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Pediatric Competency Development. Bridget Mudge, RN, MS Judy Kertis RN BSN Pediatric Clinical Nurse Specialist . Objectives. Determine didactic content Creating scenarios Integrating core practice issues in to simulations Evaluating performance. OVERVIEW: Pediatric Nurse Residency.

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pediatric competency development

Pediatric Competency Development

Bridget Mudge, RN, MS Judy Kertis RN BSN

Pediatric Clinical Nurse Specialist

objectives
Objectives
  • Determine didactic content
  • Creating scenarios
  • Integrating core practice issues in to simulations
  • Evaluating performance
overview pediatric nurse residency
OVERVIEW:Pediatric Nurse Residency
  • 4 components.
  • 16-week program.
  • Each week two (2) class days:
    • Web-based learning.
    • Didactic with experts to review institutional specific.
    • Followed by simulations.
  • Two days of eight-hour clinical; then progresses to 12 hours after 8 weeks.
orientation
Orientation

Content:

Clinical Orientation

Identify common patient diagnosis (e.g. Neuro, Oncology, Resp distress: RSV)

Problem prone areas ( Medication delivery, Isolation)

Skills or tasks ( Blood administration)

orientation content
Orientation Content

Complex skills or infrequent skills ( Chest tubes)

High Risk: Sedation

Clinical Questions asked ( How do you evaluate seizures)

New processes or skills

National patient safety goals

Feedback

simulation additional uses
Simulation Additional Uses
  • Add National Safety Goals:

Medication safety.

Patient Identification.

Clinical Alarms.

Verbal Orders.

Critical Labs.

program components pediatric nurse residency
PROGRAM COMPONENTS:Pediatric Nurse Residency

Web-based:

Pediatric intensive-care course developed by Indiana University (http://original-oncourse.iu.edu).

web based learning modules pediatric critical care
WEB-BASED LEARNING MODULES:PEDIATRIC CRITICAL CARE

Psychosocial Renal/Endocrine

Respiratory GI

Cardiovascular Neurology

Multi-system Comfort

Hematology/Oncology Immunology

component of program didactic
COMPONENT OF PROGRAM:DIDACTIC
  • Didactic with specialist/ unit experts:
  • Respiratory: CF, Asthma, RSV.
  • Pain Management: Assessment Tools, PCA,

Epidurals, Pain Free Program.

  • Developmental Aspects: Chronic Illness, Bereavement.
  • Cardiac: CHF, Cardiac Cath Postoperative Care.
component of program didactic10
COMPONENT OF PROGRAM:DIDACTIC
  • Family-centered Care.
  • Wound and Skin: Braden Q.
  • Nutrition: Feeding Techniques, Formula,

GU Care.

  • Responding to Medical Emergencies.
  • Orthopedic Care.
  • GI Care.
component of program didactic11
COMPONENT OF PROGRAM:DIDACTIC
  • Diabetic Care: Management and Teaching.
  • Organ Donation.
  • Pre- and Post-Op Care.
  • Child Abuse.
  • Communication: SBAR.
  • Transfer and Discharge Planning.
  • IV Central Line Care.
  • Newborn.
component of program didactic12
COMPONENT OF PROGRAM:DIDACTIC
  • Trauma Care.
  • PICU Specific:

Ventilators,

EKG monitoring, Defibrillator,

IV Therapy,

Vasoactive Medications,

ICP,

Hemodynamic Monitoring.

simulations
SIMULATIONS:

Simulation Development

  • Who, What?
  • Sample:
  • Airway Management.
  • RSV.
simulations14
Simulations
  • Seizures.
  • EEG Monitoring.
  • Responding to

Medical Emergencies

  • Documentation
  • Admission
  • Trauma
  • Diabetes
simulation development
Simulation development

Diabetes:

  • Who: Unit experts
  • What:

Frequently asked questions of the expert

Chart review for orders

Review of standards of care for diabetes

Patient Education

simulation development16
Simulation development
  • RSV

Review of standards and skills

Isolation

Room set up

Nasal cannula application

Patient Education

simulation development17
Simulation development
  • Time out
  • SBAR
  • Team building
challenges
CHALLENGES:
  • Logistics:

Ideal number of new grads.

  • Schedule:

Presenters.

Preceptors around fixed classes.

  • Securing lab and Sim Baby.
challenges19
CHALLENGES:

Simulation:

  • How complicated to make scenarios?
  • Scenarios consistent?
  • Ideal class size?
challenges what is best done in simulation
CHALLENGES:What is best done in simulation?

Responding

to

medical

emergencies.

Skin Care

and

Diabetic Education

versus

evaluation
Evaluation
  • What are critical Clinical Behaviors?
  • Objective information
  • Experts evaluate
  • Final Simulation = Integration of skills
  • Pass / Fail
outcomes
OUTCOMES:
  • Increased proficiency and accuracy with technical skills.
  • Developed skills as team members.
  • Developed relationships with the clinical experts and learned to utilize a variety of resources.
outcomes23
OUTCOMES:
  • The simulations became a place to learn about safety and how errors can and do occur.
  • Experienced staff members stated an increase in their own knowledge by their participation in the didactic.
conclusions
CONCLUSIONS:
  • Utilizing a nurse residency program provides:

Opportunities to become safe, competent

caregivers.

conclusions27
CONCLUSIONS:
  • Receive immediate feedback on scenario vignettes and quizzes to enhance individual learning and review.
  • Human patient simulation supports the organizational initiatives related to patient safety and addresses the unique needs of the pediatric population.
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