Mr John Peters is a 59 year old first nation’s male who lives with his wife, one child, two grandchildren and his elderly parents in a remote area of a native reserve. He has been admitted to hospital for investigation of increasing shortness of breath. The students will be expected to perform appropriate assessment, communicate with one another and initiate appropriate treatment. Learning objectives
1. Demonstrates a focused respiratory assessment.
3. Demonstrates therapeutic communication skills with patient and family
4. Communicates with the interprofessional team
5. Collaborates with the interprofessional team on interventions
Fidelity Equipment attached to the mannequin Black wig Glasses Hospital gown In bed lying on side
Equipment Available in the room Gloves Patient Id band Oxygen flow meter Oxygen mask with rebreather Oxygen mask with nebulizer Saline lock Incentive spirometer Stethoscope BP cuff SP02 monitor Thermometer Medications
Glyburide 5 mgm tid po Metformin 500 mgm bid po Theodur 300 mgm bid po Ventolin 2 nebs q4 h PRN Atrovent 1 neb q4 h PRN 02 2litres/min NP prn to keep sats > 92% Documentation forms Physician orders Flow sheet MAR Kardex Graphic record Progress notes Number of participants One occupational therapist One respiratory therapist One nurse One family member One observer Social history
Mr. Peters has been receiving long term disability and lives on a remote area of the reserve. He uses firewood for heating. Medical History
Weight 85 kg Height 175 cm He has a past history of smoking (20 years ago), has COPD (CO2 retainer) and type 2 diabetes. As a child he had an appendectomy and tonsillectomy. Proposed treatment outline OT Wash hands Introduce self Indentify patient Discuss energy conservation Notices deteriorating condition Calls nurse Nurse introduces self to OT and patient
Nurse repositions patient Obtain BP, pulse, respiratory rate, temp, SPO2 Assess breathing Applies oxygen Checks physician orders Asks OT for details Calls RT RT gets information from nurse and OT Focused respiratory assessment Adjusts oxygen delivery Administers ventolin Chest assessment post ventolin Nurse calls physician for further orders Report to student nurse and OT
It is Mr. Peters fourth day of admission. The OT has been called in to speak to the patients about energy conservation. Mr. Peters continues to be short of breath on exertion and his vital signs have been stable.
Check SP02 Apply oxygen Focused respiratory assessment Provides support to daughter and patient Asks for details from OT
RT does chest assessment Adjusts oxygen delivery Administers ventolin Chest assessment post ventolin
physician Receives orders for chest xray and ABG
Debriefing/Guided reflection Questions
1. How did you feel throughout the simulation experience? 2. Describe the objectives you were able to achieve? 3. What were the key assessments and interventions that you observed? 4. Were you satisfied with your ability to work through the simulation? 5. What did the group do well? 6. How could the group have handled the situation differently? 7. Did you understand the roles of the different professionals? 8. Did you notice any similarities or differences with your own role? 9. Were you satisfied with your ability to communicate with the client and his
10. Were you satisfied with your ability to communicate with other team members? 11. Did you work together as a team why or why not? 12. Is there anything else you would like to discuss?
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