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  • Elizabeth Burns, MSN, RN, WHNP-BC Clinical Educator

    Brenda Schoenherr MBA, BSN, RN, BBL Administrative Director Home Health and

    Hospice

  • {

    The Future of Home Health and Hospice Staffing

  • What if……..

  •  The learner will state one benefit of simulation training for home health clinicians

     The learner will state how the debriefing process benefits the new and experienced clinician.

     The learner will state one way to use post simulation data to keep learning on- going

  •  “is the imitation of the operation of a real- world process or system. The act of simulating something first requires that a model be developed; this model represents the key characteristics, behaviors and functions of the selected physical or abstract system or process”.

  •  Psychologically safe learning environments are essential for optimal learning within simulation.

     Learning is enhanced with students perceiving a psychologically safe learning environment in simulation.

     Essential attributes in the build include making mistakes without consequences, qualities of the facilitator, and orientation activities.

  • Out of 4 agencies in the Indianapolis metro area, Franciscan/VNS is the only agency using simulation to educate their home care clinicians.

  • Part 1: The Simulation Lab—All nursing staff participated in January 2018.

    Part 2: Home Care Heart Failure Program presented at Clinical Meeting to all staff February 2018.

  •  Medication Teaching & Reconciliation

     Heart Failure Zones—Identification and

    Teaching

     Diet Modifications

     Exacerbation Factors

     Teaching Tools

  • Home Care Setting A Variety of

    Environments

    Hospital Controlled Environment

    https://www.google.com/imgres?imgurl=http://jewishhealthcarecenter.com/wp-content/uploads/2018/01/JHC_homecare-1024x682.jpg&imgrefurl=http://jewishhealthcarecenter.com/jhc-homecare/&docid=sx7zAu8NOzCVIM&tbnid=AdPVwI_hLOZ2FM:&vet=12ahUKEwj3_fLcxPvZAhUSTKwKHWuJBN84ZBAzKAYwBnoECAAQBw..i&w=1024&h=682&bih=971&biw=1920&q=homecare images&ved=2ahUKEwj3_fLcxPvZAhUSTKwKHWuJBN84ZBAzKAYwBnoECAAQBw&iact=mrc&uact=8 https://www.google.com/imgres?imgurl=https://cdn.aarp.net/content/dam/aarp/home-and-family/caregiving/2017/09/1140-nurse-wheelchair-home-care-health.imgcache.rev01e17c1f3a958cbd32e4c7ebbb936de0.jpg&imgrefurl=https://www.aarp.org/caregiving/home-care/info-2018/hiring-caregiver.html&docid=CB-9MhNNwdpmuM&tbnid=uzPQqkkVu7CYPM:&vet=10ahUKEwjT7ZbTxPvZAhUSYK0KHXM6CegQMwi3ASghMCE..i&w=1140&h=655&bih=971&biw=1920&q=homecare images&ved=0ahUKEwjT7ZbTxPvZAhUSYK0KHXM6CegQMwi3ASghMCE&iact=mrc&uact=8 https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjqn9uuxfvZAhVk0oMKHSdrDoQQjRx6BAgAEAU&url=https://www.synergyhomecare.com/agencies/pa/philadelphia/pa07/&psig=AOvVaw1GcY87RF8yY2GKNPkhe0GB&ust=1521657122519608 https://www.google.com/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwiB4bCwx_vZAhUo6YMKHYEoBd8QjRx6BAgAEAU&url=https://www.visitingangels.com/homecare-services&psig=AOvVaw1GcY87RF8yY2GKNPkhe0GB&ust=1521657122519608

  •  Planning meetings—Educator and Managers

     Setting the Objectives

     Completing the initial “worksheet”

    (“Designing” your patient)

     Submit to Simulation Educator

     Completing the scenarios

     Gather props

     Schedule clinicians and establish facilitators

     Provide staff with pre-Sim material

  •  Orient staff to the room and the manikin. Provide guidelines and expectations for their scenario

     Facilitator is behind two way window with technician. Microphone provides communications with patient’s “wife” in room (who wears ear piece)

     2 staff performing the #1 scenario, 2 staff who watch in debriefing room live

    then switch for scenario #2

     Ends with debriefing

  •  REACTION

     DESCRIPTION

     APPLICATION / SUMMARIZING

    (Instructor Driven or Learner Driven)

     ANALYSIS

  • Identified yellow zone quickly How: 5lb wgt gain,  B/P, SOB , HOB to sleep Properly applied O2NC Zeroed in on the previous 24 hrs activity Got to office nurse right away Utilized SBAR

    Consider utilizing Teachback method Focus on the next 24 hrs since nurse visit tomorrow Adjust visit frequency so patient is seen more in the next couple weeks Gather all teaching materials, discharge paperwork, admission folders, etc. and separate important, duplicated, refrigerator candidate, etc.

  • OBJECTIVES: Learner will demonstrate general assessment skills w/ critical thinking & interventions as appropriate.

    SCALE: 0 -- Did not Perform 1 -- Sub Standard Knowledge/Performance 2 -- Minimal Knowledge/Performance 3 -- Adequate Knowledge/Performance 4 -- Above Avg Knowledge/Performance 5 -- Exceptional Knowledge/Performance

    SCENARIO: BOTH BOTH BOTH #1 BOTH #1 BOTH #2 BOTH BOTH BOTH BOTH #2

    EMPLOYEE SCENARIO

    PERFORMED Timely

    VS/Assess

    Early Focus:

    CP assess

    (correct)

    Utilizes all sources for gathering

    history/info

    Quickly identifies

    Yellow Zone

    Utilizes SOAP/ SBAR

    communi- cation

    Verbalized urgent need to speak

    w/nurse (does not

    leave message)

    Utilizes Team

    STEPPS when

    receiving orders

    Evaluates visit

    Frequency & adjusts to

    patient

    Displayed knowledge of medication(s) classification, action & side

    effects

    Teaching: DIET (appropriate to

    scenario)

    Teaching: Yellow Zone

    Teaching: Utilized Teach- back

    Method

    Timely Observation

    Skills

    Worked well with teammate

    Left patient/CG with Emerg

    Plan

  • 1) “Psychological Safe Environment: A Concept Analysis, Clinical Simulation in Nursing”, Volume 18, May 2018, Pages 47-55,b Sufia Turner, BN, RN , Nicole Harder, PhD, CHSE, RN

    2) Lori Hardie, MSN, RNC, CHSE

    Simulation Education Coordinator

    Franciscan Hospital, Indianapolis

    Office #(317) 528-5725

    https://www.sciencedirect.com/science/article/pii/S1876139917301469 https://www.sciencedirect.com/science/article/pii/S1876139917301469 https://www.sciencedirect.com/science/article/pii/S1876139917301469 https://www.sciencedirect.com/science/article/pii/S1876139917301469 https://www.sciencedirect.com/science/article/pii/S1876139917301469

  • A Healthy heart…

    You can’t beat it!

    What Questions Do You Have?

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