross-sectional, quasi-experimental design using secondary data. Participants included undergraduate nursing students in a southern private university. The students were enrolled in the prelicensure nursing program and the obstetric or the transition to practice course. The control group received …

The Effects Of A Healthcare Simulation Escape Room On Clinical Judgment: A Randomized Controlled Trial, Jennifer Peltier

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: The predominant pedagogy of traditional lecture-based learning should include meaningful active content to foster clinical judgment, engagement, and knowledge retention. Innovative active learning strategies must be tested to understand if they can better facilitate nursing learners’ readiness for practice.

Aims: This research study investigated the impact of a healthcare simulation escape room as an innovative platform on individual and team clinical judgment to determine whether this active learning strategy can benefit nursing learners’ preparedness and increase clinical judgment.

Method: A randomized, double-blinded, waitlist control design was used to examine the effect of a healthcare simulation escape room on clinical …

Comparing Student And Np Faculty Simulation Satisfaction And Confidence Following Debriefing, Rhonda D'Agostino

Doctor of Nursing Practice Scholarly Project

The utilization of simulation technology can increase critical thinking, as well as advance practice skills, satisfaction and confidence in learning. The purpose of this research was to evaluate the impact of in-person student debriefing on students and NP faculty confidence and satisfaction in student learning utilizing standardized patient simulation. The study was open to the 50 enrolled students and 10 faculty participating in the summative SP simulation for advanced health assessment at Pace University’s Pleasantville campus. Students were randomly selected to undergo in-person debriefing by faculty. After simulation, students and faculty participated in a survey. Of the 33 students, 15 …

Undergraduate Nursing Students’ Simulation Experiences With End-Of-Life Care In A Rural Setting: A Scoping Review, Christopher Norman Msn, Aprn, Gnp-Bc, Jodi Sutherland Phd, Rn, Acrn, Cne, Lori Marie Sprague Phd, Rn, Chse, Deborah Palmer Ms, Rn, Alma Rood Msn, Rn, Laura Lipke Ms, Mlis, Ahip

Nursing Faculty Scholarship

Objective: The purpose of this scoping review is to provide nurse educators and nurse leaders in practice with the findings on the state of the science surrounding undergraduate nursing education simulation-based experiences focused on end-of-life (EOL) care in rural settings. This scoping review aims to identify undergraduate nursing student experiences with EOL care in the rural setting and identify key simulation-based educational strategies utilized in undergraduate nursing programs to inform educational programs about simulation practices. The outcome of this review is intended to advance nursing education to better prepare future nurses for practice and to develop competence in providing EOL …