Use of Quick Response Codes for Postpartum Hemorrhage Simulation in Nursing Education

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Limited clinical experiences have led to an increase in the use of simulation to teach and evaluate clinical judgement. Provision of hands-on simulated experience of postpartum hemorrhage (PPH) management can prepare health care providers to manage one of the obstetric emergent situations that occur in 2.9% of all U.S. births each year. The use of high-fidelity mannequins provides realistic patients to practice clinical skills and knowledge application, but cost and availability of these mannequins can be barriers. The purpose of this activity was to demonstrate how the use of low-fidelity mannequins and Quick Response (QR) code technology during PPH simulation can enhance learning. Implementation of a low-fidelity PPH simulation using QR codes to provide undergraduate prelicensure students the opportunity for a specialized patient care experience. This approach was intended to compensate for the limitation of having only one high-fidelity obstetric mannequin available. Due to equipment limitations and large student groups, no PPH simulation had been attempted. QR codes representing fundal assessment, bladder distention videos, patient information, symptoms audio, and urinary output were placed onto a low-fidelity mannequin. Gelatin was used as simulated blood for students to estimate blood loss. Students were placed on teams and were given a case scenario for a postpartum patient. Standard orders were provided, and supplemental orders were given when students notified the provider of abnormal assessment findings. Critical thinking and knowledge application were assessed on the basis of the clinical judgment used to assess, diagnose, implement, and evaluate the patient’s condition. After the activity, student debriefing included evaluation of the simulation and learning. Student evaluations regarding the simulation reported that the use of QR codes enhanced the experience by using an engaging technology while developing their understanding of PPH management. The use of QR codes can be adopted by any health education or hospital program that has barriers to use of high-fidelity simulation for clinical management of obstetric emergent events. The cost and time benefits will allow programs and hospitals more opportunities to provide clinical simulation that will affect mortality and morbidity in maternal-fetal health care.