multidimentional care

INACSL Standards of Best

Practice: SimulationSM

(See Appendix A)

Simulation Design

Outcomes & Objectives

Facilitation

Debriefing

Participant Evaluation

Professional Integrity

Simulation Enhanced IPE

Operations

Learning Objectives

Should be measureable and link the clinical experience to the course competencies and Program SLOs.

Perform an assessment for a suspected UTI in the older adult.

Describe the appropriate nursing interventions for the frail elder with an acute UTI.

Describe strategies for safe, effective multidimensional nursing practice when providing care for clients experiencing immunologic, infectious, and inflammatory disorders.

Complete care plan for client with medical diagnosis of UTI

Brief Scenario Description

Mrs. Court is an 89-year-old white widow living in the long-term skilled care facility where you work. She was admitted several weeks ago after a hospitalization for pneumonia following a bout with the flu. She has moderate dementia with severe short-term memory loss and some executive dysfunction characterized by distractibility and episodes of inappropriate behavior like sexual aggressiveness or screaming at other residents. She also has Parkinson’s, mild hypertension, and anemia.

Topic

Description of Activity

Deliverable(s)

Activity Time

Orientation/ Pre-Briefing

(See Appendix B)

Review the ATI skills module on urinary catheterization; specifically, the FAQ (Frequently Asked Questions. Review Sterile Technique for Procedures: https://www.youtube.com/watch?v=BIZJdzqgF88

Describe the difference between aseptic and sterile technique.

Submission to the dropbox.

1 hour

Tasks

(See Appendix C)

Research one scholarly article on decubitus ulcers and summarize its findings, utilizing APA. Consider the impact urinary incontinence and recurrent UTIs may have on the development of a decubitus ulcer. Review the Braden Scale: https://www.aafp.org/afp/2008/1115/afp20081115p1186-s1.pdf Review the following types of dressings commonly used in decubitus ulcers and discuss when they may be indicated: Hydrocolloid, Hydrogel, Alginate (ie calcium and silver), Honey (ie medihoney and manuka) and Collagen. There is good information available on ATI’s skill module on wound care. Kennedy ulcers often mistaken for decubitus ulcers. Review the following information on Kennedy ulcers and create two nursing diagnoses for a patient who has a Kennedy ulcer, knowing that these are terminal.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6161640/

https://www.woundsource.com/blog/kennedy-terminal-ulcerpalliative-care-and-hospice-care

http://www.kennedyterminalulcer.com/Photos.aspx

Submission to the dropbox

3 hours

Virtual Scenario

(See Appendix D)

https://www.usd.edu/~/media/files/health-sciences/nursing/simulation-scenarios/organ-failure-sepsis-1-scenario.ashx?la=en

The students follow along with the scenario, answering questions as asked in the prebriefing and questions 2-4 in the debriefing.

1. Submit all questions with answers as well as the word document from above.

2. Submit an ATI procedure template for straight catheterization with sterile specimen collection

3. Submit an ATI System Disorder template on UTI

2 hours

On-Line group work

(See Appendix C)

The students work with a colleague to review their individual work on templates, questions, and the scenario (if they did not work in groups prior). They need to document what they would consider key things to discuss in the debriefing

These should include but not limited to:

· System disorder template: UTI

· System disorder template: Asymptomatic Bacteriuria

· Nursing skill template: Straight Cath procedure with sterile specimen collection

· 4 key things learned during scenario that they think are important for their colleagues to know

2 hr.

Debriefing

(See Appendix E)

Discussion regarding legal issues encountered in nursing.

https://www.registerednursing.org/nclex/legal-rights-responsibilities/

https://www.jointcommission.org/-/media/tjc/documents/standards/r3-reports/r3_report_issue_9_cauti.pdf

https://ltcombudsman.org/about/about-ombudsman

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_q_immedjeopardy.pdf

https://allnurses.com/should-i-carry-nursing-malpractice-t278767/

3 hr.

Post-Cognitive Activity

May be done as a post-conference type activity alone or as a group

Reflection using the following key topics:

1. What new information did you learn today? How will this be applied to your practice as a nurse?

Reflection submitted to dropbox

1 hr.