SIMULATION
Incorporating Disclosure of Adverse Events into Simulation Learning Experiences
Bonnie Haupt, DNP (C), MSN, RN, CNL, CHSE defines disclosure of adverse events and efforts to incorporate best practice components of disclosure into community scenarios.
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Our Mr. Sims, VA Connecticut. Image Credit: Bonnie Haupt.
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r. Sims is a 78 year old white male who presents to the Emergency Room with signs and symptoms of pneumonia. Sims’ wife states he has had increased shortness of breath, a wheezy cough and fever for several days. His vital signs and monitor readings are: oxygen saturation 88-91%; blood pressure 90/50; elevated respiratory rate of 36 and heart rate of 120 sinustach. The team collaborates and believes Mr. Sims is exhibiting signs and symptoms of sepsis requiring transfer to Medical Intensive Care Unit (MICU). After arrival in the MICU, Sims has continued hypotension (BP 70/40), requiring IV pressors and placement of a triple lumen catheter. The new line is established. While awaiting
X-ray placement for confirmation the ER patient experiences increased respiratory rate over 40 and heart rate in the 160s. His wife is expressing concerns to the team that her husband just doesn’t “look right.” Suddenly Sims complains, “I don’t feel right. I can’t catch my breath.” He begins to de-sat quickly and becomes unresponsive. It is identified there are no respirations and no pulse. The case study reviewed above is a typical simulation scenario that is practiced in many simulation centers across
MEDSIM MAGAZINE 4.2013
22/11/2013 15:47