Improving Care Delivery to Patients Through Multiple-Patient Simulation Experience

Simulation-based learning is part of the standard curriculum in many nursing programs across the nation. However, most simulation experiences focus on single-patient scenarios. This focus does not reflect the reality of professional clinical settings, in which nurses take care of multiple patients simultaneously. Caring for multiple patients can be challenging for even the most experienced registered nurses (RN). Because improving patient safety provided by new RN's is crucial, preparing student nurses for clinical practice by offering them opportunity to provide care to multiple patients concurrently in a safe atmosphere promotes safe and of high quality care and addresses concerns regarding new-nurse inexperience. Growing evidence asserts the benefits of multiple-patient simulation for nursing students. For example, Ironside, Jeffries, and Martin (2009) found nursing students' patient safety competencies improved significantly when participating in multiple-patient simulation. In addition, Kaplan and Ura (2010) report that student nurses who experienced multiple-patient simulation were better able to bridge the gap between the role of nursing student and that of practicing nurse. Prior to this project, there has not been a multiple-patient simulation program for College of Nursing (CON) students at Brigham Young University (BYU), which limited learning and applicability to real world experience. The purpose of this project was to improve care delivery to patients through a simulation experience of caring for multiple patients. Objectives of this project were: 1) Develop a multiple-patient simulation scenario for Baccalaureate CON students at BYU, including pre and post-questionnaires; 2) Administer a pilot program of multiple-patient simulation scenarios at BYU, including pre and postquestionnaires; 3) Disseminate findings of the multiple-patient simulation experience to the Baccalaureate faculty at BYU, with recommendations to implement multiple-patient simulation as part of the program curriculum. Multiple-patient simulation scenarios were developed consisting of three patients presenting typical illnesses addressed on a medical-surgical floor. These included a patient with diabetic ketoacidosis (DKA), a postoperative partial gastrectomy patient, and a patient with chronic obstructive pulmonary disease (COPD). Content experts reviewed and approved the scenarios, IRB approval was obtained, and the pilot program was administered to BYU Baccalaureate CON students. The students completed a pre and post-questionnaire regarding their simulation exercise. Results from the pre and post-questionnaires demonstrated that following their participation in the simulation experience, students experienced increased positive attitude, motivation, and knowledge of the content involved in multiple-patient scenarios. Using a 5- point Likert scale, differences between the pre and post-questionnaire were calculated for each statement. Scores for each item improved from the pre to post-questionnaire. Student feedback was overwhelmingly positive and enthusiastic. Students expressed that they found the multiple-patient simulation experience to be beneficial to their learning as it helped with critical thinking and was more representational of clinical settings. They felt like additional multiple-patient simulations would be beneficial to their education