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  • 1.  Ambulatory Simulation Scenarios

    Posted 04-21-2023 06:22
    Hello Members, 

    I searched our AAACN resources site for Ambulatory Care Services simulation scenarios but didn't find any. Does anyone know where I can find some or does anyone have any scenarios they'd like to share? We have a new high tech Sims lab for the organization and I want to make sure ACS is able to take advantage of this learning opportunity. 

    Thanks



    Sent from my Galaxy



  • 2.  RE: Ambulatory Simulation Scenarios

    Posted 04-21-2023 15:56

    Hi Toni,

    I am also unaware of any AAACN resources, but our ambulatory education team engages in SIM training every year as a part of emergent training and uses high fidelity sims for some situations. Their Sim scenarios are all home grown, but the topics that have been seen as most beneficial are managing respiratory emergencies (recognition, administering appropriate oxygen support, calling provider for meds, transportation etc.), active seizure in the clinic (with similar response - recognition, following appropriate seizure care, calling provider, administering medications as ordered, transportation), anaphylaxis for our allergy clinic, hypoglycemia for endo and syncopal episodes. We're a peds specialty clinic but I would imagine in adults there are additional common scenarios such as managing a cardiac emergency that could be useful. We set up our sim equipment in the clinic space to try to mimic the environment as closely to a real-life situation as possible and the staff seem to really enjoy the learning experience each year! 



    ------------------------------
    Brandy Williamson BSN RN CPN
    Ambulatory Nursing Manager
    Children's Healthcare-Atlanta
    Atlanta GA
    (404)785-8978
    brandy.williamson@choa.org
    ------------------------------



  • 3.  RE: Ambulatory Simulation Scenarios

    Posted 04-22-2023 08:43
    Great ideas Brandi!  In addition to cardiac emergencies,  behavioral health emergencies are helpful to prepare for- suicidal patient in the clinic or on the phone, de-escalation of threatening behavior, application of patient engagement (MI) is also helpful.
    Stephanie 





  • 4.  RE: Ambulatory Simulation Scenarios

    Posted 04-28-2023 15:31

    Thanks Stephanie



    ------------------------------
    Toni Isaacs MSN AMB-BC
    ACS Primary Care Clinical Resource Nurse
    Harris Health System
    Houston TX
    (713)339-0276
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  • 5.  RE: Ambulatory Simulation Scenarios

    Posted 04-28-2023 15:31

    Thanks Brandy



    ------------------------------
    Toni Isaacs MSN AMB-BC
    ACS Primary Care Clinical Resource Nurse
    Harris Health System
    Houston TX
    (713)339-0276
    ------------------------------



  • 6.  RE: Ambulatory Simulation Scenarios

    Posted 05-01-2023 08:51

    Love these scenarios and a great call out- what are the recent events (last 2 years) that your organization has had to call EMS for? What are the "war stories" that the seasoned team members would share that could be used in a simulation that could help a newer team member get more comfortable with a low volume situation? I joke about those but they're great learning experiences for our newer team members, especially for those situations we may not encounter often. 

    The National League for Nursing has a great simulation design template that I've used in the past, available at https://www.nln.org/docs/default-source/uploadedfiles/professional-development-programs/sirc/simulation-design-template-2023.docx?sfvrsn=d26a60d_13

    Writing the scenarios is always fun for me, especially the scripted parts. Always pre-brief to ensure safety (like "that's a live defibrillator"). 

    Situations we have encountered in adult settings include some of the same ones Brandy mentioned, the scenario would just need adapted for adult ranges/treatments. We've also had patients present having an MI, stroke, sepsis, respiratory distress, pulmonary edema, anaphylaxis (bee stings, medications), behavioral health emergencies, and hypovolemia. For specialty clinics you could do most of these as well but could also include sedation procedures if you have an endoscopy suite or compartment syndrome for orthopedics or urgent care*. 

    *For anything with a cold leg, you can use make-up and a good make-up sponge to make the leg appear mottled. Ask your teams to bring in their old eye makeup (especially that blue eyeshadow and bright red blush they bought for a single Halloween use) for you to use on the manikin. Sponge it onto the manikin leg and then put an ice pack on the leg. You can turn the pulse off in that leg when the simulation starts (and just toss the ice pack in a corner where they can't see it). You now have a cold, mottled, and pulseless leg! 



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    Andrea Kelly MSN, RN, NPD-BC
    Director, Population Health
    ECU Health Physicians (formerly Vidant Medical Group)
    Greenville NC
    (252)847-3930
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