1. 1. S Procedural Sedation Simulation Stephanie Ricketts NURS 693 Summer 2015
2. 2. OBJECTIVES S Recap of last semester S Constructivism philosophical theory of learning S Standards of simulation S Simulation pilot
3. 3. Knowledge without experience is just information-Mark Twain
4. 4. EVENT BASED APPROACH TO LEARNING Simulation is a technique, not a technology, to replace or amplify real experiences with guided experiences, often immersive in nature, that evoke or replicate substantial aspects of the real world in a fully interactive fashion.
5. 5. RECAP S Subjective Director of Perioperative Services, OR Manager and Sedation Educator all endorse the need for further procedural sedation training S Objective Kaisers Procedural Training takes place on anesthesia patients NOT procedural sedation patients No national guidelines for training of personnel S Assessment Hands on competency is not measurable and not enforced S Plan Create a clinical simulation tailored to procedural sedation for realistic & consistent training
6. 6. PROJECT TIMELINE Identified problem: inconsistent & unrealistic training Participated in training Identified project: clinical simulation Created evidenced based scenarios for simulation Consulted Simulation technician Studied simulation software and EBP of scenarios Observed specific procedural sedation scenario in real life: Kyphoplasty Inputted kyphoplasty scenario into software with successful trial run
7. 7. Constructivism Philosophical Theory of Learning S Individuals construct knowledge for themselves through their interaction with their environment. S Learning is contextual and occurs when situated in a realistic setting. Simulation is based on constructivist theorie
8. 8. Standards of Best Practice S Standard I: Terminology S Standard II: Professional Integrity of Participants S Standard III: Participant Objectives S Standard IV: Facilitation S Standard V: Facilitator S Standard VI: The Debriefing Process S Standard VII: Participant Assessment and Evaluation -The International Nursing Association for Clinical Simulation and Learning (INACSL), 2013
9. 9. Standard Specific Focuses Consistent terminology Pre-briefing Confidentiality to preserve integrity of scenarios Incorporate EBP Achievable in time frame Who will facilitate? Correspond to RN knowledge level & experience Who can facilitate? Promoting learner-centered reflective conversation Summative evaluations
10. 10. KAISER PROCEDURAL SEDATION SIMULATION
11. 11. CNS COMPETENCIES Competency Sphere of Influence Nurse Characteristics Detailed Actions performed Consultation Nurse & System Facilitation of Learning, collaboration & clinical judgment Initiated consultation with CRNAs, clinical educators & RNs while collecting resources Systems Leadership Nurse & System Collaboration & systems thinking Created clinical simulation objectives & scenarios Collaboration Nurse & System Clinical Inquiry & Collaboration Collaborated with CRNAs, physicians, RNs and simulation technicians to ensure all needs are addressed in training. Coaching Nurse Facilitator of learning & clinical inquiry Promoted professional development through presentation & application of EB care Research Nurse & System Clinical Inquiry, systems thinking Analyzed research findings, national standards & clinical facts for integration to SIM
12. 12. My Clinical Journey
13. 13. All Competencies Complete!
14. 14. TEAMWORK!
15. 15. REFERENCES American Association of Nurse Anesthetists. Qualified Providers of Conscious Sedation Position Statement 2.2. Park Ridge, IL: American Association of Nurse Anesthetists; 1996. American Association of Nurse Anesthetists. Qualified Providers of Conscious Sedation Position Statement 2.2. Park Ridge, IL: American Association of Nurse Anesthetists; 1996. Bailey, M. (2002). Constuctivist Foundations of Teaching For Learning. Retrieved July 10, 2015, from http://education.ed.pacificu.edu/aacu/workshop/constructivism.html Caperelli-White, L., & Urman, R. D. (2014). Developing a Moderate Sedation Policy: Essential Elements and Evidence-Based Considerations. AORN Journal, 99(3), 416-430. doi:10.1016/j.aorn.2013.09.015 Conway, A., Rolley, J., Page, K., & Fulbrook, P. (2014). Clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory: a modified Delphi study. Journal Of Advanced Nursing, 70(5), 1040-1053. doi:10.1111/jan.12337 Conway, A., Rolley, J., Page, K., & Fulbrook, P. (2014). Issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: a qualitative study. Journal Of Clinical Nursing, 23(3/4), 374-384. doi:10.1111/jocn.12147 Ketcham, E., Ketcham, C., & Bushnell, F. L. (2013). Patient safety and nurses' role in procedural sedation. Emergency Nurse,21(6), 20-24. doi:10.7748/en2013.10.21.6.20.e1218 Murphy, J. M. (2013). Credentialing Process for Nurse Providers of Moderate Sedation. Journal Of Radiology Nursing, 32(1), 10-18. doi:10.1016/j.jradnu.2012.06.002 Ogg, M. (2008). Clinical issues. Recommended practices for moderate sedation/analgesia. AORN Journal, 88(2), 275-277. Registered Nurses Engaged in the Administration of Sedation and Analgesia. (2005, November 1). Retrieved May 7, 2015, from http://www.aana.com/resources2/professionalpractice/Documents/PPM Consid 4.2 RNs Engaged in Sedation Analgesia.pdf Spruce, L. (2015). Back to Basics: Procedural Sedation. AORN Journal, 101(3), 345-353. doi:10.1016/j.aorn.2014.09.011 Wunder L, Glymph D, Newman J, Gonzalez V, Gonzalez J, Groom J. Objective Structured Clinical Examination as an Educational Initiative for Summative Simulation Competency Evaluation of First-Year Student Registered Nurse Anesthetists Clinical Skills. AANA Journal [serial online]. December 2014;82(6):419-425. Available from: CINAHL with Full Text, Ipswich, MA. Accessed April 5, 2015.