Scenario-Based Learning Used for Orientation to a New Adult Blood and Marrow Transplant Unit

1. Scenario-Based Learning Used for Orientation to a New Adult Blood and Marrow Transplant Unit Karen Harden MS, RN, AOCNS, Katy Gudritz MS, RN, Cortney Dennis BSN, RN 7 West - Adult BMT Inpatient Unit - University of Michigan, Ann Arbor, MI Purpose Methods Overcoming the Challenge Support of the management team, including scheduling all staff to attend, allowed for this extensive training to take place and was a foundation to our success. Early in our training the building was still under construction and hard hats, goggles and proper attire were required. This made conditions for learning a little more challenging. The intensive care unit would now be 15 minutes away –Mock emergency situations were practiced and refined. We went from one Omnicell for medications to five for the unit. There were challenges about being the only adult unit in a pediatric hospital. The purpose of this project was to provide orientation to all nurses and techs moving to a new unit. Orientation focused on navigating the new large unit and learning to function in the new space. Using a multimodal approach we wanted nurses to have fun, become familiar with the unit in a relatively short period of time and to identify individually what there own needs were to begin feeling prepared to care for patients on the new unit. Nurses were given 12 hours of formal orientation to the new unit. Additionally, they were encouraged to spend as much extra time on the unit as they felt they needed to learn their way around. Power Point presentation to orient nurses to features of the new hospital and unit. Guided Unit Tour/self guided hospital Tour – handheld maps provided Various hands-on sessions to orient to new equipment and technology (monitors, TV-computer-patient education system, call lights, hand-held phones, mock codes, fire safety). Scenario-based simulations of patient care activities including use of new call light and personal phones while completing patient care activities. Nurses were required to move throughout the unit to discover the location of equipment and supplies that would be needed for care. Background Typically orientation on our unit consists of written resources and many weeks of one to one partnership with a designated small group of preceptors. By working closely with a preceptor, new nurses are able to see tasks and procedures modeled and eventually the new nurse takes on more responsibility for completing the work independently. In our situation, all nurses knew how to care for patients, but not necessarily in the new space. We would be required to teach nurses how to navigate the new unit and learn how to get their job done in an unfamiliar environment. Essentially, their entire work flow would change. One major challenge was that there were no patients and each individual nurse would be required to teach themselves how to become comfortable on our new unit and be ready to care for patients on day ONE. Clinical Activities Checklist Navigate the unit to find items needed to accomplish the following tasks for your patient. Simulate care activities without using actual resources. Travel to all areas and think about how you would do your work, what you will need and where you need to go. The more real you make the scenario, the better your learning experience will be. Results Welcome to 7West! 100% staff trained (nurses, techs, clerks and unit host) Feedback sessions yielded pages of staff feedback about what they liked, what concerned them and how we could make positive changes Successful arrival of all patients from previous unit on move day Staff began caring for patients on one unit and continued on the new unit Trouble shooting and problem solving continued in the early weeks Staff played an integral role in identifying problems and creating solutions Acknowledgements Thanks to the entire 7W staff for their dedication to making this move a huge success Manager, Carol Kristofik and Supervisor, Jill Gibbons led this team and managed many of the details Thanks to all other support services in our institution, who added to the success of our move.