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Elizabeth Burns, MSN, RN, WHNP-BC Clinical Educator
Brenda Schoenherr MBA, BSN, RN, BBL Administrative Director Home Health and
Hospice
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{
The Future of Home Health and Hospice Staffing
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What if……..
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The learner will state one benefit of simulation training for home health clinicians
The learner will state how the debriefing process benefits the new and experienced clinician.
The learner will state one way to use post simulation data to keep learning on-going
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“is the imitation of the operation of a real-world process or system. The act of simulating something first requires that a model be developed; this model represents the key characteristics, behaviors and functions of the selected physical or abstract system or process”.
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Psychologically safe learning environments are essential for optimal learning within simulation.
Learning is enhanced with students perceiving a psychologically safe learning environment in simulation.
Essential attributes in the build include making mistakes without consequences, qualities of the facilitator, and orientation activities.
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Out of 4 agencies in the Indianapolis metro area, Franciscan/VNS is the only agency using simulation to educate their home care clinicians.
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Part 1: The Simulation Lab—All nursing staff participated in January 2018.
Part 2: Home Care Heart Failure Program presented at Clinical Meeting to all staff February 2018.
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Medication Teaching & Reconciliation
Heart Failure Zones—Identification and
Teaching
Diet Modifications
Exacerbation Factors
Teaching Tools
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Home Care Setting A Variety of
Environments
Hospital Controlled Environment
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Planning meetings—Educator and Managers
Setting the Objectives
Completing the initial “worksheet”
(“Designing” your patient)
Submit to Simulation Educator
Completing the scenarios
Gather props
Schedule clinicians and establish facilitators
Provide staff with pre-Sim material
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Orient staff to the room and the manikin. Provide guidelines and expectations for their scenario
Facilitator is behind two way window with technician. Microphone provides communications with patient’s “wife” in room (who wears ear piece)
2 staff performing the #1 scenario, 2 staff who watch in debriefing room live
then switch for scenario #2
Ends with debriefing
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REACTION
DESCRIPTION
APPLICATION / SUMMARIZING
(Instructor Driven or Learner Driven)
ANALYSIS
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Identified yellow zone quickly How: 5lb wgt gain, B/P, SOB , HOB to sleep Properly applied O2NC Zeroed in on the previous 24 hrs activity Got to office nurse right away Utilized SBAR
Consider utilizing Teachback method Focus on the next 24 hrs since nurse visit tomorrow Adjust visit frequency so patient is seen more in the next couple weeks Gather all teaching materials, discharge paperwork, admission folders, etc. and separate important, duplicated, refrigerator candidate, etc.
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OBJECTIVES: Learner will demonstrate general assessment skills w/ critical thinking & interventions as appropriate.
SCALE: 0 -- Did not Perform 1 -- Sub Standard Knowledge/Performance 2 -- Minimal Knowledge/Performance 3 -- Adequate Knowledge/Performance 4 -- Above Avg Knowledge/Performance 5 -- Exceptional Knowledge/Performance
SCENARIO: BOTH BOTH BOTH #1 BOTH #1 BOTH #2 BOTH BOTH BOTH BOTH #2
EMPLOYEE SCENARIO
PERFORMED Timely
VS/Assess
Early Focus:
CP assess
(correct)
Utilizes all sources for gathering
history/info
Quickly identifies
Yellow Zone
Utilizes SOAP/ SBAR
communi-cation
Verbalized urgent need to speak
w/nurse (does not
leave message)
Utilizes Team
STEPPS when
receiving orders
Evaluates visit
Frequency & adjusts to
patient
Displayed knowledge of medication(s) classification, action & side
effects
Teaching: DIET (appropriate to
scenario)
Teaching: Yellow Zone
Teaching: Utilized Teach-back
Method
Timely Observation
Skills
Worked well with teammate
Left patient/CG with Emerg
Plan
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1) “Psychological Safe Environment: A Concept Analysis, Clinical Simulation in Nursing”, Volume 18, May 2018, Pages 47-55,b Sufia Turner, BN, RN , Nicole Harder, PhD, CHSE, RN
2) Lori Hardie, MSN, RNC, CHSE
Simulation Education Coordinator
Franciscan Hospital, Indianapolis
Office #(317) 528-5725
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A Healthy heart…
You can’t beat it!
What Questions Do You Have?