|
Public
|
Nursing Students |
|
Prior knowledge of the learner
|
Skills in caring for patients with suspected sepsis |
|
Learning objectives
|
Primary: recognize the risk of sepsis and make decisions. Secondary: collect data in order to identify the patient with suspected sepsis; communicate effectively with the patient and their family members in search of signs and symptoms suggestive of sepsis; when suspecting sepsis, open a protocol and call the medical team; perform and prioritize nursing care. |
|
Simulation time
|
Briefing: 5 minutes; Scenario: 15 minutes; Debriefing: 30 minutes |
|
Human Resources:
|
Three monitors to assume the following roles: simulated patient (high-fidelity simulator control room); doctor who will appear when requested by the nurse; patient’s child; two teaching facilitators with experience or training in simulation. |
Material resources/equipment |
Hospital bed with side rails, bedding, pillow, gas ruler, auxiliary table, two-step ladder, hospital gown, parrot, serum holder, infectious waste, sealed emergency trolley, procedure and sterile gloves, antiseptics, equipment personal protective equipment, gauze, stainless steel tray, saline, glucose and ringer lactate solutions, needles (40×12; 30×7; 13×45 mm), heparinized syringe, syringes (3, 5, 10, 20 mL), equipment of serum and two-way connector, label for serum identification, hypoallergenic microporous tape, tourniquet, flexible catheter for venipuncture (#20, 22), transparent film, sachet of 70% alcohol, antibiotics and analgesics, flasks for blood culture, tubes for blood collection, kit for indwelling urinary catheter, electrodes, multiparametric monitor, stethoscope, sphygmomanometer, pulse oximeter, spectacle-type nasal oxygen catheter, oxygen humidifier, distilled water, discharge patient simulator dummy fidelity. |
|
Documentation
|
Medical prescription, nursing record, sheet with laboratory results: blood glucose: 90 mg/dL (RV: 65 to 99 mg/dL); leukocytes: 25,100/cell.mm3 (RV: 5,000-10,000 mm3); lactate: 2.5 mmol/L (RV: 0.3-2.4 mmol/L); imaging exam with report (abdominal tomography): moderate-volume ascites and densification of the peritoneal adipose planes (inflammatory process); splenomegaly. |
|
Scenario preparation
|
|
Theme: Sepsis with abdominal focus. Scenario fidelity: High fidelity. Characterization of actors/collaborators: Laerdal SimMan® Traditional high-fidelity patient simulator, featuring hospital-appropriate attire (gown with open back); patient’s son (monitor wearing jeans and a short-sleeved shirt); doctor (monitor wearing jeans, short-sleeved shirt, and white coat). Physical space: The scene takes place in an environment characterized as the box bed of the emergency unit. Scenario complexity: Medium complexity. Expected actions: confirmation of the clinical case for sepsis, opening of the protocol and start of the first hour package. Previous skills: biosafety principles, measurement and analysis of vital signs, physical examination, communication and interaction with the patient, analysis of data provided by the patient, family, exams, medical records. |
|
Scenario development:
|
|
Clinical case description
|
JRS, male, 65 years old, married, with a history of type 2 diabetes mellitus controlled with diet and regular physical activity. He was admitted to the emergency room accompanied by his son and previous history of hospitalization for laparoscopic cholecystectomy with hospital discharge two days ago. One day ago, oliguria and abdominal pain with the use of analgesics (paracetamol) at home. According to the son, today the patient woke up with a fever of 38oC and worsening abdominal pain, tachypnea and talking about strange things. |
|
Medical record information
|
Clinical History: Type 2 diabetes mellitus, laparoscopic cholecystectomy. Denies allergies. Medications in use: Paracetamol every 6 hours in the last 24 hours. Anthropometric data ; Body mass: 85kg |
|
Devices attached to the simulator
|
Hospital gown, identification wristband, orange color risk rating wristband |
|
Debriefing
|
Structured |
|
Assessment
|
Students’ practical performance |
