2. Example: Changing Multiple Choice, T/F question into a scenario. Original version: You should gel your hands before you interact with each patient? True False Scenario version: David and Tanya carpool and park in the garage each day. As they leave the car, they get on the elevator and then proceed across the bridge to the Medical Building. They press the elevator button, board the elevator and go up to the 4th floor. As they get off the elevator, they use their card to open the staff entrance door and proceed to the staff room where they hang up their coats and put their bags away. They then make their way over to the department nursing station, gel their hands and pick up their first patient chart for the day. Did David and Tanya do the right thing? Yes: (incorrect) Once they approached the nursing station it was probably a good idea to gel their hands, however they should have done this step at the first dispenser they came across. Our facility has hand sanitizer dispensers at each entrance to each building, near time swipe stations, near elevators, etc. No: (correct) No, David and Tanya should have performed hand hygiene at the first dispenser they came across. Our facility has hand sanitizer dispensers at each entrance to each building, near time swipe stations, near elevators, etc. Maybe: (incorrect) Once they approached the nursing station it was probably a good idea to gel their hands, however they should have done this step at the first dispenser they came across. Our facility has hand sanitizer dispensers at each entrance to each building, near time swipe stations, near elevators, etc.

3. Challenge: Describe the situation here/introduce the challenge/use a question to trigger ideas Explain/Illustrate Choice AExplain/Illustrate Choice BExplain/Illustrate Choice C Feedback – Correct Answer Feedback – Incorrect Answer Remedial Information This area is required Not required, but recommended One challenge can use info to lead to another challenge

4. Challenge: David and Tanya carpool and park in the garage each day. As they leave the car, they get on the elevator and then proceed across the bridge to the Medical Building. They press the elevator button, board the elevator and go up to the 4th floor. As they get off the elevator, they use their card to open the staff entrance door and proceed to the staff room where they hang up their coats and put their bags away. They then make their way over to the department nursing station, gel their hands and pick up their first patient chart for the day. Did David and Tanya do the right thing? Explain/Illustrate Choice A No they did not. Explain/Illustrate Choice B Yes they did. Explain/Illustrate Choice C Maybe, I’m not really sure. Feedback – Correct Answer No, David and Tanya should have performed hand hygiene at the first dispenser they came across. Our facility has hand sanitizer dispensers at each entrance to each building, near time swipe stations, near elevators, etc. Feedback – Incorrect Answer Once they approached the nursing station it was probably a good idea to gel their hands, however they should have done this step at the first dispenser they came across. Our facility has hand sanitizer dispensers at each entrance to each building, near time swipe stations, near elevators, etc. Feedback – Incorrect Answer Once they approached the nursing station it was probably a good idea to gel their hands, however they should have done this step at the first dispenser they came across. Our facility has hand sanitizer dispensers at each entrance to each building, near time swipe stations, near elevators, etc. Remedial Information This falls under Our Commitment to Put Patients First and is outlined in Policy #1254 Note: when providing feedback you can give 1 correct and 2-3 incorrect,or 1 correct and 1 incorrect and 1 neither quite right/quite wrong as in this example FEEDBACK ANSWER TO CHOICE C

5. Challenge: Your 78 year old, female patient, Mrs. Tyler is experiencing severe abdominal pain. She has been ordered HYDROmorphone IV 0.4 mg to 0.8 mg q2 hours prn. You have 1mL vials of HYDROmorphone 2mg / mL available to you. You decide to give HYDROmorphone 0.4 mg. What volume of HYDROmorphone 2 mg / mL contains the correct dose of HYDROmorphone 0.4 mg? Explain/Illustrate Choice A 0.2 mL Explain/Illustrate Choice B 0.6 mL Explain/Illustrate Choice C 0.8 mL Feedback – Correct Answer You can give this amount to Mrs. Tyler. You should still monitor her closely as she is elderly and there is still the potential that she will experience an increased level of sedation and respiratory depression. Feedback – Incorrect Answer Better check your calculation again. You may have caused harm to Mrs. Tyler had you given her this dosage. The amount you chose is significantly higher than should be given and she may have experienced increased sedation and respiratory depression. Feedback – Incorrect Answer Better check your calculation again. You may have caused harm to Mrs. Tyler had you given her this dosage. The amount you chose is significantly higher than should be given and she may have experienced increased sedation and respiratory depression. Remedial Information Calculation: 2 mg = 0.4 mg 1 mL X mL X = (0.4 mg X 1 mL) divided by 2 mg X = 0.2 mL Volume of 0.2 mL equals 0.4 mg of HYDROmorphone Note: when providing feedback you can give 1 correct and 2-3 incorrect,or 1 correct and 1 incorrect and 1 neither quite right/quite wrong as in this example FEEDBACK ANSWER TO CHOICE C