Board #220 - Program Innovation A Multidisciplinary, Longitudinal Simulation to Teach Pediatric Residents and Nurses How to Diagnose, Treat, and Manage Pediatric Patients with Diabetic Ketoacidosis (Submission #8207)

Abstract

Objectives: Nursing programs are challenged to produce nursing students who can provide safe, competent and quality care while struggling with limited clinical placements and restrictions in what students can actually do in their clinical practice. The American Association of Colleges of Nursing (AACN) and Quality and Safety Education in Nursing collaborative (QSEN) developed safety competencies for graduate-/ entry-level nurses to guide nursing curricula as well the development of simulation experiences that provide for targeted, repetitive practices to enhance safety competence. We describe a capstone, immersion simulation course based on these competencies to provide multiple opportunities for students to explore and refine their knowledge, skills and attitudes related to safe practice. A behavioral checklist applied in the course measures the impact of the course on safety practices, with individual student assessments completed at mid-and end-points of the course. This presentation describes the components of the course, the evolution of the assessment tool, and the assessment outcomes of the course as they relate to safety competencies. This innovative course can serve as a model for nursing programs to enhance safety competence of their graduates.Description: Senior nursing students are immersed in 40 hours of acute care simulation over 15 weeks, with ongoing focus on safety competence. With this format, students become very comfortable in the simulation setting, working with teams and analyzing performance. Students practice communication skills in codes, patient handoffs/interprofessional communication using SBAR, patient communication, as well as safe medication administration. Students are challenged to apply safety principles in every simulation encounter. Debriefing always includes discussion of the effectiveness of communication, actual or potential errors, and strategies to improve safety. Written reflections following the simulations specifically address the safety issues encountered. Scenario implementation occurs with two-nurse teams. However, at the mid-and endpoints of the course, each individual is assessed, using a behavioral checklist which targets safety competencies. These assessments are highly revealing of the extent to which safety has been ingrained in each student's practice. The use of two positive identifiers, determining allergies, medication administration safety and effective communication is emphasized on the behavioral checklist, with specific recommendations given to each student.