Answer the 3 Questions
EBOOK: Potter, P.A., Perry, A. G., Stockert, P. & Hall, A. (2021). Fundamentals of Nursing (10th ed.). Elsevier.
Student Instructions for Standardized Simulation
NR 224 Maria Hernandez
PURPOSE: The following information is to be used in guiding your preparation and participation in the scenario for this
course. This document will provide applicable course outcomes in preparation for your simulation.
SCENARIO OVERVIEW: Maria Hernandez is an 80-year-old Hispanic female. She is widowed and lives alone in a senior housing
apartment. Her two children live out of state. She spends most days watching television, rarely leaving her
apartment. Mrs. Hernandez was admitted for surgical debridement of a non-healing sacral ulcer, which has been
present for several months.
APA Format
12-170478 ©2017 Chamberlain University LLC. All rights reserved. 1017ccnlcpe
COLLEGE of NURSING
National Management Office | 3005 Highland Parkway, Downers Grove, IL 60515 | 888.556.8226 | chamberlain.edu
Please visit chamberlain.edu/locations for location specific address, phone and fax information.
SIMCARE CENTER™ EXPECTATIONS FOR
SIMULATION-BASED LEARNING
Important information about the educational debt, earnings, and completion rates of students who attended Chamberlain College of Nursing can be found at chamberlain.edu/ge.
Fiction Expectations
The Chamberlain University SIMCARE CENTER provides educational opportunities using simulation to improve and provide safety for actual clients. Simulation is
used to mimic real situations for educational benefit. Simulation may require models, manikins/simulators, and/or role-play by students, volunteers, standardized
clients, staff or faculty.
Facilitator Responsibilities:
• Participate in all required trainings and demonstrate competency and knowledge in simulation pedagogy.
• Ensure facilitation of simulation and comply with required activities and guidelines set forth by the national Center for Simulation Excellence in accordance with
pre-briefing standards.
• Partner with SIMCARE CENTER colleagues in accordance with facilitation standards to agree on when and how to appropriately add realism to each
simulation and deliver cues (predetermined and/or unplanned).
• Foster reflective practice in accordance with Chamberlain University debriefing standards, provoking interesting and engaging discussions immediately after and
beyond the simulation experience to help support participants in achieving expected outcomes.
Participant Responsibilities:
• Suspend judgment of realism for any given simulation in exchange for the promise of learning new knowledge and skills, treating the simulated patients with
the same care due an actual patient, act with a genuine desire to learn even when it may be difficult to do so.
• Consciously make a personal choice to act with professional integrity, being:
– Respectful of simulation equipment, standardized clients, staff, faculty and peers.
– Organized and prepared for the simulation-based experience.
– Accountable for one’s role and responsibilities.
– Collaborative, supportive, non-intimidating and mutually respectful.
– Able to share expertise and/or experiences in a safe, nonjudgmental manner.
– Calm, compassionate and creating a sense of trust.
– Cognizant of issues related to the care of diverse populations and the diversity among all involved in the simulation-based experience.
– Honest, mindful and sensitive to cultural differences and ethical issues related to the simulation-based experience.
• Recognize unprofessional and unethical behavior during simulation and takes steps to abate it.
– Student Handbook – Clinical Expectations
• Follow standards of practice, guidelines, principles and ethics of one’s profession.
– American Nurses Association (ANA) Professional Standards
• Create and maintain a safe learning environment.
Confidentiality
To preserve the educational value, integrity and safety of the learning environment, participants and facilitators agree to maintain strict confidentiality about the
proceedings of the simulation session, details of the training scenarios and the performance of all participants. Participants and facilitators acknowledge that
this expectation aligns with the guidelines related to the Health Insurance Portability and Accountability Act (HIPAA) as well as laws governing Protected Health
Information (PHI) in client care environments.
Participants and facilitators will not view, discuss, share, record or disclose any confidential information pertaining to the session. Participants and facilitators
understand that lapses in confidentiality are considered academic misconduct, and could result in access to the SIMCARE CENTER being revoked and/or dismissal
from the academic program.
Photography and Video Recording
Video recording is often necessary to confirm the learning objectives of simulation have been met. Participants and facilitators authorize the use of photography and
video recording for educational purposes, including but not limited to debriefing, training of staff and faculty, educational presentations, and quality assurance.
NR 224 Maria Hernandez Student Instructions Revised 6.7.17 1
Student Instructions for Standardized Simulation
NR 224 Maria Hernandez
PURPOSE:
The following information is to be used in guiding your preparation and participation in the scenario for this
course. This document will provide applicable course outcomes in preparation for your simulation.
SCENARIO OVERVIEW:
Maria Hernandez is an 80-year-old Hispanic female. She is widowed and lives alone in a senior housing
apartment. Her two children live out of state. She spends most days watching television, rarely leaving her
apartment. Mrs. Hernandez was admitted for surgical debridement of a non-healing sacral ulcer, which has been
present for several months.
STUDENT ROLES DURING SIMULATION:
During pre-briefing, you will be assigned one of these roles according to the description below to participate in
the simulation as a nurse.
Charge Nurse (1):
The charge nurse is responsible for the overall organization of safe, quality patient care. You are the team leader
and serve as a resource to all interdisciplinary members and are responsible for appropriate delegation of
duties. You will serve as the point person for communication and can anticipate speaking with the physician or
other primary care provider, ancillary support services, and others directly involved with the care being
provided. You must be knowledgeable about the patient’s condition and able to dictate orders obtained and
assist with implementation if needed. Additionally, be prepared to prioritize care and anticipate future needs.
Documentation Nurse (1):
The documentation nurse is responsible for recording of all patient event activities during the simulation
with the exception of medication administration. You are responsible for documenting assessments,
interventions, and outcomes on the designated tool (paper or electronic). Be prepared to read back and
verify your documentation when requested and/or clarifying the details. Additionally, you will be part of the
interdisciplinary team and will contribute observational assessment findings to include but not limited to
changes in vital signs, alerts, psychosocial needs, and anticipated care.
Assessment Nurse (1):
NR 224 Maria Hernandez Student Instructions Revised 6.7.17 2
The assessment nurse is responsible for overseeing a comprehensive assessment of the patient. This includes
but is not limited to obtaining vital signs, head-to-toe assessment of all systems, and psych/social assessment of
the patient. You will be prioritizing care, executing independent interventions, collaborating with
interdisciplinary team members, anticipating the needs of the patient/family, and re-assessing or continually
monitoring the patient for any changes in condition. You are responsible for implementing all non-medication
related interventions, verbalizing your findings to the team, and recommending any actions/interventions
required. Additionally, you will be providing appropriate education to the patient and family/significant others.
Observer Nurse:
The observer is a non-participant role and will not communicate directly with the simulation team. The
observer nurse will view the simulation in the briefing room through Learning Space as it is occurring. There
may be multiple observer nurses in each scenario. The observer nurse will be given an observation guide to
complete during the simulation. The data you collect will help the team during the debriefing process and
facilitate an open and active discussion regarding the simulation experience. You will be an active participant in
the debriefing and will be encouraged to share your observations and thoughts. Please keep in mind that your
observations should be conveyed in a respectful, educational manner. The goal is to work together as
colleagues in providing safe and effective care.
COURSE OUTCOMES:
The NR224 standardized simulation enables the student to meet the following priority course outcomes:
CO 1. Differentiate between the components and apply the principles of the nursing process in the
learning laboratory setting using simulated patient care scenarios (PO 1)
CO 3. Demonstrate communication skills necessary for interaction with other health team members and
for providing basic nursing care in a simulated environment (PO 3)
CO 8. Explain the rationale for selected nursing interventions based upon current nursing literature (PO
8)
**Although this scenario can address multiple course outcomes, faculty and students should focus on
the course outcomes listed above**
DUE DATE:
The standardized simulation will be conducted during Units/Weeks 6-8 to ensure students are prepared to meet
the objectives. Simulation will be performed during the lab component of this course. Medication
administration will not be completed during this scenario.
NR 224 Maria Hernandez Student Instructions Revised 6.7.17 3
SIMULATION TIMING:
Pre-brief: 10-12 minutes
Run Time: 20-25 minutes
Debrief: 40-50 minutes
REVIEW AND COMPLETE PRIOR TO THE START OF PRE-BRIEFING:
In order to prepare for the simulation, you should complete your assigned reading for the course. In addition,
you should be prepared to complete and document a thorough nursing assessment along with completing the
following skills:
Vital signs
Infection control
Pressure ulcer & wound healing
Client rights
Please keep in mind you will also be required to recognize a variety of signs and symptoms linked to
abnormalities in these skills.
Therefore, in order to prepare for the simulation, you are required to complete the pre-briefing questions below
and submit to the faculty facilitating the simulation prior to the start of pre-briefing. If you do not complete the
pre-briefing questions below and submit to faculty facilitating the simulation prior to the start of pre-briefing,
you will not be permitted to participate in the simulation.
1. What are some non-pharmacological measures that can be used for pain relief in care for this patient?
2. What vital signs could be indicative of complications for this patient?
3. Based on what you’ve learned about the nursing process, describe one applicable nursing diagnosis,
treatments, and nursing considerations for this diagnosis.
**Immediately following the completion of debriefing, you will complete the evaluation of the simulation within
Learning Space**
Running head: STANDARDIZED SIMULATION 1
Student Instructions for Maria Hernandez
Priscilla Mensah
Chamberlain College of Nursing
NR 224: Fundamentals
June 8, 2017
Professor Smith
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STANDARDIZED SIMULATION 2
Review
1. What are some non-pharmacological measures that can be used for pain relief in care
for this patient?
Relaxation techniques- it helps to relieve stress, relax, and decrease pain.
Self-hypnosis is a way to direct your attention to something other than your
pain. For example, you might repeat a positive statement about ignoring the
pain or seeing the pain in a positive way.
Heat helps decrease pain and muscle spasms. Apply heat to the area for 20 to
30 minutes every 2 hours for as many days as directed.
Physical therapy teaches you exercises to help improve movement and
strength, and to decrease pain.
2. What vital signs could be indicative of complications for this patient?
Pain scale
Oxygen level
Pulse rate
Blood pressure
Temperature
3. Based on what you’ve learned about the nursing process, describe one applicable
nursing diagnosis, treatments, and nursing considerations for this diagnosis.
Ineffective coping- whereby inability to form a valid appraisal of the stressors,
inadequate choices of practiced responses, and/or inability to use available
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STANDARDIZED SIMULATION 3
resources. Because of decreased use of social support, fatigue, verbalization of
inability to cope or ask for help.
Treatment- Spend time with the individual. Provide supportive
companionship.
• Avoid being overly cheerful and cliché such as, “Things will get better.”
• Convey honesty and empathy.
• Offer support. Encourage expression of feelings. Let the individual know
you understand his or her feelings. Do not argue with expressions of
worthlessness by saying things such as, “How can you say that? Look at all
you accomplished in life.”
• Offer matter-of-fact appraisals. Be realistic.
• Allow extra time for the individual to respond
Nursing consideration-
Ask the individual to describe previous encounters with conflict and how he
or she resolved them.
• Evaluate whether his or her stress response is “fight or flight” or “tend and
befriend.”
• Encourage the individual to evaluate his or her behavior. “Did that work for
you?” “How did it help?” “What did you learn from that experience?”
• Discuss possible alternatives (i.e., talk over the problem with those
involved, try to change the situation, or do nothing and accept the
consequences).
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STANDARDIZED SIMULATION 4
• Assist the individual in identifying problems that he or she cannot control
directly; help the individual to practice stress-reducing activities for control
(e.g., exercise, yoga).
• Be supportive of functional coping behaviors. (e.g., “The way you handled
this situation 2 years ago worked well then. Can you do it now?”)
• Mobilize the individual to gradually increase activity:
• Identify activities that were previously gratifying but have been neglected:
personal grooming or dress habits, shopping, hobbies, athletic endeavors, and
arts and crafts.
• Encourage to include these activities in the daily routine for a set time span
(e.g., “I will play the piano for 30 minutes every afternoon”).
• Explore outlets that foster feelings of personal achievement and selfesteem:
• Make time for relaxing activities (e.g., dancing, exercising, sewing,
woodworking).
• Find a helper to take over responsibilities occasionally (e.g., sitter).
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