Minnesota Simulation for Healthcare Education Partnerships (MnSHEP)
Infant with Myelomeningocele Simulation
6 month old child admitted with pneumonia.
She was born at 32 weeks gestation with myelomeningocele.
Date:
Discipline:
Expected Simulation Run Time:
Location:
Admission Date: Today’s Date:
Brief Description of Patient:
File Name:
Participant Level:
Debrief /Guided Reflection Time:
Location for Reflection:
Psychomotor Skills Required prior
to simulation:
Name: Cassie Everly Gender: F Age: 6
months Weight: ____kg
Height:
____cm
Religion:
Major Support:
Phone:
Allergies:
Immunizations:
Attending Physician/Team:
PMH: Born with myelomeningocele
History of Present illness: Pneumonia
Cognitive Skills Required prior to
Simulation: i.e. independent reading
(R), video review (V), computer
simulations (CS), lecture(L)
Social History:
Primary Diagnosis:
Surgeries/Procedures:
Simulation Learning Objectives:
1. Perform urinary catheterization of infant following Clinical Standards
2. Communicate effectively with parent
Submitted 2007 – Updated 2015
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Minnesota Simulation for Healthcare Education Partnerships (MnSHEP)
Fidelity
Setting/Environment
o Peds
Simulator Manikin/s Needed:
Medications and Fluids
o IV Fluids:
o Oral Meds:
Nursing Baby Manikin
o IVPB:
Props:
Equipment attached to manikin:
o IV Push:
Equipment available in room
o IM or SC:
o
o
o
o
Bedpan/Urinal
Straight Catheter Kit
Sterile and clean gloves
Clinical Standard (access from
internet)
Diagnostics Available
o
o
o
o
Labs
X-rays (Images)
12-Lead EKG
Other
Documentation Forms
o
o
o
o
o
o
o
o
o
o
o
o
Physician Orders
Admit Orders
Flow sheet
Medication Administration Record
Kardex
Graphic Record
Shift Assessment
Triage Forms
Code Record
Anesthesia / PACU Record
Standing (Protocol) Orders
Transfer Orders
Other Props
Recommended Mode for simulation:
Roles / Guidelines for Roles
o
o
o
o
Primary Nurse
Secondary Nurse
Family Member #1
Observer/s
Submitted 2007 – Updated 2015
Participant Information Needed
Prior to Scenario:


Has been oriented to simulator
Understands guidelines /expectations
for scenario
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Minnesota Simulation for Healthcare Education Partnerships (MnSHEP)
Important information related to
roles:
Critical Lab Values:
Physician Orders:



Has accomplished all pre-simulation
requirements
All participants understand their
assigned roles
Has been given time frame
expectations
Report Participants will receive
before simulation:
Time:
Cassie Everly is a 6 month old child admitted
with pneumonia. She was born at 32 weeks
gestation with myelomeningocele. Due to
neurogenic bladder, she requires intermittent
urinary catheterization. She has physician
orders for intermittent catheterization every 6
hours while hospitalized. Cassie’s mother has
been rooming in with her during her
hospitalization, but she left earlier this
morning to get her other children off to
school. You have taken over care for Cassie
at 0730 and have completed her initial
assessment. It is now 0800 and she is due to
be catheterized.
**After supplies have been gathered, the
mother returns to the hospital.
References, Evidence-Based Practice Guidelines, Protocols, or Algorithms
used for this scenario: (site source, author, year, and page)
Myelomeningocele
http://emedicine.medscape.com/article/311113-treatment
Pneumonia
http://emedicine.medscape.com/article/967822-treatment
Simulation Development
Simulation developed by the Metro Alliance Nursing Simulation Task Force
Simulation updated November 2015 by Children's Hospitals and Clinics of MN, 2015.
Submitted 2007 – Updated 2015
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Minnesota Simulation for Healthcare Education Partnerships (MnSHEP)
Scenario Progression Outline
Timing
Manikin Actions
(approximate)
0800
Expected Interventions
May use the following Cues:
Access clinical standard as necessary
Perform urinary catheterization
following clinical standard
Demonstrate effective communication
techniques with family member
Display clinical judgment skills when
confronted with conflicting information
Document accurately on EMR
Role member providing cue:
Mother
Cue:
Enter room after RN has started
setting up for catheterization
procedure.
State “Oh, it’s time for her to be
catheterized? Does anything contain
latex?”
Wait for reply, but start looking at
all of the supplies. If any sterile
products are open attempt to touch
them. Ask “Are you sure?” and
continue to hover, if she says no.
If RN asks if you want to perform
procedure, decline.
Say, “That is not how we do it at
home.” Ask “Why are you doing it
like that? Why are you using that to
wash her? Why are you using sterile
gloves?” Be insistent about the way
you do it at home, the way you were
taught to do it.
Submitted 2007 – Updated 2015
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Minnesota Simulation for Healthcare Education Partnerships (MnSHEP)
Debriefing / Guided Reflection Questions for this Simulation
Link to Participant Outcomes and Professional Standards
(i.e. QSEN, NLN {Nursing}, National EMS Standards {EMS}, etc.)
1. What do you feel went well in this simulation?
2. To the Participant in RN role: What do you feel went well? What could have gone better?
3. To the Participant in the role of the parent: How did you feel in the role of the parent?
What was done well? What things might have been done differently?
4. Was it difficult to answer the mother’s questions and concerns while preparing and doing
the procedure?
5. How will being involved in this scenario effect you if you encounter a similar situation in
the clinical setting?
Complexity – Simple to Complex
Suggestions for changing the complexity of this scenario to adapt to different
levels of learners:
Submitted 2007 – Updated 2015
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Minnesota Simulation for Healthcare Education Partnerships (MnSHEP)
SIMULATION SCENARIO
Infant with Myelomeningocele
Participant Copy
LEARNING OBJECTIVES
1. Perform urinary catheterization of infant following Clinical Standards
2. Communicate effectively with parent
SUPPLIES NEEDED
Lab book, Clinical Standard, or Procedure for urinary catheterization
Pediatric text book
Other supplies will be provided
PATIENT DATA
Cassie Everly is a 6 month old child admitted to Children’s Hospital with pneumonia. She was
born at 32 weeks gestation with myelomeningocele. Due to neurogenic bladder, she requires
intermittent urinary catheterization. She has physician orders for intermittent catheterization
every 6 hours while hospitalized. Cassie’s mother has been rooming in with her during her
hospitalization, but is a single mother and has 4 other children at home. You have taken over
care for Cassie at 0730 and have completed her initial assessment. It is now 0800 and she is due
to be catheterized.
REFERENCES
Myelomeningocele
http://emedicine.medscape.com/article/311113-treatment
Pneumonia
http://emedicine.medscape.com/article/967822-treatment
Simulation Development
Simulation developed by the Metro Alliance Nursing Simulation Task Force
Simulation updated November 2015 by Children's Hospitals and Clinics of MN, 2015.
Submitted 2007 – Updated 2015
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