Running Head: SIMUALITON CENTERS IMPROVE CARE PART 2 1
Simulation Center Improve Care part 2
Katie Armstrong
Liberty University
SIMULATION CENTER IMPROVE CARE PART 2 2
Simulation has been a part of the health care system for quite some time. As previously
stated, the goal is to bring a simulation education center to a hospital enhance interdisciplinary
competency skills and fill a need for area nursing education programs. In this paper we will
cover the plan of action, evaluation of the QSEN (Quality and safety Education in nursing,
knowledge, skill and attitude (KSA), health IT, ethical considerations and benefits of having a
simulation center in the facility. Having a plan of action is crucial to starting anything new. In
order to have a smooth process there must be a plan in place. With a plan of action there should
be a mission statement, a vision, and goals (short term and long term).
Within the plan of action, a mission statement should be made to start off the planning
process and give a framework. The mission statement for this new simulation education center is
to help grow, develop, and educate all members of the interdisciplinary team to provide the
highest quality of care. All simulation-based experiences require purposeful and systematic, yet
flexible and cyclical planning (INACSL, 2016). In the planning phase after the mission statement
also comes a vision. For the new simulation center, the vision will be to have a robust simulation
center with top of the art medical simulation tools. It will be utilized not only by the medical staff
within the hospital but local nursing programs and family members of patients and patients
themselves. It will be a great resource to many people who are providing care to others.
Team establishment is crucial to a positive development of any new area. As a simulation
is starting up the core team members will be tasked with developing scenarios. They will also
gather equipment, ensure a space to dedicate to simulation, and share the news of this
opportunity with others. The team will consist of a simulation center manager, assistant manager,
and simulation center instructors. The development of a team will help ensure that there is a
mixture of nurses, doctors, certified nursing assistants and health administration. Other
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interdisciplinary team members could be laboratory, respiratory, radiology, chaplain’s office,
social works/case management, and special providers such as cardiology or emergency medicine.
There should be a board developed within the team establishment that will continue to monitor
and improve the simulation center. They will also ensure the most up to date and correct
education is being taught to better patient outcomes base on the evidence-based practice.
Instructors for the simulation would need to be chosen prior to complete development.
They would need to be well rounded educators. It would be beneficial to learning if they are
recently in the healthcare setting and are familiar with the hand on application of healthcare. It is
one thing to learn from a book or set of power points, but having an instructor that is familiar
with what they are teaching aide in better learning. The instructors should be from each specialty
with in the healthcare system. So, nursing, providers, certified nursing assistants, respiratory,
radiology, laboratory and any other members of the healthcare team that would benefit from
hands on simulation as independent departments or as an interdisciplinary teams.
Infrastructure development of the simulation center is a step that needs to start in the
beginning of development. Within the infrastructure is the purchasing or gathering of equipment.
Specifically, the mannequins. Training on higher-fidelity mannequins was associated with
improved performance immediately post-intervention when compared with training on lower-
fidelity mannequins for knowledge and psychomotor outcomes (Sherwood & Francis, 2018).
Studies have shown the importance of using high fidelity mannequins and using different
medical equipment on these mannequins. There is great value in practicing the muscle memory
of all the different interventions that nurses, doctors, and other members of the interdisciplinary
members should practice how we will provide care. For example, the placement of a Foley
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catheter is a sterile technique that takes time to learn the steps. A simulation center provides the
environment, equipment, and mannequin to safely learn this skill. The mastering of the skill of
Foley catheter placement then increases positive patient outcomes by decreasing the risk of
infection because the nurse knew correct sterile technique. Other items of the infrastructure are
medical supplies, beds, monitors, pumps, ventilators, and many of the other items used every day
in healthcare. The infrastructure of the simulation center should be set up the same way or as
close as possible to the actual areas where the healthcare teams will be providing care to real
patients.
Before the roll out of a simulation center there needs to be development of scenarios. The
scenarios need to be prepared by members of the interdisciplinary team. These scenarios need to
be realistic and based on evidence-based practice. All areas of education should be developed by
multiple members of the simulation team. This allows for a wider view of ideas and experience.
All scenarios need to be referenced to the best practice and should not be based on “what we
always do” mentality. The different team members can all contribute to the development of the
scenarios, but a nurse informaticist can look at a review of the hospital and see what areas need
to be reviewed and practices to better the delivery of care across the board. A survey should be
completed by the hospital staff to determine areas that they would like to see in simulation. This
way the scenarios are areas that the team feels they want to practice and improve on. The goal of
the simulation center is to better the staff so that they are providing better care.
Last a development of a debrief or evaluation system. One of the best ways to improve is
to receive feedback. Once the simulation center is developed and being put into use the members
using it will be able to fill out a simulation evaluation. Within the evaluation would be questions
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like how was your experience, was it a valuable learning, how can we improve, what are other
areas you would like to practice in simulation and any additional feedback. When debriefing
happens, its purpose is to allow reflective thinking by allowing participants to think about and
clarify actions that occurred during the simulation (Nelson, & Staggers, 2018).
QSEN was first introduced in 2005. Its goal is to meet the challenge to prepare the future
nurses with the correct knowledge, skills, and attitude (KSA). There are six areas of
competencies with that are there to address key areas of practice that apply to all professional
nurses at some level (Bristol, 2016). The competencies are quality improvement, patient safety,
team work, patient centered care, evidence-based practice, and informatics. Bringing these
competencies to life during clinical can help the student develop habits for professional growth
(Bristol, 2016).
The first area within the QSEN is quality improvement. Quality improvement is using
data to monitor the outcomes of care processes and use improvement methods to design and test
changes to continuously improve the quality and safety of health care systems (AACN, 2016).
In relation to the implementation of the simulation education center this is important because this
pushes students and graduate level professionals to always pursue improving their career field.
Quality improvement within simulation is needed because it is ever changing and developing.
There is no need to recreate things that are working, but there is value in improving the way
things are done, that is quality improvement.
Second is patient safety. In a simulation center medical professionals, students, patient
and family members all have the ability to practice care in a safe environment. Regarding the
QSEN the focus is on error prevention. With the incorporation of EHR (electronic health
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records) there are now barriers that prevent patient harm by adding safety checks. An example is
the bar code scanning for medication administration. Within a simulation center nurses are able
to become familiar with the equipment, the EHR, and the facilities system. Simulation centers
provide the ability to deliver safe care because it allows for mistakes to be made in a setting
where it can be corrected and no harm is done to a live patient.
Third in the QSEN is the team work and collaboration. In a study completed with nursing
students and end of life care in a simulation center the focus was on the team work and
collaboration. The students stated that, “Teamwork helps magnify our professionalism and also
lets us accomplish our goals more effectively” (Lindemulder, 2018). The main focus of
implementing a new simulation education center is to have interdisciplinary skills and team work
scenarios. Not only will the simulation centers work on skills for each individual, one of the best
aspects of it is the use for team work and collaboration. During a simulation the nurses and
providers are able to work together and practice their collaboration and communication while in
a controlled environment. They can also practice with other members of the interdisciplinary
team such as pharmacy, respiratory, lab, blood bank and the techs or nurses’ aides. There are
many potentials for different collaborations with different groups of the interdisciplinary team in
the simulation center. In a simulation center the whole team is able to work together in practicing
communication and manage conflict. SBAR (situation, background, assessment and
recommendation) is a great tool for communication. In a simulation center the students and staff
are able to go through different scenarios while working on communication, respect and shared
learning.
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Fourth is the patient centered care aspect of the QSEN. Patient centered care is becoming
a major focus for many hospitals, which it always should have been. Hospitals are making sure
that we are not just doing skills and things to our patient, but for our patients. Patient centered
care is involving the patient in all aspects of their care. It recognizes that the patient or power of
attorney is the source of control and full partner in providing compassionate and coordinated care
based on respect for patient’s preferences, values, and needs (ACCN, 2012). Without the patient
no one in healthcare wouldn’t have a job. The focus should always be on the patient. Within the
simulation center patient centered care is the driving force. From healthcare member to family
members practicing skills in the simulation center allows for the beset thing to be done for the
patients and done the best way.
Fifth is evidence-based practice. Evidence-based practice is the integration of best current
evidence with clinical expertise and patient/family preferences and values for delivery of optimal
healthcare (ACCN, 2012). Within healthcare there is always room for improvement and many
members of healthcare and nurses specifically, are looking into the best evidence out there. As an
advanced Nurse, evidence-based practice is often a focus of study and research. Within a
simulation center the new evidence can be used to continually educate all members of the
interdisciplinary healthcare team to better the patient outcomes. Within the facility there are
policies and protocols based on evidence-based practice. The simulation center can ensure
standardized education of these policies and protocols to better the delivery of care.
Sixth is the informatics. Informatic is very important and crucial to the development and
implementation of the simulation center. Informatics deals with the technology aspect to reduce
errors and improve healthcare. The simulation is possible due to the use of technology. Health
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Information Technology with in the simulation center is paramount. The way that simulation
centers thrive is with high fidelity simulation. In addition, the development and progression of
the HITTECH Act has increase the ways that technology is used within healthcare education.
There are many websites, tools, cell phone applications and other mobile ways to learn (Nelson,
& Staggers, 2018). As technology makes advance the healthcare system then uses those advances
to development new ways to educate. Simulation centers are the forefront of these advances.
In regard to ethical consideration in a simulation center, it really takes the potential of
ethical issues out of healthcare. Medical simulation is in fact the gold standard method of reliable
prediction of future behavior of complex systems in health today (Garbayo, & Stahl, 2017). A
well-done simulation center provides the best area to practice all skills on mannequins and
doesn’t allow any patient harm to be done. Simulation provides the ability for healthcare member
to make mistakes and errors in the simulation center so that no patient harm is done. There are
also no patients involved so the ethical dilemma of practicing on patient or other staff members
is not an issue.
Benefits of the simulation education center are limitless. When we focus on the
interdisciplinary affects there are many. When you look at some of the best teams or groups out
there, they are interviewed, and they discuss the importance of practicing together, that they are a
team. The on an interdisciplinary medical there are different players from specialty areas, yet
they form a team. Medical simulation provides a safe area for team members to practice their
skills but also practicing with the other team members. So, when it comes time for a real high
intensity life saving situation everyone knows their role and how it fits into the big picture. So
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much of health care if hands on ad requires more than one person, so interdisciplinary simulation
is crucial to the outcomes of patients.
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References
AACN. Graduate-Level QSEN Competencies Knowledge, Skills and 24 Sept. 2012,
www.aacnnursing.org/Portals/42/AcademicNursing/CurriculumGuidelines/Graduate-
QSEN-Competencies.pdf.
Bristol, Tim. “QSEN in Clinical.” Teaching and Learning in Nursing, vol. 11, no. 1, 2016, pp.
23–26., doi:10.1016/j.teln.2015.09.005.
Garbayo, L., & Stahl, J. (2017). Simulation as an ethical imperative and epistemic responsibility
for the implementation of medical guidelines in health care. Medicine, Health Care, and
Philosophy, 20(1), 37-42. doi:http://dx.doi.org.ezproxy.liberty.edu/10.1007/s11019-016-
9719-0
INACSL Standards of Best Practice: SimulationSM Simulation Design. (2016). Clinical
Simulation in Nursing, 12. doi:10.1016/j.ecns.2016.09.005
Lindemulder, Lorinda, et al. “Using QSEN Competencies to Assess Nursing Student End-of-Life
Care in Simulation.” Nursing, vol. 48, no. 4, 2018, pp. 60–65.,
doi:10.1097/01.nurse.0000531006.94600.28.
Nelson, R., & Staggers, N. (2018). Health informatics: An interprofessional approach. St. Louis,
MO: Elsevier.
Quality and Safety Education for Nurses, qsen.org/competencies/graduate-ksas
Sherwood, R. J., & Francis, G. (2018). The effect of mannequin fidelity on the achievement of
learning outcomes for nursing, midwifery and allied healthcare practitioners: Systematic
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review and meta-analysis. Nurse Education Today, 69, 81-94.
doi:10.1016/j.nedt.2018.06.025
