Building QSEN Competencies in Simulation

Jacinda Bunch, MSN, RN

Ellen Cram, PhD, RN

Our aims

• Utilize QSEN to provide a foundation for novice students

• Provide a framework for building teamwork skills in simulation

• Enhance communication skills within simulation • Support and develop faculty skills • Ensure a consistent experience within the cohort

BSN Structure

• Second semester of the nursing curriculum

• 15 week course for BSN

• Maximum of 8 students/lab section

• Each group divides into smaller group of 4

1 small group works on clinical skills

1 small group participates in simulation

Small groups rotate each week

Differences for MSN-CNL

• 10 week course

• 8 weeks of simulation

• Repetition of simulations

• Simulation groups and Skills groups scheduled separately

• 8 students in Skills labs

• 4 students in Simulation labs

Simulation Schedule

1) Med-Surg scenario

2) Related TeamSTEPPS tool

3) Purposeful debriefing

4) Thoughtful reflection

Learning Activities BSN

Simulations

• Post-Op DVT

• Post-Op Hemorrhage

• Chronic Heart Failure

• GI Bleed

• Pneumonia

• Chest Pain

• Cardiopulmonary Arrest

• End of Life

TeamSTEPPS

• TeamSTEPPS Overview

• SBAR

• Feedback

• 2 Challenge Rule

• CUS

• I PASS the BATON

• Call-out & Check-back

• I’M SAFE

Learning Activities MSN-CNL

Simulations

• Post-Op DVT

• Post-Op DVT

• Chest Pain

• Chest Pain

• Heart Failure

• Heart Failure

• Cardiopulmonary Arrest

• End of Life

TeamSTEPPS

• TeamSTEPPS Overview

• SBAR

• Feedback

• 2 Challenge Rule

• CUS

• DESC

• Call-out & Check-back

• I’M SAFE

Team Structure

• Focus on Patient

• Team Size

• Membership

• Leadership

• Composition

• Identification

• Distribution

Leadership

• Organization

• Clear Goals

• Collective Input

• Empowerment

• Teamwork Promotion

• Conflict Resolution

Situation Monitoring

• Situational Monitoring

• Situational Awareness

• Shared Mental Model

Components of Situation Monitoring:

Mutual Support

• Task Assistance

• Feedback

• Advocacy & Assertion

• Conflict Resolution

Communication

• Clear exchange of information

– Patients

– Team

“I believe that communication is the most important aspect of teamSTEPPS that our group needs to develop over the semester. “

Assumptions Fatigue Distractions HIPAA

QSEN Concepts

• Teamwork/Collaboration

• Patient Centeredness

• Safety

Evaluation

• PDSA

• Formal Evaluations

• Reflections

Student Reflections

• “Giving the feedback was pretty hard for me, but I knew that it would help out my team member and ultimately the team as a whole and the patient. I felt that I didn’t have the authority to tell the teammate what she did wrong, when I know that I did some things wrong too.”

Student Reflections

• “Our first simulation our group would somewhat leave the patient alone, while we were discussing as a group. This simulation someone was always working with the patient and was available to answer any questions or concerns the patient may have.”

Student Reflections

• “Teaching the patient and putting big medical terminology has also been getting easier. It is exciting to see how our concern for patient safety is almost becoming second nature to us.”

Thanks for your attention

jacinda-bunch@uiowa.edu or ellen-cram@uiowa.edu