SIMULATION IN NURSING: LEADING INNOVATIVE COLLABORATIVE PROJECTS - PDF document

SIMULATION IN NURSING: LEADING INNOVATIVE COLLABORATIVE PROJECTS Celeste M. Alfes DNP, MSN, RN, CNE, CHSE-A Associate Professor Director of the Center for Nursing Education, Simulation, and Innovation Frances Payne Bolton School of Nursing, Case Western Reserve University BACKGROUND • Nurse Educator for 25 years • Simulation Leader for 15 years • Direct our Center for Nursing Education, Simulation, and Innovation • Host 10,000 student visits a semester • BSN • MSN (NNP, PNP, Adult Gero, Midwifery, ACNP, Nurse Anesthesia) • NUMN (Graduate Entry) • 150% increase in # of Simulation experiences over last 5 years • Limited clinical placements, implementation SP, OSCE • NCSBN Study: In Ohio we can replace up to 10% 1

SIMULATION: OPPORTUNITIES FOR COLLABORATION • Simulation: increasingly instrumental in both pre-licensure and post licensure programs • Increased interprofessional opportunities • Opportunities to for DNP to consult on PhD projects • Ideal setting to involve computer and biomedical engineering, nursing’s opportunity to take the lead • Sample DNP/PhD Nursing and Engineering Faculty CLINICAL THEATER ASSISTANT • Colin Drummond, PhD, Biomedical Engineering • Celeste Alfes DNP, MSN, RN Nursing • James Rowbottom MD Anesthesiologist University Hospitals • Colonel Douglas Hodge, Wright Patterson Air Force Base • Medevac: Unstructured, uncertain, unforgiving environments • CTA helps decision-making in high-stress, time, resource constraints • Field-enabled ipad for civilian life-flight and military medevac • Virtual mentor to the caregiver, aggregating available critical cues • Real time civilian or military protocols recognize the patient condition 2

EVALUATING TELEHEALTH TO IMPACT VULNERABLE POPULATIONS • Celeste Alfes DNP, MSN, RN, Carol Kelly PhD, RN, Latina Brooks PhD, RN • Colin Drummond PhD BioMed & Ram Fish, Computer Engineer Silicon Valley • Funded by Ruth Mercatz, FPB Alum, $9,000.00, 3/1/18-3/31/19 • Introduce APN students to technology with Alumni SP Volunteers • Evaluate the efficacy and validate the feasibility of “19 GALE” • NP Faculty will evaluate telehealth technology with geriatric patients • Device will travel to two NP led service trips to Guatemala this Fall • Goal: Improve access to care for vulnerable populations in Cleveland, Ohio. • Pilot data: potential economic impact on reducing re-hospitalization and inappropriate emergency room visits in the US 3

Building family caregiver skills using a simulation-based intervention for care of patients with head & neck cancer NIH/NCI: 1R01 CA224416-01, $2,294,356, 4/1/2017-3/31/2021. • Susan Maznec PhD, RN, Celeste Alfes DNP, RN, Barb Daly PhD, RN • Purpose: Test a multicomponent caregiver intervention -- to be used during radiation treatment – that includes simulation experiences for training family caregivers grounded in self-efficacy theory • Two-groups with random assignment of caregivers to simulation based training or to the control group, • Focus on persons with cancer of the head and neck, esophagus, who undergo radiation therapy – a population that is reported to suffer more severe treatment side effects than other cancers treated with radiation. • Study findings provide crucial information for translating the psychoeducational and simulation method to other caregiver populations 4

Standardized patient versus role play strategies: A comparative study measuring patient-centered care and safety in psychiatric mental health nursing. Celeste Alfes DNP, RN and Margaret Wheatley PhD, RN • National League for Nursing Joyce Griffin-Sobel Education Grant $20,000.00 • Nursing faculty traditionally use role-play to demonstrate mental health behaviors. • SP interactions can be used to overcome this challenge. • Compared pre-licensure nursing students’ knowledge, attitudes, and self-efficacy following a sequence of psychiatric mental health role-play and SP experiences. • Results: Order of teaching strategies does not significantly impact student knowledge, attitude, or self-efficacy, students need repetition when interacting with psychiatric mental health patients & practicing effective communication • Student scores improved in all categories after the second experience • We now employ health care thespian students for theater in the round: lecture • End of semester video recorded SP experience for psych mental health EMERGENCY PATIENT HANDOFFS: IDENTIFYING ESSENTIAL ELEMENTS AND DEVELOPING AN EVIDENCE- BASED TRAINING TOOL ANDREW P. REIMER, PHD, RN, CFRN; CELESTE M. ALFES, DNP, MSN, RN; LAERDAL FOUNDATION, STAVANGER, NORWAY. $20,000.00 - Background: Patient handoffs between care teams have been recognized as a major patient safety risk due to inadequate exchange or loss of critical information - Literature review: to identify the essential elements of effective patient handoffs in emergency situations - Goal: develop a standardized tool to support a structured patient handoff procedure capable of guiding education and training. 5

Method: A literature search of handoff procedures and patient transfers was conducted using the Cumulative Index to Nursing and Allied Health Literature and PubMed between 2008 and 2015. • End Product: Standardized Handoff Tool • 30 objective and 5 subjective items • Used to guide standardized education, training, and future research in pre-hospital and emergent patient handoffs • IP Training: Medevac/EMT/Fire Rescue • J Contin Educ Nurs. 2018;49(1):34-41. 6

Mock Page Exercise Chris Winkelman, Angela Arumpanayil, Kelly McConnell, Celeste Alfes, Jacqueline Robinson, & Donna Thompson S IMULATION TO IMPROVE C OMMUNICATION AND D IAGNOSTIC R EASONING IN N URSE P RACTITIONER STUDENTS Methods Results Introduction Mock Page Simulation used • Pre-licensure students had two roles for Each page lasted about 15 minutes, followed established scenarios and each of the five mock pages: by an additional 5 minutes for pre-licensure rubrics to deliver a message • Initiate the page and deliver students to provide feedback. of a changing patient patient information in script Classroom debriefing took about 30 minutes conditions & communicate • Provide immediate feedback to a management plan. the ACNP student using rubric. Use of pre-established scenarios, scripts, and • ACNP students received the rubrics contributed to consistent training, Background page then detailed the delivery and debriefing of this exercise. problems that needed to be Additional materials to teach closed loop articulated in plan of care. communication and rehearse simulations • ACNP students provided feedback were helpful to streamline course faculty Mock Page exercises provide about the communication effort. real time practice in delivering content to providers and have The addition of using the final page with faculty monitoring the conversation over a been used in medical speaker phone provided summative education for many years. 1 evaluation. Goal: provide professional Conclusion/Discussion growth to our pre-licensure students while simultaneously Pre-licensure students reported increased challenging our ACNPs to confidence in communication respond to limited information given each page. ACNP students consistently rated this as a valuable simulation in course evaluations. Future iterations ACNP students will arrive at the “bedside” to provide definitive care for manikins with life-threatening changes in condition. Cleveland, NORTH AMERICA’S FIRST FLIGHT SIMULATION CENTER: AN EXEMPLAR OF ADVANCED SIMULATION Dorothy Ebersbach Academic Center for Flight Nursing 7

Kolb’s Experiential Learning Theory Guides Simulation Training in the Austere Environment TIMELINE FOR NATION’S FIRST FULLY ARTICULATING HIGH FIDELITY FLIGHT SIMULATOR • Vision for project 12 years ago by Christopher Manacci DNP, ACNPC • 18 month project of LRC Director and Director of Flight Program • Sikorsky S76 Fuselage: HP Aviation: Florida $5,000 • FAA approved EMS interior Arrow Aviation: Louisiana $10,000 8

BUILDING THE FLIGHT SIMULATOR 9 MONTH PROCESS BEGINS S tripping and Preparing the Interior Fuselage Mounted to Simulator Base Body Work and Paint FLIGHT SIMULATOR ARRIVES IN CLEVELAND, OHIO: 12/5/14 Redbird Crew Mounts Fuselage to Base Rear Projection System and Cowling Installed Ramp and Teaching Station 9

INTERIOR VIEWS OF FLIGHT SIMULATOR HIGH FIDELITY FLIGHT SIMULATIONS • Flight simulation scenarios progress in complexity to match the knowledge and experience level of the student/participant. • Scenarios are mapped with any two flight coordinates in the world • Flight teams, first responders in the community, industry, or military • 600 flight personnel yearly for high stakes testing • Developing pre-deployment scenarios which may reduce rates of PTSD 10

FLIGHT NURSING HELICOPTER SIMULATOR VIDEO https://youtu.be/w-F9s9Qukqo WAYS TO BECOME INVOLVED • NLN Simulation Leader Program for Nurse Educators • International Association for Clinical Simulation and Learning • Society for Simulation in Healthcare • Starting a NY Collaborative for Simulation and Learning Labs Sharing of Resources Annual Conference Leadership Team Please contact me if you are interested in visiting or collaborating! 11