Adverse occurrence report
Date of incident: _______________ Time: ________ AM/PM
Name of injured person:
Date of birth: ________________ Male ______ Female _______
School name: _______________________________________________
Type of injury:
Details of incident:
Injury requires physician/hospital visit? Yes ___ No _____
Name of physician/hospital:
Physician/hospital phone number:
Signature of injured party
*No medical attention was desired and/or required.
Form must be forwarded to and reviewed by simulation center Director within 24 hours of incident.
Simulation-based training involves immersion of the participant in a realistic clinical situation. This training can involve the administration of simulated medications, therapies, treatments and communications techniques. During the participation in such session, students observe the performance of peers in managing nursing events. In order to create a safe learning and constructive debriefing environment for the participant, strict confidentiality of what transpires on both clinical and interpersonal level throughout the exercise must be maintained. Educators should discuss confidentiality and note that the session is a safe learning environment during orientation to the center. Individual feedback provided publicly to each learner during the debriefing process must also be confidential.
In keeping with this policy, students undergoing training at the CSC are required to complete and sign the “Clinical Simulation Center Confidentiality Agreement”. A signed copy of the consent must be on file in order for a student to participate in simulation based training. Students are expected to uphold all requirements of the Health Insurance Portability and Accountability Act (HIPPA) and any other federal or state laws requiring confidentiality. Students agree to report any violations to the simulation educators and/or clinical educators.
Clinical Simulation Center
I have access to Confidential Clinical Simulation Center Information and need to be aware of and abide by procedures that apply to simulation information:
Confidential simulation information is defined as anything that I, or those individuals with whom I interact, would expect to remain private including information relating to
- simulation patients;
- standardized patients;
- patient models; and
Confidential information may be used only as needed to perform my specific activity related responsibilities.
As a student, learner, trainee or patient actor, I am required to comply with the Clinical Simulation Center guidelines relating to confidential information. I understand that:
1. I may have access to confidential simulation information.
2. I am responsible for protecting all simulation information.
3. Confidential simulation information may only be used as needed to perform my assigned activities. I may:
a. not share any simulation scenario information with others outside of my clinical simulation group and clinical faculty;
b. not share or disclose specific simulation patient health information;
c. not share student performance with anyone other than those in my clinical simulation group and clinical faculty;
d. not misuse or be careless with simulation information.
4. Violating this Agreement may subject me to loss of simulation privileges.
5. Video recordings/photos may be used for follow-up instruction, orientation to the simulated environment, CSC tours, seminars, and RU simulation center website/RU Facebook page.
By signing below, I acknowledge that I have read and understand the above Agreement and agree to abide by the terms of this Agreement.
Printed Name _____________________________
Revised: May 2014
Equipment maintenance and replacement plan
To ensure equipment compliance with Radford University Policies and standards of operation, maintaining optimal equipment conditions for operations.
1. Equipment problems will be reported to Clinical Simulation Center Information Technologist (CSC IT) for follow-up and resolution of problem in a timely manner.
2. CSC IT will communicate to staff and/or educators the outcome of the problem and any process changes nessessary to maintain operations.
3. Disposable parts (arm skins, injection pads etc.) will be replaced on as needed basis.
4. Non-disposable parts will be repaired or troubleshooted by CSC IT according to vendors Directions for Use (DFU) and Manuals. If part is not repairable it will be replaced in shortest possible time to minimize interruption of CSC operations.
5. Preventive maintenance on simulators/simulation equipment will be conducted by CSC IT on a biannual basis during academic breaks either independently or in conjunction with vendor during purchased Preventive Maintenance services.
6. Preventive maintenance will be conducted on all computers and servers on monthly basis to ensure compliance with Radford University Information Technology guidelines. This maintenance will include but not limited to:
a. Updating all systems (OS updates)
b. Running full system anti-virus and anti-malware scans
c. Hardware diagnostics, repair and replacement.
7. IT specialist in collaboration with CSC director will analyze extended warranty criteria annually and determine which simulators need additional warranty purchases.
III. Laerdal Simulators Care
At least once a week to flush used tanks (Body fluids and/or blood) with distilled water until purged liquid is colorless. Then charge one or both tanks with 100 ml of 70% isopropyl solution and flush again. This way remaining liquid in the tanks and tubing is mainly alcohol which prevents molding and ensures mannequin’s liquids system’s functionality.
Flush urine tank with uncolored distilled water as described above for SimMan 3G until purged liquid is colorless. After that load tank with 100 ml of 70% isopropyl solution and purge all liquid one more time.
Wash/flush tanks with tap water
How often to perform this care
Manufacture’s recommendation: Perform all of the mentioned procedures every day when liquids were used on either of the simulators. Even if only distilled water was used without any coloring.
Clinical Simulation Center
School of Nursing Faculty Expectations
Overview: The Clinical Simulation Centers (CSC) are designed to provide the student with the opportunity to practice skills and problem solving in a simulated healthcare environment. The centers will provide the equipment and the resources to facilitate the student’s acquisition of competence with the skills to care for clients in the clinical setting.
Clinical Simulation Sessions:
- Dissemination of clinical information to students prior to CSC session:
- The CSC staff will send pre-simulation materials to the SON faculty responsible for the clinical group.
- The SON faculty will need to provide this information to the students scheduled for the CSC.
2. Student dress code:
- The clinical simulation center adheres to your School of Nursing (SON) specific clinical site dress code – student is expected to dress as if they were reporting to clinical in the hospital setting.
- Any student not following their SON dress code will be sent home. The CSC staff will notify faculty via email if a student has been sent home. NOTE: It will be the responsibility of the student to follow his/her SON process regarding missed clinical time.
3. Faculty are not required nor expected to come with their students to the CSC: Faculty are of course welcome to accompany their students.
4. Students will be required to prepare for clinical at the Simulation Center. If students are not prepared they will be sent home and the CSC will notify you of such an occurrence. The CSC will not be responsible to reschedule those students who are sent home. It will be up to the SON faculty to follow-up with their student regarding their missed clinical.
5. If post-clinical work is required (i.e. clinical log), we suggest that faculty require the same post-clinical work for the CSC experience. However, that work will need to be submitted to their clinical faculty.
Inclement weather policy
I. Purpose: To provide guidance to student and partnering agency faculty in case of inclement weather.
A. For RU West Clinical Simulation Center (CSC) Site:
1) The Radford CSC will follow Radford University (RU) closings and delays.
a. If RU is delayed, simulations scheduled during delayed hours are cancelled
b. If RU closed, all sessions are cancelled
2) WCC and NRCC students follow their own School of Nursing (SON) closings and delays. NOTE: If your SON is open and RU is closed do not report to the simulation center
B. For Roanoke Higher Education Center (RHEC) Site:
1) The Roanoke CSC will follow Roanoke Higher Education Center (RHEC) closings and delays.
a. If RHEC is delayed, simulations scheduled during delayed hours are cancelled
b. If RHEC is closed, all sessions are cancelled
2) JCHS, PHCC and VWCC students follow their own School of Nursing (SON) closings and delays. NOTE: If your SON is open and RHEC is closed do not report to the simulation center
3) RU Students follow RU student handbook which states that RU Roanoke Campus will follow RHEC inclement weather announcements.
C. Rescheduling – The CSC will make every attempt to reschedule sessions based on scheduling availability.
1) Reschedule high-fidelity or clinical front-loading (bootcamps) simulations will be done by CSC educator and SON faculty.
2) Rescheduling standardize patient simulations will be done by CSC administrator and SON faculty.
D. Contact information per site
RU West Center: Radford University – Radford Campus, New River Community College and Wytheville Community College
Margaret Mullins, MSN
Christina Keller, MSN
Jackie Muir, Admin
RHEC Center: Radford University - Roanoke Campus, Jefferson College of Health Sciences, Patrick Henry Community College and Virginia Western Community College
Millie Sowder, MSN
Lisa Foote, FNP
Roy Baugher, Admin
Clinical Simulation Center Quality Improvement Process
To provide quality simulation education incorporating feedback from student pre/post simulation surveys, clinical agency surveys, suggestions/comments from partnering schools, and feedback from participants and clinical educators to evaluate and revise simulations.
For Annual Scenario Review:
1. Prior to the annual meeting the educators gather information from the following sources during the designated time:
a. post simulation surveys on completed sessions
b. clinical agencies surveys
c. suggestions/comments from partnering schools
d. clinical educators and/or participants that utilized CSC
2. Simulation Educators examine data and make recommendations.
3. Simulation Educators develop appropriate solutions based on consensus among group.
4. Simulation Educators provide successful implementation of changes and devise plan to evaluate the outcome of approved changes.
For Problems Identified During the Semester:
1. Problem identified by simulation educators, staff, standardized patients or partnering agencies,
2. Complete “Quality Improvement Template” located in policy and procedure folder on CSC share drive.
Clinical Simulation Center Safety
To ensure physical and psychological safety of individuals involved in simulation.
1. Simulation center users should follow universal precautions while participating in clinical activities. While practicing skills at the simulation center, learners should practice the same safety precautions followed in clinical settings.
2. CSC educators exercise their discretion in allowing students that present to the center with signs of infectious illnesses to participate in simulation activities.
3. All sharps must be disposed of in an appropriately labeled sharps container. Under no circumstances may sharps or supplies be removed from the Center.
4. Hand washing or use of hand sanitizers are part of practice in the Center.
5. All injuries should be reported to the Center educators. Appropriate medical treatment will be recommended and an adverse occurrence report will be completed if warranted. If an injury occurs with a needle or sharp instrument, wash the wound thouroughly with soap and water as soon as possible. Basic first aid can then be applied by simulation center staff.
6. Any damaged or potentially dangerous equipment should be reported to the Center educators. The educators will attempt to correct the problem and if unsuccessful, the CSC Information Technologist will be notified.
7. Food and drinks are not allowed in the patient care areas. Drinks with lids are allowed in the debriefing rooms only.
8. In the event of a fire, the simulation center must be evacuated according to the plans set out by Radford University for the RU West Corporate Park and the Roanoke Higher Education Center locations.
9. Psychological safety during simulation will be addressed during the debriefing process. Simulation educators who have been trained to handle debriefing sessions are available for consultation.
10. Learners are expected to adhere to their respective school dress code policies to ensure safety while participating in simulation activities.
11. The simulation center educators make every effort possible to ensure a latex free environment. All gloves and medication administration equipment used during simulation activities are latex free.
12. Simulation Center staff will notify security of any suspicious behavior:
a. RU West call 831-5500 (campus police).
b. RHEC call 767-6001 (RHEC Security).
Clinical Simulation Center Scenario Development Procedure
I. Purpose: To produce, test and validate objective clinical scenarios that are based on standards of care/practice. The scenarios will progress according to student intervention or lack of intervention and will be run objectively by each CSC simulation educator.
Actions: Manikin responses
Events: Student interventions or student performance expectations
Frames: Section of flowchart that includes simulated manikin (patient) actions
Trends: Physiological changes in manikin actions over time
Handlers: Events customized to initiate an “Action” (vocal, trend, comment, physiological change…)
II. Scenario Development Expectations:
1. To develop objective scenarios driven by student events.
2. Student event(s) or time constraint will progress frames.
3. Trends will be used whenever possible to simulate changes in physiological changes in the manikin.
4. Scenarios will develop and change overtime during testing and validation process.
New Scenario Development Process TEAM Approach:
1. Each team member will be assigned roles in scenario development:
Admission Ticket Developer
Debrief Template Developer
Pre/post Encounter Developer
Review Question Developer
2. Complete “Scenario Planning Worksheet”. This can be done as a team or done by an individual and shared with the team for feedback and revisions prior to programming.
3. Researcher – reviews literature for best practice regarding scenario topic and provides input during feedback session listed above
4. Programmer – programs scenario in appropriate simulator software using pre-recorded vocals, standardized event menu, handlers and trends in a student driven format.
5. Documentation Developer – develops chart/EHR forms
6. Admission Ticket Developer – completes student admission ticket template
7. Debrief Template Developer – completes debriefing template
8. Pre/post Encounter Developer – develops pre/post encounter questions and after approval gives questions to Administrative Specialist to enter into simulation management system.
9. Review Question Developer – chooses standardized exam questions that correlate with simulation case
10. Team reviews and revises simulation case documents
11. Team participates in running scenario to test trends, cueing, etc., regarding flow of scenario and student interventions.
12. Programmer will make revisions in program as needed based on team feedback
13. Place scenario and supporting documentation in “Final Sim” folder on the CSC Share.
Scenario Revision and Validation Process:
1. During academic year simulation educators will note possible scenario revisions/improvements during student education sessions.
a. If a critical change is needed prior to the end of the semester, the team will vote on when the change should be implemented and determine assignments for changes and deadlines for making those changes.
NOTE: Critical need for change means that student education is compromised without making such change.
b. The update will be made and program or documents will be placed on CSC share drive in appropriate folder. With notification via mail to team describing changes.
c. All other revisions will wait until annual scenario review process.
2. Every May simulation educators will meet as a team to review scenarios for best practice and revise as needed.
a. Role assignments will be made to each team member
b. Scenario program will be run using different student interventions at different times. The following scenario items will be reviewed:
- Student interventions
c. Each portion of the scenario will be reviewed as a team and changes made by individual assigned to that role.
d. Old version if necessary will be moved to archived scenario folder.
e. All changes will be saved to the CSC share drive.
Standardized Patient (SP) Session Development and Scheduling Procedure
I. Purpose: To provide a scheduling procedure for the Clinical Simulation Centers (CSC) located at the Roanoke Higher Education Center (RHEC) and the Radford University West (RU West) Campus. To schedule the appropriate number of students per session per site that will provide each student with a focused learning experience and time for individual reflection.
II. Orientation Expectation: All students must be oriented to the CSC prior to participating in clinical scenarios. A general orientation will be provided by the CSC staff at your School of Nursing. A site and equipment specific orientation will be provided during the fundamental training session and/or pre-simulation as needed to prepare student for simulation experience.
III. Available Time Slots:
1) High Fidelity training sessions are 3 hours in duration scheduled Monday through Friday.
a. First session RU West and RHEC 0745 – 1100
0745 - 0800 students complete pre-encounter survey. CSC educator review admission tickets
Scenario start time 0800.
b. Second session RU West 1115 – 1430
1115 - 1130 students complete pre-encounter survey. CSC educator review admission tickets
Scenario start time 1130
c. Second session RHEC 1145 – 1500.
1145 - 1200 students complete pre-encounter survey. CSC educator review admission tickets
Scenario start time 1200
d. Flexibility in session times may be negotiated with CSC educator if necessary to accommodate student schedules
2) Mid-Fidelity training sessions will be negotiated with your CSC educator or CSC director.
3) Standardized Patient (SP) times will be scheduled in 30-minute to 1.5-hour blocks of time dependent on encounter objectives and encounter time. SP encounters are typically a one-on-one experience with the student and the SP. See SP Specific scheduling policy.
IV. CSC site contact information:
RU West Center: Radford University, New River Community College and Wytheville Community College
Margaret Mullins, MSN
Christina Keller, MSN
Jackie Muir, Admin
RHEC Center: Radford University, Jefferson College of Health Sciences, Patrick Henry Community College and Virginia Western Community College
Millie Sowder, MSN
Lisa Foote, FNP
Roy Baugher, Admin
1) CSC educator will contact SON faculty in May for the fall semester and in December for the spring semester to assign dates and times for CSC experiences for the following semester.
Each individual SON faculty will negotiate with each other to determine which clinical group will use the assigned session times.
2) The CSC prioritizes session availability as follows:
a. Number of sessions depends on SON enrollment numbers and SON faculty requests.
b. Every effort will be made to meet requests.
3) The SON faculty will need to provide individual student names per scheduled CSC session to the CSC educator a week prior to the first scheduled session for that clinical specialty. August or early September for fall semester and January for spring semester.
4) CSC educator will send SON faculty admission tickets per scenario.
5) SON faculty are responsible for sending admission ticket documents to students at least one week prior to scheduled CSC time.
6) CSC educator will place session times on outlook calendar.
7) CSC educator or CSC administrative specialist will add student names to outlook calendar.
8) CSC administrative specialist will schedule sessions in simulation management system (Orion).
9) Specifications for sending students home without completion of simulation training experience:
a. Students will be sent home if they arrive late. The CSC educator (or designee) will notify SON faculty that student did not arrive on time to participate.
b. Students without completed admission ticket will not be allowed to participate in simulation. The CSC educator (or designee) will notify SON faculty that student was not prepared for simulation training experience.
c. Rescheduling students for training sessions due to tardiness and unpreparedness will be limited. SON faculty will negotiate rescheduling with CSC educator dependent on scheduling time availability.
Supplies, Medication, and Equipment Procedure
I. Purpose: To provide a standardized patient encounter development and scheduling procedure for the Clinical Simulation Centers (CSC) located at the Roanoke Higher Education Center (RHEC) and the Radford University West (RU West) Campus. To schedule student learning encounters efficiently and economically.
II. Procedure for Standardized Patient Sessions:
1) School of nursing (SON) faculty will contact the CSC Director to discuss use of the CSC for SP education.
2) CSC Director will determine if the CSC can offer services based on fiscal resources for Schools of Nursing in the CSC regional partnership. Financial fees for SP education services offered to non-partnering institutions will be covered in education services quote.
3) SON faculty and CSC representative will develop the case to include but not limited the following components:
a. Case objectives
b. Case description and flow
c. Case feedback document
d. SP checklist
e. Student admission ticket (preparation document)
f. Student Pre-simulation checklist, Post-simulation checklist and/or post simulation survey as appropriate to case
4) SON faculty and CSC Director or designee will identify appropriate personnel to perform SP training.
5) SON faculty and CSC Director or designee will determine scheduling availability and CSC site location for SP experience
6) CSC Administrator in collaboration with SON Faculty requesting sessions will coordinate scheduling of SP sessions in regards to SP availability and student availability.
CSC SP Scheduling Coordinator
RU West CSC Administrator
RHEC CSC Administrator
7) CSC scheduling coordinator will send an email to student at least two days prior to scheduled encounter reminding them of their appointment date, time and any additional information pertinent to the scheduled encounter.
8) Schedule changes are acceptable prior to the day of the encounter if there are empty time slots available on the CSC calendar.
9) Scheduling issues the day of the encounter will be managed as follows:
a. A student “no show” (does not report to scheduled appointment and does not notify CSC) will not be permitted to reschedule their appointment at the CSC. The CSC scheduling coordinator will notify the SON faculty via email of the occurrence. If rescheduling is permitted a $50 fee will be charged to student. Payment must occur prior to completing rescheduled session.
b. Student attempts to change appointment the day of the encounter:
- If student is sick, they will be instructed to stay home.
- CSC scheduling coordinator will notify the faculty via email
- If student is sick the CSC coordinator will make every attempt to reschedule.
- If student is not sick – SON faculty will determine if the student should be rescheduled.
10) Students reporting late to their appointment will only have the time scheduled for their encounter to complete their experience (if encounter is scheduled for 30 min and they are 10 minutes late they will only have 20 minutes to complete the experience). This may significantly affect their ability to meet their learning objectives. The SP will indicate on their post encounter how many minutes late the student was for their scheduled experience. If the student is more than 15 min late, the will be considered a “no show”. See section 8 (a).
III. Procedure for use of Standardized Patient in manikin simulation sessions:
1) Simulation educators identify which high-fidelity manikin simulations will include an SP role to act as significant other to the manikin patient.
2) Simulation director will determine if fiscal resources are available to incorporate SP role into simulation training session.
3) Simulation educator and/or SP scheduler coordinator (Administrative Specialist) will coordinate SP schedule with high-fidelity session schedule and assign SP to session.
Clinical Simulation Center Student Expectations Agreement
Overview: The Clinical Simulation Center (CSC) is designed to provide the student with the opportunity to practice skills and problem solving in a simulated healthcare environment. The centers will provide the equipment and the resources to facilitate the student’s acquisition of competence with the skills to care for patients in the clinical setting.
Clinical Simulation Sessions: Students in a professional nursing program must function within the legal, moral, and ethical standards of the profession. The ability to utilize the nursing process is the major focus of the clinical simulation center. Therefore, each student must adhere to the following guidelines for your clinical simulation preparation and performance.
1. Attendance: Clinical simulation experiences are offered at specific times. Students are expected to be on time. NOTE: If you are late you will be sent home and your instructor notified. This is considered a missed clinical experience
2. Dress Code: The clinical simulation center adheres to your School of Nursing (SON) specific clinical site dress code - dress as if you were going to the hospital for a clinical rotation. NOTE: If you do not follow your SON dress code you will be sent home and your instructor notified. This will be considered a missed clinical experience.
3. Required Equipment: Stethoscope, penlight, bandage scissors, pen with black ink, and watch with second hand.
4. Personal Items:
a. There is no secure area to store personal items. b. Cell phones and pagers may not be used in the clinical simulation setting. Leave them at home/in automobile or turned off during your time in the center.
5. Prior to coming to the CSC: Review materials sent to you by your SON clinical instructor.
- Review clinical disease process(s)
- Medication administration literature specific to simulation-patient medication list.
- Review procedures for simulation-patient specific nursing interventions.
- Prepare for CSC session as you would for a hospital clinical experience.
- COMPLETE ADMISSION TICKET for each scenario.NOTE: If you do not bring completed admission tickets with you for your scheduled simulation experience you will be sent home and your instructor notified. This is considered a missed clinical experience.
6. Food and drink are not allowed in the CSC patient care areas.
7. CSC patient information is considered confidential and patient cases cannot be discussed outside the CSC clinical environment.
8. The CSC process includes audio-videotaping of the simulation activity. These video recordings may be used for follow-up instruction, orientation to the simulated environment, CSC tours and seminars.
By signing below, I acknowledge that I have read and understand the above expectations and agree to abide by the terms of this Agreement.
Revised May 2014