1. Pediatric Competency Development
Bridget Mudge, RN, MS Judy Kertis RN BSN
Pediatric Clinical Nurse Specialist

2. Objectives
Determine didactic content
Creating scenarios
Integrating core practice issues in to simulations
Evaluating performance

3. OVERVIEW: Pediatric Nurse Residency
4 components.
16-week program.
Each week two (2) class days:
Web-based learning.
Didactic with experts to review institutional specific.
Followed by simulations.
Two days of eight-hour clinical; then progresses to 12 hours after 8 weeks.

4. Orientation Content: Clinical Orientation
Identify common patient diagnosis (e.g. Neuro, Oncology, Resp distress: RSV)
Problem prone areas ( Medication delivery, Isolation)
Skills or tasks ( Blood administration)

5. Complex skills or infrequent skills ( Chest tubes)
Orientation Content
Complex skills or infrequent skills ( Chest tubes)
High Risk: Sedation
Clinical Questions asked ( How do you evaluate seizures)
New processes or skills
National patient safety goals
Feedback

6. Simulation Additional Uses
Add National Safety Goals:
Medication safety.
Patient Identification.
Clinical Alarms.
Verbal Orders.
Critical Labs.

7. PROGRAM COMPONENTS: Pediatric Nurse Residency
Web-based:
Pediatric intensive-care course developed by Indiana University (

8. WEB-BASED LEARNING MODULES: PEDIATRIC CRITICAL CARE
Psychosocial Renal/Endocrine
Respiratory GI
Cardiovascular Neurology
Multi-system Comfort
Hematology/Oncology Immunology

9. COMPONENT OF PROGRAM: DIDACTIC
Didactic with specialist/ unit experts:
Respiratory: CF, Asthma, RSV.
Pain Management: Assessment Tools, PCA,
Epidurals, Pain Free Program.
Developmental Aspects: Chronic Illness, Bereavement.
Cardiac: CHF, Cardiac Cath Postoperative Care.

10. COMPONENT OF PROGRAM: DIDACTIC
Family-centered Care.
Wound and Skin: Braden Q.
Nutrition: Feeding Techniques, Formula,
GU Care.
Responding to Medical Emergencies.
Orthopedic Care.
GI Care.

11. COMPONENT OF PROGRAM: DIDACTIC
Diabetic Care: Management and Teaching.
Organ Donation.
Pre- and Post-Op Care.
Child Abuse.
Communication: SBAR.
Transfer and Discharge Planning.
IV Central Line Care.
Newborn.

12. COMPONENT OF PROGRAM: DIDACTIC
Trauma Care.
PICU Specific:
Ventilators,
EKG monitoring, Defibrillator,
IV Therapy,
Vasoactive Medications,
ICP,
Hemodynamic Monitoring.

13. SIMULATIONS:
Simulation Development
Who, What?
Sample:
Airway Management.
RSV.

14. Simulations Seizures. EEG Monitoring. Responding to
Medical Emergencies
Documentation
Admission
Trauma
Diabetes

15. Simulation development
Diabetes:
Who: Unit experts
What:
Frequently asked questions of the expert
Chart review for orders
Review of standards of care for diabetes
Patient Education

16. Simulation development
RSV
Review of standards and skills
Isolation
Room set up
Nasal cannula application
Patient Education

17. Simulation development
Time out
SBAR
Team building

18. Securing lab and Sim Baby.
CHALLENGES:
Logistics:
Ideal number of new grads.
Schedule:
Presenters.
Preceptors around fixed classes.
Securing lab and Sim Baby.

19. How complicated to make scenarios? Scenarios consistent?
CHALLENGES:
Simulation:
How complicated to make scenarios?
Scenarios consistent?
Ideal class size?

20. CHALLENGES: What is best done in simulation?
Responding to
medical
emergencies.
Skin Care
and
Diabetic Education
versus

21. Evaluation
What are critical Clinical Behaviors?
Objective information
Experts evaluate
Final Simulation = Integration of skills
Pass / Fail

22. Increased proficiency and accuracy with technical skills.
OUTCOMES:
Increased proficiency and accuracy with technical skills.
Developed skills as team members.
Developed relationships with the clinical experts and learned to utilize a variety of resources.

23. OUTCOMES:
The simulations became a place to learn about safety and how errors can and do occur.
Experienced staff members stated an increase in their own knowledge by their participation in the didactic.

24. Pediatric Residents

25. Global Scores for Pediatric Residents

26. Utilizing a nurse residency program provides:
CONCLUSIONS:
Utilizing a nurse residency program provides:
Opportunities to become safe, competent
caregivers.

27. CONCLUSIONS:
Receive immediate feedback on scenario vignettes and quizzes to enhance individual learning and review.
Human patient simulation supports the organizational initiatives related to patient safety and addresses the unique needs of the pediatric population.