NURSING SKILLS COURSE
Designed for
the Simulation
Laboratory
Kim K. Oelke
APN, FNP-C
OUTCOMES
 Discuss advantages and disadvantages of utilizing the nursing
skills laboratory for basic and advanced skills instruction
 Describe the components of the skills course
 Identify three teaching methods that can be employed using
this course
 Describe use of the course as an adjunct to a
Medical/Surgical Nursing course, as skills units, or as
individual skills to be practiced prior to clinical assignments
SIMULATION
LABORATORIES
ADVANTAGES OF USING A SKILLS
LABORATORY
 “Safe” environment
 Immediate detailed feedback and debriefing
 Increase student confidence
 Practice skills
 Introduce challenges
ADVANTAGES CONTINUED
 Self-paced learning
 Remediation
 Applies theory to practice
DISADVANTAGES OF USING A SKILLS
LABORATORY
 Interpersonal interactions
 Professional judgement
 Clinical environment
 Skills loss
 Misdirected focus
 Cost
MAXIMIZE THE
ADVANTAGES
MINIMIZE THE
D I S A DVA N TAG E S
MAXIMIZE
 School
 Attract students
 Decrease liability
 Clinical settings
 Students with required skills
 Less dependence on staff nurses
 Safer care of patients
 Students
 Supervised learning in “safe” environment
 Practice
 Resources
 NLN SIRC
 SSH experts
 Other programs
MINIMIZE
 Role playing
 Interpersonal interactions
 Professional judgement
 Adjunct to clinical experiences
 Interpersonal interactions
 Professional judgement
 Redirect focus - skill as part of total patient care
 Costs
 Funding opportunities
 Shared facilities and equipment
SYLLABUS
SKILLS
OUTLINE
COURSE COMPONENTS
CASE
SCENARIOS
CLINICAL
CHECKLISTS
SYLLABUS
Course Description:
 Clinical course for nursing simulation lab
 Incorporates
basic med/surg nursing skills
 use of resources
 critical thinking skills
 cooperation skills
 patient education
 Active student participation required.
SYLLABUS: COURSE OUTCOMES
 Upon completion of each system unit, the student will be able
to:
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Identify skills for specific systems
Discuss patient education points
Assemble equipment needed
Identify patients
Obtain informed consent
Perform procedure or skill.
Discuss nursing measures
 patient safety
 comfort
 privacy
 Demonstrate correct documentation
SYLLABUS: CONTENT OUTLINE
 Content Outline:
 Skills and procedures
 Patient education
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reason for procedure
prep for procedure
expected experience
risks and side effects
expected follow -up
 Informed consent
 Documentation of nursing education
 Documentation of procedure
SYLLABUS: LEARNING ACTIVITIES
 Case scenarios for role playing
 Work in pairs
 Work in small groups
SYLLABUS: STUDENT EVALUATION
 Group discussions
 Positive feedback
 Constructive criticism
 Instructor evaluation
 Group debriefing
 One to one discussion
 Case scenarios
 Video-taped performance
 Graded performance
SKILLS OUTLINE
 Skills organized by body systems
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Respiratory
Cardiovascular
Gastrointestinal
Genitourinary
Integumentary
Musculoskeletal
Nervous
 Skills outlined in steps
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Patient education
Equipment/supplies
Patient identification
Technique
Documentation
CASE CHECKLISTS
 Skills - examples
 Tracheostomy care
 Chest tube
 Insertion
 Routine care
 Discontinuation
 Outline format
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Information and patient education
Assembling equipment/supplies
Identification of patient
Performing procedure
Documentation of education, procedure, and patient status
Case Checklist 2.2 IV catheter site care
2.2.1 Describes the education provided to the patient
 Introduces self
 Explains purpose of procedure
 Explains procedure
 Describes expected results
2.2.2 Assembles all necessary equipment and supplies
 Tape
 Occlusive clear dressing if not changed in past 72 hours
 Alcohol prep pads
Education -
____ /4
Organization - ____ /3
2.2.3 Identifies patient using 2 identifiers
 Wrist band
 Verifies name and date of birth
Identification - ____ /2
2.2.4 Performs catheter site care
 Performs hand hygiene
 Raises bed to working position and lowers side rail
 Dons non-sterile gloves
 Assesses site for possible infection or infiltration
 Removes and replaces any soiled tape and/or dressing
 Records date and time on new dressing
 If catheter has been in place 72 hours, removes dressing and catheter
 Holds pressure until bleeding stops
 Restarts IV in another site
 Returns bed to control position and raises side rail
 Removes and disposes of used equipment and gloves
 Assesses patient and provides comfort measures as needed
Skill performance -
2.2.5 Documents patient teaching and performance of procedure
 States education provided and who was educated
 Records the patient identifiers used
 Briefly describes the procedure, the outcomes, and patient comfort provided
Documentation -
Total score -
____ /12
____ /3
____ /24
CASE SCENARIOS
 Multiple scenarios for each skill
 Simple to complex
 Incorporate clinical knowledge and professional judgement
 Multisystem scenarios available to reflect reality
 IV rehydration
 Teaching intermittent selfcatheterization
 Hydrocolloid gel burn dressing
SIMPLE
CASE
SCENARIO
ex a m p le s
 Heart failure patient
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Respirations 18, slightly labored
Pulse oximetry 88%
Nail beds cyanotic
Breath sounds slightly diminished
Gurgling
 Assess
 Oropharyngeal suctioning
 Provider notification
COMPLEX
CASE
SCENARIO
ex a m p le
 MVA patient
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Coma
Respirator
Chest tube
Thomas splint
Vasopressors
Antibiotics
 Skills
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Oral care
Neurological checks
Suction ET tube
Bed bath /skin assessment
Chest tube care
 Issues
 Organization
 Complications
 Assistance
MULTISYSTEM
CASE
SCENARIO
ex a m p le
CASE SCENARIO
METHOD
FOR USE
WITH THE
SIMULATION
COURSE
INSTRUCTOR
SINGLE STUDENT
 Scenario provided
 Decisions made by student
 Skill demonstrated
 Instructor provides immediate or delayed feedback
 Scenario may change
 Instructor may record session for review and feedback
INSTRUCTOR
GROUP OF STUDENTS
 Instructor assigns student roles
 Scenario provided
 Decisions made with group input
 Skill demonstrated
 Students and instructor provide feedback
 Students rotate performing skill
STUDENTS
SMALL GROUP SETTINGS
 One student performs the skill
 One student may assist
 Another student completes the checklist
 Other students provide feedback
 Students rotate positions
STUDENTS ALONE
 Student follows checklist to
complete the skill
 Student may record session
for review and feedback
from other students or the
instructor
WAYS TO IMPLEMENT
THE COURSE
TO MEET
THE NEEDS
OF YOUR
FACILIT Y
REFERENCES
For this
presentation
Durham, C.F., & Alden, K.R. (2008). Chapter 51: Enhancing patient safety in nursing education
through patient simulation. In Patient safety and quality: An evidence-based handbook for
nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from
http://www.ncbi.nlm.nih.gov/books/NBK2628/
Grant, J., Epps, C., Moss, J., & Watts, P. (2009). Promoting reflective learning of students using
human patient simulators. Clinical simulation in nursing, 5(3), S6.
Kneebone, R., Scott, W., Darzi, A., & Horrocks, M. (2004). Simulation and clinical practice:
strengthening the relationship. Medical Education, 38(10), 1095-1102. Retrieved from
EBSCOhost.
Kowalak, J.P. (Ed.) (2009). Lippincott’s nursing procedures (5th ed.). Hong Kong (China):
Lippincott Williams & Wilkins.
Monahan, F.D., Sands, J.K., Neighbors, M., Marek, J.F., & Green, C.J. (Eds.) (2007). Phipps’
medical -surgical nursing: Health and illness perspectives (8th ed.). St. Louis, MO: Mosby
Elsevier
Morgan, R. (2006). Using clinical skills laboratories to promote theory-practice integration
during first practice placement: an Irish perspective. Journal of Clinical Nursing, 15(2), 155161. Retrieved from EBSCOhost.
Wilson, A., & Godson, N. (2007). Evaluating the use of clinical skills laboratories for teaching
student nurses. British Journal of Nursing (BJN), 16(19), 1178. Retrieved from EBSCOhost.
THANK YOU FOR YOUR ATTENTION
“The most wasted of all days is one without laughter.” e.e. cummings