simulation of a cardio-respiratory arrest in a hospital setting: preparing undergraduate nurses for the reality of a cod

1. Simulation of a Cardio-Respiratory Arrest in a Hospital Setting: Preparing Undergraduate Nurses for the Reality of a Code

2. Basic Questions All the undergraduate nurses have BLS training, does this prepare them for a hospital code? Where in the undergraduate training is this addressed now, if it is addressed at all? When a nursing student graduates do they feel that they have the skills needed to participate in a code? Do they feel they have the confidence to participate in a code?

3. Answers to these questions BLS does not prepare them for a hospital code Most curriculums do not address this in any detail Our surveys reveal that the nursing students do not believe they have the skill or confidence to participate in a code

4. What elements should be included in a Mock Code Realism is the key, it must mimic the aspects of a hospital code as closely as possible Attention to details A small instructor to student ratio to give each and every student individual attention Allotting the time needed to accomplish this

5. How have we met these requirements? The mock code is a “lab” activity required of all semester 3 students The mock code activity is given 2 hours and 4 to 6 students participate at the same time 2 instructors are present for the activity Friday’s are reserved for the activity, so that on a given Friday 4 groups of students or a total of 16 to 24 students can be taken thru the mock code activity

6. Meeting the requirements of realism Performed in the lab where a regular hospital bed is placed in a true room like area with bedside tables, telephone, wall “oxygen”, air, and suction available Use of the Human Patient Simulator to create a relatively appearance Having the students talk to the simulator and not to the instructors and all responses coming via the simulator (via wireless communication to a speaker in the simulator) THIS IS VERY IMPORTANT!!!!!!!!!

7. Why we choose the Meti Simulator for the Mock Code Physiologic responses of the simulator Ability for the simulator to provide direct feedback during training of seeing what BP is generated during CPR Ability for the simulator to respond realistically to ventilation with an Ambu bag or other ventilatory devices Ability to place IVs with “blood return” during the code

8. What we do not attempt to do We do not attempt to teach ACLS material during the mock code We focus on the first 5 minutes of the response

9. What we believe to have accomplished Creating a realistic enough environment to capture the attention of the student and create enough “tension” or “anxiety” to stimulate the ability to learn to the maximal possible in a short time period However, at the same time create a safe environment so that no student has to feel intimidated An approach that gives each student equal individual attention and participation so that no student is felt left out in this process

10. Results measured by the following techniques: A form that grades the technical skills for the mock code A survey to evaluate perceived ability and confidence before and after the mock code activity

11. Technical Skills Evaluation 50 point for all skills being performed Scores measured after basic explanation of the equipment and roles of the students in the code and then measured again at the end of the mock code session

12. Student Roles in the Mock Code

15. Results Average score out of 50 points at the beginning of the session was 13 Average score out of 50 points at the end of the session was 45

17. Results of Survey: Average Response Perceived ability to respond to a code prior to the mock code exercise: 1 Perceived ability to respond to a code after the mock code exercise: 4 Perceived confidence to respond to a code prior to the mock code exercise: 1 Perceived confidence to respond to a code after the mock code exercise: 4

18. Results of Survey: Average Response Satisfaction with the Mock Code exercise: 5 Would you recommend the Mock Code exercise to other students? 5

19. Best way to Explain exactly how the Mock Code exercise works is to demonstrate, so let us demonstrate now!!!!!!