Designing Adult Code Simulations for Antepartum and Postpartum Nurses
Title: Designing Adult Code Simulations for Antepartum and Postpartum Nurses
- To describe how a simulation-based learning program can help staff gain confidence in the skills and critical thinking necessary during a maternal code.
- To design antepartum and postpartum code simulation scenarios that are realistic and applicable to the setting.
- To discuss the advantages of including staff nurses as part of the simulation faculty from inception through implementation of the program.
The purpose of this program was to improve the ability of postpartum and antepartum nurses to respond in the event of a maternal code. Even very experienced nurses expressed that although they knew how to perform CPR, the whole adult code experience was overwhelming and they felt unprepared.
Proposed change:
The leadership of the antepartum and postpartum units and the nursing simulation faculty at the hospital collaborated to propose a simulation-based learning experience for the the RN staff of these units. Simulation-based learning provides an opportunity to practice skills in a safe environment while helping the nurse to develop critical thinking skills, promote effective communication, and work collaboratively with other members of the team.
Implementation, outcomes and evaluation:
Over a period of months, the program faculty (simulation staff, nurse educators and staff nurses) created 2 maternal code simulations. The final program involved 3 stages: skills sessions, simulated code scenarios and debriefings. During the skill sessions the staff reviewed skills such as use of the defibrillator, contents of the code cart, medications used in a code, and communication techniques. The participants toured the simulation lab before the actual simulation to see the room set up and how the manikin works. When it was time for each scenario, participants were given role cards to remind them of critical activities during a code. The primary nurse received report on the mock patient and the simulation started. One half of the group participated in each simulation while the other half watched the scenario on a live feed to a conference room. Immediately after each scenario a debriefing session took place. Consistent themes during debriefing included discussions about the role of the nurse in a code situation, effective communication in an emergency and the value of effective team work. Without exception, results of the 196 written evaluations indicated that staff nurses felt more knowledgeable and confident about adult codes.
Implications for nursing practice:
Based on the overwhelmingly positive feedback to simulation-based learning, the program was offered again the following year to all RN staff. Anecdotally, many nurses in the second year commented that in other emergencies on the units they also felt more confident after having participated in the maternal code simulation the previous year. The current plan is to offer simulation-based learning experiences to all RN's on the antepartum and postpartum units annually.
Keywords:
simulation, maternal code, antepartum, postpartum