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Scholarly Project. Stephanie Monroe Ferris State University . Presentation Objectives . Define purpose of scholarly project State project goal and objectives Describe personal and professional accountability Analyze project outcomes Provide summary of evaluations - PowerPoint PPT Presentation
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Scholarly ProjectSTEPHANIE MONROEFERRIS STATE UNIVERSITY
Presentation Objectives
Define purpose of scholarly project State project goal and objectives Describe personal and professional accountability Analyze project outcomes Provide summary of evaluations State recommendations for similar projects
Project Description
To develop, implement, and evaluate a clinical simulation for the cardiothoracic unit nursing staff at Munson Medical Center
Project Goal and Objectives
Goal: A2 nurses will improve their documentation of procedures using sedation and cardiac rhythm strips after completion of the simulation
Objectives: Demonstrate proper set up of a room for a cardioversion per a2 protocol Demonstrate competency in documenting a procedure requiring sedation per MMC
standards Describe proper documentation of cardiac rhythm strips per A2 protocol Demonstrate competency in the use of a biphasic defibrillator including application Apply Teamwork principles to performance of BCLS/ACLS algorithms
Pre-simulation Audits of Documentation of Procedural Sedation on A2
Procedure
Documented under
procedure/treatments in I -
View
Documented in a focus note
Mentioned in shift summary
Vital signs documented
Strips posted if DCCV
Chest tube insertion
X
Chest tube insertion
X
Chest Tube insertion
X
DCCV X XDCCV X X DCCV X DCCV X X DCCV X
(from RT) X
DCCV X X X X(no resp.)
X
DCCV X X XDCCV X X XDCCV X X
(1 set)
Central line insertion
X X(BP & HR only)
Total 1% 92% 15% 53% 56%
Pre-simulation Audits of Procedural Sedation Documentation on A2
Procedure Sedation Medication Patient's Tolerence Vital Signs Aldrete Score012345678
Documentation Audit of DCCVs on A2
DCCV
Occ
urre
cne
in D
oc-
umen
tion
out
of 9
D
CCVs
Project Outcomes
At completion of the clinical simulation the cardiothoracic nurses were able to: Demonstrate proper set-up of a room for a cardioversion per A2 unit
standards Demonstrate competency in documenting a procedure requiring sedation
per Munson Medical Center’s standards of care Describe proper documentation of cardiac rhythm strips per A2 unit
standards Demonstrate competency in the use of a biphasic defibrillator including
application Apply teamwork principles to performance of BLS/ACLS algorithms
Post-Simulation Audit of Procedural Sedation Documentation
Proced
ure/Tr
eatm
ent F
lowshe
et Used
Aldrete
Score
Used
Vital Si
gns D
ocumen
ted
Patie
nt To
leren
ce Docu
mented
Seda
tion M
edica
tion U
sed 0%
40%
80%
120% 100% 100% 100% 100% 100%100% 100% 100% 100% 100%100%
0%
100% 100% 100%
Procedural Sedation Documentation
Chest tube Placement DCCV Reintubation
Required Components To Documenting Procedural Sedation
Perc
ent T
hat D
ocum
enta
tion
Occu
rred
Analysis of Outcomes:Adherence to Legal and Ethical Standards
Autonomy: Utilization of pre-procedure checklist ensures patient has given informed consent
Beneficence & Nonmaleficence: Being compliant to policies and standards of care we ensure quality care and protect patients from harm
Fidelity: compliance to the hospital policies and standards of care demonstrate commitment to safe and quality care
Justice: All patients on the cardiothoracic unit will receive a level of care that is in compliance with hospital policies and standards of care
(ANA, 2011)
Analysis of Outcomes:Adherence to Organizational Standards
Congratulations A2 staff! In post-simulation chart audits of documentation of procedural sedation the staff was found to be nearly 100% complaint to the hospitals policies and standards of care.
Analysis of Outcomes:Adherence to Nursing Standards
As a future nurse educator it is my responsibility to be in compliance with the National League for Nursing’s [NLN] (2005) Core Competencies of Nurse Educators: Facilitate Learning Facilitate Learner Development and Socialization Use Assessment and Evaluation Strategies Participate in Curriculum Design and Evaluation of Program Outcomes Function as a Change Agent and Leader Pursue Continuous Quality Improvement in the Nurse Educator Role Engage in Scholarship Function within the Educational Environment (NLN, 2005)
Personal and Professional Accountability
Project was implemented in an organized way I completed all project tasks within the agreed timeframe I provided excellent communication to all individuals involved A2 staff was provided with all necessary materials needed to
successfully complete the simulation I have served as a valuable resource to staff on all aspects related to
the project
Evaluation of ProjectAt the end of this program, I was able to:
Strongly Agree
Agree Neutral Disagree Strongly Disagree
1. Demonstrate proper set-up of a room for a cardioversion per A2 protocol.
90% 10%
1. Demonstrate competency in documenting a procedure requiring sedation per MMC standards.
97% 3%
1. Describe proper documentation of cardiac rhythm strips per A2 protocol.
93% 7%
1. Demonstrate competency in the use of a biphasic defibrillator including application.
90% 10%
1. Apply teamwork principles to performance of BCLS/ACLS algorithms.
93% 7%
I clearly understood the purpose and objectives for the simulation.
93% 7%
The scenario resembled a real-life situation. 90% 10% Did the scenario allow you to use your critical thinking and decision making skills?
93% 7%
The simulation provided a variety of ways in which to learn the material.
87% 13%
The materials provided to review before the simulation were valuable.
93% 7%
The debriefing session was well-organized. 93% 7% The facilitator, Stephanie Monroe demonstrated expertise in the content area.
93% 7%
Feedback provided during the debriefing was constructive. 90% 10% The simulation activity reinforced my knowledge base. 93% 7% After participating in the simulation activity, do you feel more confident in a similar situation in the clinical environment?
90% 10%
Evaluation of Project
Q: What did you find most helpful about the simulation?A: The education related to procedural sedation was most helpful
Q: What would you like to seen done differently in the future? A: Incorporate open chest at the bedside and sterile procedures
Q: How will you apply the information learned in clinical practice?A: I will now utilize the proper form to document procedural sedation
Recommendations for Future Simulations
Offer a variety of opportunities to complete simulation Assign roles to participants and ensure understanding of role Allow enough time for participants to switch roles and repeat the
simulation Start simulation planning early
Summary
Simulation has been proven to be an effective learning tool for the staff on A2
Pre-simulation audits identified a learning gap in procedural sedation documentation
Post-simulation audits found A2 staff to be nearly 100% compliant with hospital policies and standards of care
In the future staff would like to see open chest at the bedside incorporated into simulation
References
American Nurses Association (2011). Short definitions of ethical principles and theories familiar words, what do they mean? Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Resources/Ethics-Definitions.pdf
National League for Nursing (2005). Core competencies of nurse educators with task statements. Retrieved from http://www.nln.org/profdev/corecompetencies.pdf
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