NR452 Multi-Client Simulation: Student Instructions

Scenario Overview

This simulation involves two clients:

Client 1: Maria Hernandez

• Age: 81 years old
• Diagnosis: Urinary Tract Infection (UTI)
• Current Condition:
  • Recently admitted from the Emergency Room (ER)
  • Experiencing acute confusion and altered vital signs:
    • Temperature: 101.6°F
    • Heart Rate: 110 beats per minute
    • Respiratory Rate: 20 breaths per minute
    • Blood Pressure: 96/60 mmHg
  • Orientation: Alert and oriented to person and place only (AxOx2)
  • Additional Information: Her daughter reports that Maria has not been eating or drinking well.
  • Timeframe: The scenario takes place on Monday at 1400 hours.

Client 2: Keola Akana

• Age: 71 years old
• Diagnosis: Acute left-sided heart failure
• Current Condition:
  • Admitted directly from his healthcare provider via urgent transport.
  • Weight:
    • Current weight: 217 pounds
    • Previous weight (2 days ago): 210 pounds
  • Timeframe: The scenario takes place on Monday at 1400 hours, approximately 45 minutes after his arrival from the provider’s office.

Purpose of the Simulation

This simulation exercise is designed to enhance your ability to manage multiple clients with varying conditions. The simulation will provide you with an opportunity to apply critical thinking, prioritize care, delegate tasks, and collaborate with interdisciplinary team members in a controlled and realistic environment.

Student Roles During Simulation

During the pre-briefing, you will be assigned one of the following roles. Your role will dictate your responsibilities and actions during the simulation.

1. Charge Nurse (Registered Nurse)
   • Role Overview: The charge nurse is responsible for the overall organization and management of safe, high-quality client care.
   • Key Responsibilities:
     • Serve as the team leader and primary point of communication for the care team.
     • Delegate tasks appropriately to other members of the interdisciplinary team.
     • Communicate with the physician, ancillary support services, and other healthcare providers as needed.
     • Be knowledgeable about each client’s condition and be prepared to dictate orders and assist with their implementation.
     • Prioritize care needs and anticipate future requirements for each client.
2. Staff Registered Nurse (Assessment/Documentation/Medications)
   • Role Overview: The staff nurse is responsible for conducting comprehensive assessments, recording all client activities, and ensuring the safe administration of medications.
   • Key Responsibilities:
     • Perform thorough assessments of both clients.
     • Document all client-related activities and interventions accurately.
     • Administer medications safely and monitor for any adverse reactions.
     • Prioritize client care and execute necessary independent interventions.
     • Collaborate with other interdisciplinary team members to meet the clients’ needs.
     • Continuously monitor the clients for any changes in their condition and respond accordingly.
3. Licensed Practical Nurse (LPN)
   • Role Overview: The LPN provides safe and competent care under the supervision of a registered nurse, within the scope of LPN practice.
   • Key Responsibilities:
     • Administer medications and treatments as per the care plan.
     • Collaborate with the registered nurse and other team members to ensure effective client care.
     • Be aware of the limitations of the LPN role and avoid performing tasks that require the judgment, skill, or knowledge of a registered nurse.

Preparation and Participation

• Pre-briefing: Attend the pre-briefing session to understand the scenario details, review the patient information, and discuss the roles and responsibilities with your team.
• Simulation: Actively participate in the simulation by performing your assigned role to the best of your ability. Use critical thinking to prioritize tasks, delegate responsibilities, and ensure safe and effective care for both clients.
• Post-Simulation Debriefing: After the simulation, participate in the debriefing session to reflect on your performance, discuss what went well, identify areas for improvement, and apply lessons learned to future clinical practice.

This simulation is an essential component of your NR452 Capstone Course, designed to prepare you for real-world nursing practice by enhancing your ability to manage complex clinical scenarios involving multiple clients.