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Nursing Skills Sim Kit:
Focus on Pediatrics
Scenario Guide
Nursing Skills Sim Kit: Focus on Pediatrics
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Every effort has been made to trace the ownership of copyrighted material and to make full acknowledgement of its use. If errors or omissions have occurred, they will be corrected in subsequent editions, provided that notification is submitted in writing to the publisher.
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Table of Contents
Scenario Guide Components 4
Scenario Structure 5
Scenario One – Neonatal Abstinence Syndrome 6
Pre-Brief 8
Scenario 12
Debrief 14
Sources 16
Scenario Two – Skin Conditions 17
Pre-Brief 19
Scenario 23
Debrief 25
Sources 27
Scenario Three – Premature Infant Care 28
Pre-Brief 30
Scenario 34
Debrief 36
Sources 38
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This Skills Sim Kit will focus on three different scenarios in a pediatric care setting: neonatal abstinence syndrome in an acute care setting, infant skin conditions in a home setting, and care of a premature infant in an acute care setting.
Scenario Guide Components The scenario guide is composed of the following components. Approximate times are included.
Scenario Title Approximate Time
One Neonatal Abstinence Syndrome Pre-Brief 20 minutes Scenario 20 minutes Debrief 20 minutes
Two Skin Conditions Pre-Brief 20 minutes Scenario 20 minutes Debrief 20 minutes
Three Premature Infant Care Pre-Brief 20 minutes Scenario 20 minutes Debrief 20 minutes Total 3 hours
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Scenario Structure Each Scenario contains an Overview, Pre-brief, Scenario, and Debrief.
Scenario Sections
Each scenario follows the sections described below:
OVERVIEW Each scenario begins with an OVERVIEW of scenario objectives, materials needed, preparation instructions, and a brief patient description.
PRE-BRIEF The PRE-BRIEF activity is intended to capture participants’ attention and prepare them for the scenario. During this activity, participants are introduced to the topic of the scenario.
SCENARIO The SCENARIO activity in each scenario varies in its script and topic. Participants will be playing the role of nurse and patient using simulation products.
DEBRIEF Every scenario ends with a DEBRIEF activity intended to briefly review the scenario’s main points and the feelings of the participants.
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Scenario One – Neonatal Abstinence Syndrome
Scenario Objectives After completing this scenario, participants will be able to: • Verbalize empathy for a new parent with a baby who has Neonatal Abstinence Syndrome • Demonstrate caring for a baby with Neonatal Abstinence Syndrome • Implement patient education
Scenario Materials
Activity Materials Preparation Approximate
class time
PRE-BRIEF • Neonatal Abstinence Syndrome Pre-Brief Student Worksheet
• Neonatal Abstinence Syndrome Pre-Brief Student Worksheet – Answer Key
• Neonatal Abstinence Syndrome Scenario Guidelines and Expectations
1. Print/photocopy Neonatal Abstinence Syndrome Pre-Brief Student Worksheet and Neonatal Abstinence Syndrome Scenario Guidelines and Expectations (one per participant)
20 minutes
SCENARIO • Provider’s Orders Skills Sim Kit Component: • Drug Affected Baby • Diaper • Bottle Environmental Props: • Bed or chair • Diaper cream • Diaper wipes • Towel • Blanket for swaddling • Infant clothes • Table with pads or blankets to be used as a
changing table • Armbands for baby and parent • Sink with soap or hand sanitizer
1. Print/photocopy the Provider’s Orders (one per participant)
2. Prepare area as stated in the Scenario Setup
20 minutes
DEBRIEF • Neonatal Abstinence Syndrome Debrief Instructor Resource
1. Optional: Display questions to students on a projector or print/photocopy Neonatal Abstinence Syndrome Debrief Instructor Resource
20 minutes
Scenario Overview The purpose of this simulation is to gain empathy for the new parent, learn about caring for a baby with Neonatal Abstinence Syndrome, and practice patient education.
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Scenario Roles This scenario is designed to simulate the roles of both nurse and patient. If time allows, the scenario may be repeated and the roles may be reversed for optimal learning of empathy and skill. Assign two students to the following roles:
• Patient
• Nurse
Scenario Setup The setting is an acute care environment. Position female patients in a bed sitting up. Position male patients in a chair in the room. The patient should have an armband that matches the baby. The nurse will bring the baby into the room. Have diaper, cream, wipes, bottle, towel, clothes, and blanket available in the room on a table.
Patient Description Name: Mr./Mrs. Jesse Wells (title based on preferred gender of student in patient role)
Age: 29
History of Present Illness: Mr./Mrs. Jesse Wells is the new parent of an infant with neonatal abstinence syndrome. This is their first child.
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Scenario One – Neonatal Abstinence Syndrome
Pre-Brief 20 minutes
Purpose:
To gain empathy for the new parent, learn about caring for a baby with Neonatal Abstinence Syndrome, and practice patient education.
Materials:
• Neonatal Abstinence Syndrome Pre-Brief Student Worksheet
• Neonatal Abstinence Syndrome Pre-Brief Student Worksheet – Answer Key
• Neonatal Abstinence Syndrome Scenario Guidelines and Expectations
Facilitation Steps:
1. Distribute the Neonatal Abstinence Syndrome Pre-Brief Student Worksheet to participants prior to the scenario. You can also have them complete the pre-brief independently prior to the day of scenario.
2. Review answers to the Neonatal Abstinence Syndrome Pre-Brief Student Worksheet.
3. Review the Neonatal Abstinence Syndrome Scenario Guidelines and Expectations for the scenario.
4. Orient participants to the scenario area and products.
5. Assign the roles designated in the scenario.
6. Set the patient up lying in a bed or sitting in a chair. Apply an armband.
7. Give the scenario report to both students before beginning scenario.
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Name: _____________________________________ Class: ___________________________
Neonatal Abstinence Syndrome Pre-Brief Student Worksheet
Complete the scenario preparation questions.
1. What causes Neonatal Abstinence Syndrome?
a. Increase of addictive substances in the bloodstream
b. Sudden discontinuation of fetal exposure to addictive substances
c. Decrease in the quantity of addictive substances after birth
d. Treatment of maternal addiction to illicit drugs
2. What are signs/symptoms of Neonatal Abstinence Syndrome?
a. Seizures and lethargy
b. Vomiting and constipation
c. Excessive appetite and thirst
d. Tremors and high pitch cries
3. Which of the following is a reason for swaddling a baby?
a. Provides comfort
b. Prevents Sudden Infant Death Syndrome
c. Increases body temperature
d. Prevents skin breakdown
4. Which of the following statements by a new parent indicates the need for more patient education?
a. “I should always support the head when carrying my baby upright or when laying my baby down.”
b. “I should wash my hands before caring for my baby.”
c. “I should change my baby’s diaper after each bowel movement or if the diaper is wet.”
d. “I should only burp my baby when feeding time is over.”
*It is important to review infant care basics prior to the simulation such as handling a newborn, changing the baby's diaper, dressing the baby, swaddling the baby, feeding and burping the baby, and soothing the baby.
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Neonatal Abstinence Syndrome Pre-Brief Student Worksheet – Answer Key
1. What causes Neonatal Abstinence Syndrome?
a. Increase of addictive substances in the bloodstream
b. Sudden discontinuation of fetal exposure to addictive substances
c. Decrease in the quantity of addictive substances after birth
d. Treatment of maternal addiction to illicit drugs
2. What are signs/symptoms of Neonatal Abstinence Syndrome?
a. Seizures and lethargy
b. Vomiting and constipation
c. Excessive appetite and thirst
d. Tremors and high pitch cries
3. Which of the following is a reason for swaddling a baby?
a. Provides comfort
b. Prevents Sudden Infant Death Syndrome
c. Increases body temperature
d. Prevents skin breakdown
4. Which of the following statements by a new parent indicates the need for more patient education?
a. “I should always support the head when carrying my baby upright or when laying my baby down.”
b. “I should wash my hands before caring for my baby.”
c. “I should change my baby’s diaper after each bowel movement or if the diaper is wet.”
d. “I should only burp my baby when feeding time is over.”
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Neonatal Abstinence Syndrome Guidelines and Expectations
(Based on the INACSL Standards of Best Practice: Professional Integrity)
When you come to the simulation, please be:
• Organized and prepared
• Accountable for one’s role and responsibilities
• Collaborative, supportive, nonintimidating, and respectful
• Able to share expertise and/or experiences in a safe, nonjudgmental manner
• Calm, compassionate, and creating a sense of trust
• Honest, mindful, and sensitive to cultural differences and ethical issues related to the simulation-based experience
• Aware of a safe learning environment
It is important that you follow the standards of practice, principles, and ethics of your profession.
Roles
You will be assigned the role of either the patient or the nurse. As the patient, you are to gain empathy for the new parent and learn about caring for a baby with neonatal abstinence syndrome. As the Nurse, you are to practice infant care skills and patient education. This includes correct prompting and education.
Confidentiality Agreement
This simulation requires confidentiality of the performances and scenario content. By signing below, I agree to be a participant in this simulation. I understand that the content of this simulation is to be kept confidential to maintain the integrity of the learning experience. I also understand that it is unethical for me to share information in any way regarding student performance with persons outside this simulation.
Name (printed) ______________________________ Signature ______________________________
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Scenario One – Neonatal Abstinence Syndrome
Scenario 20 minutes
After assigning roles, read the following report to students.
Report: Mr./Mrs. Jesse Wells (title based on preferred gender of student in patient role) is a 29-year-old new parent of an infant with Neonatal Abstinence Syndrome. This is their first child. They need to be educated about Neonatal Abstinence Syndrome and basic infant cares. Mr./Mrs. Wells has many questions.
Allow students time to gather their thoughts before starting. Remind students not to prompt one another and to stay within their roles. The “patient” is to follow the “nurse’s” directions and may discuss what he/she is feeling. The “nurse” is to assist the “patient” with infant care.
Note: The scenario should be paused if any real-life safety issue occurs. Once the issue is addressed, the scenario can continue. Roles can be reversed so that both students can experience the simulator.
Scenario Events and Expected Actions: State Event Expected Actions of Patient Expected Actions of Nurse
One Introduction • Acknowledges nurse • States identifiers
• Verifies orders • Knocks, washes hands • Identifies self • Explains purpose for presence • Identifies patient • Verifies armbands with baby
Two Neonatal Abstinence Syndrome and Patient Education
• Follows nurse’s prompts in providing infant care
• May express feelings or ask questions
• Correctly provides return demonstration o Handling a newborn, including
supporting the baby's neck o Changing the baby's diaper o Dressing the baby o Swaddling the baby o Feeding and burping the baby o Soothing the baby
• Discusses Neonatal Abstinence Syndrome with parent
• Correctly demonstrates • Handling a newborn, including supporting the
baby's neck • Changing the baby's diaper • Dressing the baby • Swaddling the baby • Feeding and burping the baby • Soothing the baby
Three Closing
*Baby may be left with Patient or leave with Nurse
• May thank nurse • Asks if anything else is needed before leaving • Leaves patient and baby safe (call light, etc.) • Washes hands before leaving
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Provider’s Orders Date Time Orders
Today 0700 Patient Education: Handling a newborn, Changing
baby's diaper, dressing baby, swaddling baby, feeding
and burping baby, soothing baby with Neonatal
Abstinence Syndrome -----------------Dr. Mary Thompson
NAME: Jesse Wells
MRN: 8965325
Age: 29 years
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Scenario One – Neonatal Abstinence Syndrome
Debrief 20 minutes
Purpose:
To reflect on and discuss the scenario experience.
Materials:
• Neonatal Abstinence Syndrome Debrief Instructor Resource
Facilitation Steps:
1. Review debriefing rules • Confidentiality
• Scenarios are to be kept confidential to maintain the integrity of the learning experience
• It is unethical to share information in any way regarding student performance with persons outside the scenario
• Safe space • This is a safe, non-discriminatory
learning environment for constructive feedback
2. Work through the debriefing questions on the Neonatal Abstinence Syndrome Debrief Instructor Resource as a group.
3. Praise the students for their efforts.
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Neonatal Abstinence Syndrome Debrief Instructor Resource
Group Questions 1. Describe the objectives that you were able to achieve.
2. Which objectives were you unable to achieve (if any)?
3. Which objectives did you do well?
4. If you were able to do this again, how would you handle the situation differently?
Patient Questions 1. How did you feel throughout the simulation experience?
2. What part of the simulation was the most challenging?
Nurse Questions 1. How did you feel throughout the simulation experience?
2. What part of the simulation was the most challenging?
Ending Questions 1. What are your main take-away points of this simulation?
2. Is there anything else you would like to discuss?
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Scenario One – Neonatal Abstinence Syndrome
Sources
American Academy of Pediatrics. (2020). Ages and stages: baby. https://www.healthychildren.org/English/ages-stages/baby/Pages/default.aspx
International Nursing Association for Clinical Simulation and Learning (2016). INACSL Standards of Best Practice: Simulation. Retrieved from https://www.inacsl.org/inacsl-standards-of-best-practice-simulation/
Kocherlakota, P. (2014). Neonatal Abstinence Syndrome. Pediatrics, 134(2) e547-e561. https://doi.org/10.1542/peds.2013-3524.
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Scenario Two – Skin Conditions
Scenario Objectives After completing this scenario, participants will be able to: • Verbalize empathy for a new parent with a baby who has skin conditions • Demonstrate caring for a baby with skin conditions • Implement patient education
Scenario Materials
Activity Materials Preparation Approximate class time
PRE-BRIEF • Skin Conditions Pre-Brief Student Worksheet • Skin Conditions Pre-Brief Student Worksheet
– Answer Key • Skin Conditions Scenario Guidelines and
Expectations
1. Print/photocopy the Skin Conditions Pre-Brief Student Worksheet and Skin Conditions Scenario Guidelines and Expectations (one per participant)
20 minutes
SCENARIO • Provider’s Orders Skills Sim Kit components: • Diaper • Diaper rash wound • Cradle cap wound • Wound bond Environmental Props: • Chair • Access to sink, fragrance free soap, and
warm water • Diaper cream • Infant simulator • Infant clothes • Table with pads or blankets to be used as a
changing table
1. Print/photocopy the Provider’s Orders (one per participant)
2. Prepare area as stated in the Scenario Setup
20 minutes
DEBRIEF • Skin Conditions Debrief Instructor Resource 1. Optional: Display questions to students on a projector or print/photocopy the Skin Conditions Debrief Instructor Resource
20 minutes
Scenario Description The purpose of this simulation is to gain empathy for the new parent, learn about caring for a baby with skin conditions, and practice patient education.
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Scenario Roles This scenario is designed to simulate the roles of both nurse and patient. If time allows, the scenario may be repeated and the roles may be reversed for optimal learning of empathy and skill. Assign two students to the following roles:
• Patient
• Nurse
Scenario Setup The setting is in a home environment. A sink and/or hand sanitizer should be available. The patient will be sitting in a chair in the room with the infant. Wounds should be applied to the infant simulator. Infant can be diapered and clothed. Changing table should be in room.
Patient Description Name: Mr./Mrs. Reagan McGrath (title based on preferred gender of student in patient role)
Age: 29
History of Present Illness: Mr./Mrs. Reagan McGrath is a new parent of an infant with skin conditions. This is their first child.
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Scenario Two – Skin Conditions
Pre-Brief 20 minutes
Purpose:
To gain empathy for the new parent, learn about caring for a baby with skin conditions, and practice patient education.
Materials:
• Skin Conditions Pre-Brief Student Worksheet • Skin Conditions Pre-Brief Student Worksheet –
Answer Key • Skin Conditions Scenario Guidelines and
Expectations
Facilitation Steps:
1. Distribute the Skin Conditions Pre-Brief Student Worksheet to participants prior to the scenario. You can also have them complete the pre-brief independently prior to the day of scenario.
2. Review answers to the Skin Conditions Pre-Brief Student Worksheet.
3. Review the Skin Conditions Scenario Guidelines and Expectations for the scenario.
4. Orient the participants to the scenario area and products.
5. Assign the roles designated in the scenario.
6. Set the patient up patient with the infant simulator that has skin conditions on it.
7. Give the scenario report to both students before beginning the scenario.
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Name: ___________________________ Class: ___________________________
Skin Conditions Pre-Brief Student Worksheet
Complete the scenario preparation questions.
1. What causes diaper rash?
a. Stool or urine irritation
b. Chafing
c. Infection
d. All of the above
2. How do you treat diaper rash?
a. Change dirty diapers promptly
b. Use antibiotic cream
c. Wash baby’s bottom with cold water
d. Use only cloth diapers
3. What are signs of cradle cap on the scalp?
a. Scaly patches
b. Red rash
c. Flea bites
d. Pimples
4. How do you treat cradle cap?
a. Use dandruff control shampoo
b. Wash scalp only once a week
c. Wash scalp daily with mild shampoo
d. Keep scalp covered
5. Which of the following statements by a new parent indicates the need for more patient education?
a. “I should use products that are fragrant and contain alcohol.”
b. “I should wash my hands before caring for my baby.”
c. “I should change my baby’s diaper after each bowel movement or if the diaper is wet.”
d. “I can use a soft bristled brush on my baby’s scalp.”
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Skin Conditions Pre-Brief Student Worksheet – Answer Key
1. What causes diaper rash?
a. Stool or urine irritation
b. Chafing
c. Infection
d. All of the above
2. How do you treat diaper rash?
a. Use only cloth diapers
b. Change dirty diapers promptly
c. Use antibiotic cream
d. Wash baby’s bottom with cold water
3. What are signs of cradle cap on the scalp?
a. Scaly patches
b. Red rash
c. Flea bites
d. Pimples
4. How do you treat cradle cap?
a. Use dandruff control shampoo
b. Wash scalp only once a week
c. Wash scalp daily with mild shampoo
d. Keep scalp covered
5. Which of the following statements by a new parent indicates the need for more patient education?
a. “I should use products that are fragrant and contain alcohol.”
b. “I should wash my hands before caring for my baby.”
c. “I should change my baby’s diaper after each bowel movement or if the diaper is wet.”
d. “I can use a soft bristled brush on my baby’s scalp.”
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Skin Conditions Scenario Guidelines and Expectations
(Based on the INACSL Standards of Best Practice: Professional Integrity)
When you come to the simulation, please be:
• Organized and prepared
• Accountable for one’s role and responsibilities
• Collaborative, supportive, nonintimidating, and respectful
• Able to share expertise and/or experiences in a safe, nonjudgmental manner
• Calm, compassionate, and creating a sense of trust
• Honest, mindful, and sensitive to cultural differences and ethical issues related to the simulation-based experience
• Aware of a safe learning environment
It is important that you follow the standards of practice, principles, and ethics of your profession.
Roles
You will be assigned either the patient or nurse role. As the patient, you are to gain empathy for the new parent, learn about caring for a baby with skin conditions, complete a diaper change, and dress the baby. As the nurse, you are to assess the baby and verbally prompt parent through a diaper change and dressing the baby.
Confidentiality Agreement
This simulation requires confidentiality of the performances and scenario content. By signing below, I agree to be a participant in this simulation. I understand that the content of this simulation is to be kept confidential to maintain the integrity of the learning experience. I also understand that it is unethical for me to share information in any way regarding student performance with persons outside this simulation.
Name (printed) ______________________________ Signature ______________________________
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Scenario Two – Skin Conditions
Scenario 20 Minutes
After assigning roles, read the following report to students.
Report: Mr./Mrs. Reagan McGrath (title based on preferred gender of student in patient role) is a new parent of an infant with skin conditions. This is their first child. They are scheduled to have the first home care follow-up by a nurse and need to be educated about common skin conditions. Mr./Mrs. McGrath has many questions about diaper changes and dressing the baby.
Allow students time to gather their thoughts before starting. Remind students not to prompt one another and to stay within their roles. The “patient” is to follow the “nurse’s” directions and may discuss what he/she is feeling. The “nurse” is to assist the “patient” with infant care.
Note: The scenario should be paused if any real-life safety issue occurs. Once the issue is addressed, the scenario can continue. Roles can be reversed so that both students can experience the simulator.
Scenario Events and Expected Actions: State Event Expected Actions of Patient Expected Actions of Nurse
One Introduction • Acknowledges nurse • States identifiers
• Verifies orders • Knocks, washes hands • Identifies self • Explains purpose for presence • Identifies patient
Two Skin Conditions and Patient Education
• Follows nurse’s prompts in providing infant care
• May express feelings or ask questions
• Correctly demonstrates o Changing the baby's
diaper o Dressing the baby
• Assesses baby and identifies skin conditions • Discusses skin conditions with parent and proper
treatment • Correctly verbally prompts the patient to complete:
o Changing the baby's diaper o Dressing the baby
Three Closing • May thank nurse • Asks if anything else is needed before leaving • Leaves patient and baby safe • Washes hands before leaving
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Provider’s Orders Date Time Orders
Today 0700 Assess McGrath baby for skin conditions. Provide patient
education on diapering and dressing baby--------------
------------------------------------------Dr. Mary Thompson
NAME: Reagan McGrath
MRN: 8965325
Age: 29 years
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Scenario Two – Skin Conditions
Debrief 20 minutes
Purpose:
To reflect on and discuss the scenario experience.
Materials:
• Skin Conditions Debrief Instructor Resource
Facilitation Steps:
1. Review debriefing rules • Confidentiality
• Scenarios are to be kept confidential to maintain the integrity of the learning experience
• It is unethical to share information in any way regarding student performance with persons outside the scenario
• Safe space • This is a safe, non-discriminating
learning environment for constructive feedback
2. Work through the debriefing questions on the Skin Conditions Debrief Instructor Resource as a group.
3. Praise the students for their efforts.
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Skin Conditions Debrief Instructor Resource
Group Questions 1. Describe the objectives that you were able to achieve.
2. Which objectives were you unable to achieve (if any)?
3. Which objectives did you do well?
4. If you were able to do this again, how would you handle the situation differently?
Patient Questions 1. How did you feel throughout the simulation experience?
2. What part of the simulation was the most challenging?
Nurse Questions 1. How did you feel throughout the simulation experience?
2. What part of the simulation was the most challenging?
Ending Questions 1. What are your main take-away points of this simulation?
2. Is there anything else you would like to discuss?
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Scenario Two – Skin Conditions
Sources
International Nursing Association for Clinical Simulation and Learning (2016). INACSL Standards of Best Practice: Simulation. Retrieved from https://www.inacsl.org/inacsl-standards-of-best-practice-simulation/
Mayo Clinic. (2018). Cradle cap. https://www.mayoclinic.org/diseases-conditions/cradle-cap/symptoms-causes/syc-20350396
Polcari, I. (2020). Common diaper rashes & treatments. American Academy of Pediatrics. https://www.healthychildren.org/English/ages-stages/baby/diapers-clothing/Pages/Di
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Scenario Three – Premature Infant Care
Scenario Objectives After completing this scenario, participants will be able to: • Verbalize empathy for a new parent • Demonstrate caring for a premature infant • Implement patient education
Scenario Materials
Activity Materials Preparation Approximate class time
PRE-BRIEF • Premature Infant Care Pre-Brief Student Worksheet
• Premature Infant Care Pre-Brief Student Worksheet – Answer Key
• Premature Infant Care Scenario Guidelines and Expectations
1. Print/photocopy Premature Infant Care Pre-Brief Student Worksheet and Premature Infant Care Scenario Guidelines and Expectations (one per participant)
20 minutes
SCENARIO • Provider’s Orders Skills Sim Kit Component: • Preemie Baby • Diaper • Bottle • Blanket for swaddling
Environmental Props: • Bed or chair • Diaper cream • Diaper wipes • Towel • Infant clothes • Table with pads or blankets to be used as a
changing table • Armbands for baby and parent • Sink with soap or hand sanitizer
1. Print/photocopy the Provider’s Orders (one per participant)
2. Prepare area as stated in the Scenario Setup
20 minutes
DEBRIEF • Premature Infant Care Debrief Instructor Resource
1. Optional: Display questions to students on a projector or print/photocopy the Premature Infant Care Debrief Instructor Resource
20 minutes
Scenario Description The purpose of this simulation is to gain empathy for the new parent, learn about caring for a premature infant, and practice patient education.
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Scenario Roles This scenario is designed to simulate the roles of both nurse and patient. If time allows, the scenario may be repeated and the roles may be reversed for optimal learning of empathy and skill. Assign two students to the following roles:
• Patient
• Nurse
Scenario Setup The setting is an acute care environment. A sink and/or hand sanitizer should be available. Position a female patient sitting up in a bed. Position a male patient sitting in a chair in the room. The patient should have a matching armband with baby. Have the nurse bring the baby into room. Have a diaper, cream, wipes, bottle, towel, clothes, and blanket available in room on table.
Patient Description Name: Mr./Mrs. Angel Hernandez (title based on preferred gender of student in patient role)
Age: 29
History of Present Illness: Mr./Mrs. Angel Hernandez is a new parent of a premature infant. This is their first child.
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Scenario Three – Premature Infant Care
Pre-Brief 20 minutes
Purpose:
To gain empathy for the new parent, learn about caring for a premature infant, and practice patient education.
Materials:
• Premature Infant Care Pre-Brief Student Worksheet
• Premature Infant Care Pre-Brief Student Worksheet – Answer Key
• Premature Infant Care Scenario Guidelines and Expectations
Facilitation Steps:
1. Distribute the Premature Infant Care Pre-Brief Student Worksheet to the participants prior to the scenario. You can also have them complete the pre-brief independently prior to the day of scenario.
2. Review answers to the Premature Infant Care Pre-Brief Student Worksheet.
3. Review the Premature Infant Care Scenario Guidelines and Expectations for the scenario.
4. Orient the participants to the scenario area and products.
5. Assign the roles designated in the scenario.
6. Set the patient up in a bed or chair. Apply the armband.
7. Give the scenario report to both students before beginning the scenario.
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Name: ___________________________ Class: ___________________________
Premature Infant Care Pre-Brief Student Worksheet
Complete the scenario preparation questions.
1. What is considered a premature birth?
a. A birth before 37 weeks
b. A birth between 38 and 40 weeks
c. A birth at 40 weeks
d. A birth between 41-42 weeks
2. What are signs of prematurity?
a. Smaller size
b. Thinner skin
c. Weaker cry
d. All of the above
3. Which of the following is a complication of premature birth?
a. Inability to open eyes
b. Keeping warm
c. High blood sugar levels
d. Increased urination
4. Which of the following statements by a new parent indicates the need for more patient education?
a. “I should always support the head when carrying my baby upright or when laying my baby down.”
b. “I should wash my hands before caring for my baby.”
c. “I should change my baby’s diaper every hour.”
d. “I should burp my baby after every 2-3 ounces and when feeding time is over.”
*It is important to review infant care basics prior to the simulation, such as handling a newborn, changing the baby's diaper, dressing the baby, swaddling the baby, feeding and burping the baby, and soothing the baby.
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Premature Infant Care Pre-Brief Student Worksheet – Answer Key
1. What is considered a premature birth?
a. A birth before 37 weeks
b. A birth between 38 and 40 weeks
c. A birth at 40 weeks
d. A birth between 41-42 weeks
2. What are signs of prematurity?
a. Smaller size
b. Thinner skin
c. Weaker cry
d. All of the above
3. Which of the following is a complication of premature birth?
a. Inability to open eyes
b. Keeping warm
c. High blood sugar levels
d. Increased urination
4. Which of the following statements by a new parent indicates the need for more patient education?
a. “I should always support the head when carrying my baby upright or when laying my baby down.”
b. “I should wash my hands before caring for my baby.”
c. “I should change my baby’s diaper every hour.”
d. “I should burp my baby after every 2-3 ounces and when feeding time is over.”
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Premature Infant Care Scenario Guidelines and Expectations
(Based on the INACSL Standards of Best Practice: Professional Integrity)
When you come to the simulation, please be:
• Organized and prepared
• Accountable for one’s role and responsibilities
• Collaborative, supportive, nonintimidating, and respectful
• Able to share expertise and/or experiences in a safe, nonjudgmental manner
• Calm, compassionate, and creating a sense of trust
• Honest, mindful, and sensitive to cultural differences and ethical issues related to the simulation-based experience
• Aware of a safe learning environment
It is important that you follow the standards of practice, principles, and ethics of your profession.
Roles
You will be assigned either the patient or nurse role. As the patient, you are to gain empathy for the new parent and learn about caring for a premature infant. As the nurse, you are to practice infant care skills and patient education.
Confidentiality Agreement
This simulation requires confidentiality of the performances and scenario content. By signing below, I agree to be a participant in this simulation. I understand that the content of this simulation is to be kept confidential to maintain the integrity of the learning experience. I also understand that it is unethical for me to share information in any way regarding student performance with persons outside this simulation.
Name (printed) ______________________________ Signature ______________________________
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Scenario Three – Premature Infant Care
Scenario 20 minutes
Prior to beginning the scenario (but after assigning roles), read the following report to students.
Report: Mr./Mrs. Angel Hernandez (title based on preferred gender of student in patient role) is a 29-year-old new parent of a premature infant. This is their first child. They need to be educated about premature infants and basic infant cares. Mr./Mrs. Hernandez has many questions.
Allow students time to gather their thoughts before starting. Remind students not to prompt one another and to stay within their roles. The “patient” is to follow the “nurse’s” directions and may discuss what he/she is feeling. The “nurse” is to assist the “patient” with care for a premature infant.
Note: The scenario should be paused if any real-life safety issue occurs. Once the issue is addressed, the scenario can continue. Roles can be reversed so that both students can experience the simulator.
Scenario Events and Expected Actions: State Event Expected Actions of Patient Expected Actions of Nurse
One Introduction • Acknowledges nurse • States identifiers
• Verifies orders • Knocks, washes hands • Identifies self • Explains purpose for presence • Identifies patient • Verifies armbands with baby
Two Basics and Patient Education
• Follows nurse’s prompts in providing infant care
• May express feelings or ask questions
• Correctly provides return demonstration o Handling a newborn, including
supporting the baby's neck o Changing the baby's diaper o Dressing the baby o Swaddling the baby o Feeding and burping the baby o Soothing the baby
• Discusses premature infants with parent • Correctly demonstrates
o Handling a newborn, including supporting the baby's neck
o Changing the baby's diaper o Dressing the baby o Swaddling the baby o Feeding and burping the baby o Soothing the baby
Three Closing
*Baby may be left with patient or leave with nurse
• May thank nurse • Asks if anything else is needed before leaving • Leaves patient and baby safe (call light, etc.) • Washes hands before leaving
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Provider’s Orders Date Time Orders
Today 0700 Patient Education: Handling a newborn, changing
baby's diaper, dressing baby, swaddling baby, feeding
and burping baby, soothing a premature infant-------
------------------------------------------Dr. Mary Thompson
NAME: Angel Hernandez
MRN: 8965325
Age: 29 years
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Scenario Three – Premature Infant Care
Debrief 20 minutes
Purpose:
To reflect on and discuss the scenario experience.
Materials:
• Premature Infant Care Debrief Instructor Resource
Facilitation Steps:
1. Review debriefing rules • Confidentiality
• Scenarios are to be kept confidential to maintain the integrity of the learning experience
• It is unethical to share information in any way regarding student performance with persons outside the scenario
• Safe space • This is a safe, non-discriminatory
learning environment for constructive feedback
2. Work through the debriefing questions on the Premature Infant Care Debrief Instructor Resource as a group.
3. Praise the students for their efforts.
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Premature Infant Care Debrief Instructor Resource
Group Questions 1. Describe the objectives that you were able to achieve.
2. Which objectives were you unable to achieve (if any)?
3. Which objectives did you do well?
4. If you were able to do this again, how would you handle the situation differently?
Patient Questions 1. How did you feel throughout the simulation experience?
2. What part of the simulation was the most challenging?
Nurse Questions 1. How did you feel throughout the simulation experience?
2. What part of the simulation was the most challenging?
Ending Questions 1. What are your main take-away points of this simulation?
2. Is there anything else you would like to discuss?
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Scenario Three – Premature Infant Care
Sources
American Academy of Pediatrics. (2020). Ages and stages: baby. https://www.healthychildren.org/English/ages-stages/baby/Pages/default.aspx
International Nursing Association for Clinical Simulation and Learning (2016). INACSL Standards of Best Practice: Simulation. Retrieved from https://www.inacsl.org/inacsl-standards-of-best-practice-simulation/
Lawn, J., Davidge, R., Paul, V., Xylander, S., Graft Johnson, J., Costello, A., Kinney, M., Segre, J. and Molyneux, L. (2013). Born too soon: care for the preterm baby. Reproductive Health, 10(1). S5. https://doi.org/10.1186/1742-4755-10-S1-S5