SBAR Scenario CURRENT MEDICATIONS
| CURRENT MEDICATIONS 1. IV NS at 150mL/Hr 1. Insulin injection twice each day – dose dependent upon sliding scale 1. Hypoglycemia standing orders as needed PROVIDER ORDERS 1. NPO (except medications) 1. Initiate Saline lock 1. Oxygen to maintain SpO2 greater than 94% 1. Activity as tolerated SCENARIO PROGRESSION Client will require insulin injection as indicated by blood glucose level and sliding scale, this will require the mixing of insulin and the administration of a subcutaneous injection. A simulated 30 minutes will pass and the confederate will call for help as the client becomes semi-conscious and nearly unable to respond to noxious stimuli. This will require the student to determine the situation as an adverse reaction to the previous insulin injection and require the reconstitution of glucagon and an intramuscular injection. ROLES 1. Parent 1. Nurse 1. Client STUDENT CRITICAL BEHAVIORS 1. Student will prepare and administer medications appropriately 1. Student will recognize the signs and symptoms of an adverse reaction to insulin 1. Student will interact with parent and client in a professional manner SIMULATION SET UP 1. Adult manikin with bandage wraps on extremities 1. Appropriate vials and syringes for medication administration noted in scenario progression | 1. IV NS at 150mL/Hr 1. Insulin injection twice each day – dose dependent upon sliding scale 1. Hypoglycemia standing orders as needed |
| RESOURCES | 1. NPO (except medications) 1. Initiate Saline lock 1. Oxygen to maintain SpO2 greater than 94% 1. Activity as tolerated |
| National Patient Safety Goals (Hospital) Effective January 1, 2015. The Joint Commission | Client will require insulin injection as indicated by blood glucose level and sliding scale, this will require the mixing of insulin and the administration of a subcutaneous injection. A simulated 30 minutes will pass and the confederate will call for help as the client becomes semi-conscious and nearly unable to respond to noxious stimuli. This will require the student to determine the situation as an adverse reaction to the previous insulin injection and require the reconstitution of glucagon and an intramuscular injection. |
| Accessed online: http://www.jointcommission.org/standar | 1. Parent 1. Nurse 1. Client |
| CURRENT MEDICATIONS 1. IV NS at 150mL/Hr 1. Insulin injection twice each day – dose dependent upon sliding scale 1. Hypoglycemia standing orders as needed PROVIDER ORDERS 1. NPO (except medications) 1. Initiate Saline lock 1. Oxygen to maintain SpO2 greater than 94% 1. Activity as tolerated SCENARIO PROGRESSION Client will require insulin injection as indicated by blood glucose level and sliding scale, this will require the mixing of insulin and the administration of a subcutaneous injection. A simulated 30 minutes will pass and the confederate will call for help as the client becomes semi-conscious and nearly unable to respond to noxious stimuli. This will require the student to determine the situation as an adverse reaction to the previous insulin injection and require the reconstitution of glucagon and an intramuscular injection. ROLES 1. Parent 1. Nurse 1. Client STUDENT CRITICAL BEHAVIORS 1. Student will prepare and administer medications appropriately 1. Student will recognize the signs and symptoms of an adverse reaction to insulin 1. Student will interact with parent and client in a professional manner SIMULATION SET UP 1. Adult manikin with bandage wraps on extremities 1. Appropriate vials and syringes for medication administration noted in scenario progression | 1. Student will prepare and administer medications appropriately 1. Student will recognize the signs and symptoms of an adverse reaction to insulin 1. Student will interact with parent and client in a professional manner |
| RESOURCES | 1. Adult manikin with bandage wraps on extremities 1. Appropriate vials and syringes for medication administration noted in scenario progression |
RESOURCES
| SCENARIO FOCUS | Recognition and initial actions taken given signs and symptoms of an allergic reaction to a prescribed medication | |
| OBJECTIVES | 1. Use two ways to identify the client (2015 Joint Commission NPSG.01.01.01) 1. Recognize signs and symptoms related to a possible medication reaction 1. Formulate an accurate report to a healthcare provider in SBAR format 1. Analyze assessment data to appropriately prioritize the client’s triage category according to an established criteria scheme | |
| REALTED COURSE OBJECTIVES NUR3371 | 1. Demonstrate timely and accurate documentation of administration of medications, including any adverse responses or reactions | |
| PATIENT DEMOGRAPHICS | NAME: Josie Lancaster AGE: 20 years old DOB: May 11, XXXX WEIGHT: 128 pounds (58kg) HEIGHT: 66 inches (168cm) | |
| PAST HISTORY | Sexually active in last 12 months | |
| CASE HISTORY | Josie Lancaster is a 20 year old healthy female. She is presenting to the triage desk at an outpatient care facility (urgent care) complaining of itching, runny nose and a rash over most of her body. She was seen about 18 hours ago in the primary care clinic and diagnosed with pelvic inflammatory disease. She was prescribed: Ceftriaxone 250 mg IM in a single dose (Given at PCC) Doxycycline 100 mg orally twice a day for 14 days Metronidazole 500 mg orally twice a day for 14 days She states that her first dose of oral medications was taken about 4 hours ago. | |
| INITIAL (ER) VITAL SIGNS | BP 148/90 HR 112 RR 24 TEMP 99.7 SpO2 96% (Room air) EKG Sinus rhythm | Patient is: Alert and Oriented but anxious |
| CURRENT MEDICATIONS | 1. See CASE HISTORY 1. Birth Control pill (compliant) | |
| PROVIDER ORDERS | 1. Triage for admission to clinic | |
| SCENARIO PROGRESSION | Client will remain stable throughout scenario. Focus is on recognition and appropriate reporting of signs and symptoms of a drug reaction. In this case, anaphylaxis secondary to antibiotic. | |
| ROLES | 1. Nurse 2. Client | |
| STUDENT CRITICAL BEHAVIORS | 1. Student will recognize and accurately triage the client’s condition 1. Student will recognize the signs and symptoms consistent with medication reaction |
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