By Suzi Birz, Principal, HiQ Analytics
In the beginning, there was Resusci-Annie, the
“lifelike” mannequin used in CPR training. Now, virtual patients are
being used to train health care providers around the country on steps to
take in a variety of emergency situations. Today’s virtual patients even
allow nurses to practice with virtual needles in a computer-based
environment with simulated patients. These simulations are used in nursing
and medical schools as well as continuing education and refresher training
at hospitals and other facilities.
Computer-based simulation allows for the development or practice of vascular procedures such as IV insertion or blood drawing. One
such simulation product, Immersion Medical’s CathSim® AccuTouch®
System, requires the user to determine the site for the insertion, the
sequence of steps and the size of the catheter before rewarding the user
with the feel of tissue resistance, the pop of the needle entering, the
return of blood flow and audio feedback from the virtual patient.
CathSim includes teaching aids of video, transparent
anatomy, cross-sections, playback and evaluation, which allow the user to
understand anatomically where the veins reside. Views are customized to
the selected patient scenario. The virtual patients or scenarios represent
varying ages, including pediatric, adult and geriatric, and clinical
conditions, such as dehydration or drug addiction. The evaluation/report
card includes several ratings, including a “pain factor.” Realistic
training in a risk-free environment improves patient safety and reduces
risk of error.
CathSim in Nursing School
In 2002, in an effort to “enhance dummy arms,”
Madisonville Community College (MCC), in Madisonville, Kentucky,
implemented the CathSim to provide a hands-on experience to its nursing
students.
“The more experiences we could provide the nursing
students, the more capable our graduates would be,” explained Linda
Thomas, RN, MSN, division chair of nursing at Madisonville Community
College.
The MCC faculty has not had difficulty learning and
adapting the curriculum to include the CathSim, Thomas said.
“The simulation works so well, and its use is
expanding in so many areas, that accreditation bodies are expressing the
desire to see it included,” she added.
MCC is using the simulators in the respiratory and
radiology programs as well as the nursing program. Thomas said she is
looking forward to a time when she can include more needlestick scenarios
as well as simulations for other procedures.
Additionally, Thomas noted that while the primary
motivators for using simulators were to increase nursing students’
confidence and self-directed learning, the benefits of the technology have
had far greater reach. MCC has used simulators in meetings with community
leadership groups, which have all reacted positively to the innovative use
of technology. In addition to community awareness, the technology has
gained notice among prospective students.
CathSim in the Hospital
Whether it’s with staff new to a hospital or a role or new to nursing, Dana Etzel-Hardman, RN, BSN, CPN, training and education
specialist at Children’s Hospital of Pittsburgh (CHP), in Pittsburgh,
Pennsylvania, has found the scenario-based CathSim to increase confidence
and provide an effective practice environment for all nurses.
When first taking on her position, Etzel-Hardman found that IV skills were taught via self-learning with a packet and a video.
She also discovered a carton with the CathSim inside, which she decided to
put to use in a new training program. Now, nurses at CHP attend a
four-hour class that includes lectures, dummy arms and the CathSim. The
program has been well-received and the nurses have become familiar and
comfortable with computers and the simulator.
Etzel-Hardman stated that the scenarios are especially important in a pediatric environment, where “you will not always find a
17-year-old that has been pumping iron.” Acknowledging that veins will
not always be easy to find, the CathSim provides vein sizes for infants,
toddlers, pre-school and older children.
CHP also takes advantage of the portability of the
CathSim. The simulator is brought to the floors to allow nurses an
opportunity to practice as they enter a new clinical care area or as a
refresher. At CHP, the patient care technicians draw blood; the CathSim is
available to them as well.
The Overall Benefit
“Medical simulation exposes nurses to potential
real-life situations. It prepares them with the basic understanding and
proper steps while transferring the skills and techniques from classroom
learning to clinical experience,” said Kevin Kunkler, M.D., medical
director for Immersion Medical. "Medical simulators are an affordable
way for nursing schools to improve training programs, reduce costs and
allow nurses to learn in a comfortable and lower stress environment
without risk to patients.”
Take-Away Messages
“Students of today are comfortable with computer-based
tools,” Thomas said. “I encourage students: The more you work with a
simulator, the better you will be. You have the opportunity to have more
access to realistic scenarios from which to learn.”
Etzel-Hardman also urged nursing schools to look at
simulation.
“Nursing school curricula are full of so many things
and may have limited hands-on,” she said. “Use simulation as hands-on
practice, to enhance critical thinking and decision making, and to take
away anxiety.” Resources
Immersion Medical
Madisonville Community College
Children's Hospital of Pittsburgh
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