Abstract
As an educational methodology, simulation has been used by nursing education at the academic level for numerous years and has started to gain traction in the onboarding education and professional development of practicing nurses. Simulation allows the learner to apply knowledge and skills in a safe environment where mistakes and learning can happen without an impact on patient safety. The development of a simulation scenario to demonstrate the benefits of simulation education methodologies to a large group of nurse educators was requested by nursing education leadership at The Ottawa Hospital (TOH). Since the demonstration of this scenario in the fall of 2016, there has been significant uptake and adaptation of this particular scenario within the nursing education departments of TOH. Originally written to be used with a simulated patient (SP), “Alice” has since been adapted to be used with a hi-fidelity manikin within an inpatient surgery department continuing professional development (CPD) program for practicing nurses, orientation for nurses to a level 2 trauma unit and at the corporate level of nursing orientation using an SP. Therefore, this scenario is applicable to nurses practicing in an area of inpatient surgery at varying levels, from novice to expert. It could easily be adapted for use with medicine nursing education programs. The case presented in this technical report is of the simulation scenario used for the inpatient surgery CPD program. Varying adaptations of the case are included in the appendices.
Highlights
Delirium can occur in 18%-50% of patients in acute care institutions, which can result in increased morbidity and mortality, especially in the elderly [1]
Delirium is defined as an acute change in mental status from a patient’s baseline cognition, it is often attributed to underlying disease processes or other common contributing factors, such as narcotics used to treat postoperative pain [2]
The nursing continuing professional development (CPD) program decided to employ theatre-based simulation as an educational strategy to reinforce the importance of delirium assessment and appropriate interventions
Summary
Delirium can occur in 18%-50% of patients in acute care institutions, which can result in increased morbidity and mortality, especially in the elderly [1]. The nurse should use the SBAR structure to report to the physician and suggest the use of a delirium physician order set Alice, in her confused state, attempts to climb out of bed; the nurse(s) should complete a fall risk assessment followed by the implementation of universal fall risk precautions. Primary nurse: You are working on the orthopedic surgery floor looking after Alice Smith, who is an 83-year-old widow, recently moved into her daughter’s home after being diagnosed with mild dementia and short-term memory loss Within the inpatient surgery nursing education program at TOH, the PEARLS framework [4] is used for all debriefing sessions
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