Scholarship & Research
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Item Improving preeclampsia outcomes: a high-fidelity simulation for undergraduate nursing students(Montana State University - Bozeman, College of Nursing, 2023) Tonkin, Katlin Rose; Chairperson, Graduate Committee: Sandra KuntzPreeclampsia, a hypertensive disorder of pregnancy, commonly affects women and fetuses/neonates, significantly increasing the risk for morbidity and mortality. Underutilization of evidence-based practice standards intensifies complications. Montana has limited resources to care for high-risk pregnancies, especially in rural areas of the state. However, patient outcomes can be improved with standardized care and collaboration. Therefore, it is imperative that all hospitals in the state join forces to improve evidence-based practices for obstetric patients. This quality improvement (QI) teaching project aimed to inform future advocates, nursing students, of the evidence-based guidelines and collaborative tools available in Montana to care for maternal-fetal patients with preeclampsia. The QI project adapted a preeclampsia-focused high-fidelity simulation (HFS) scenario in collaboration with a school of nursing in Montana. The purpose of the HFS scenario was to aid undergraduate nursing students in developing knowledge, psychomotor (technical), and affective (values) skills to manage intrapartum care for a patient with preeclampsia. Senior-level nursing students participated in the simulation process including preparation, pre-briefing, scenario, and debriefing. The students were evaluated on meeting the safe-care measures for an HFS patient with preeclampsia while monitoring for fetal intolerance to labor. Qualitative data were collected based on Kirkpatrick's Four Levels of Training Evaluation tool. The data revealed the students' reactions to the simulation process, plans to apply what was learned, and how the teaching modality helped achieve the learning objectives. The QI teaching project subjectively and objectively improved the students' knowledge, psychomotor skills, and values in caring for a maternal-fetal patient with preeclampsia. Students were also provided with reference materials to use as registered nurses in the event of caring for patients who develop preeclampsia in healthcare facilities throughout Montana.Item The evidence-based benefits of a dedicated simulation lab coordinator for a rural nursing program(Montana State University - Bozeman, College of Nursing, 2023) Garcia (Valdez), Jamie Michelle; Chairperson, Graduate Committee: Sandra KuntzProblem/Purpose: The pandemic created extreme challenges for the healthcare workforce and impacted the availability of clinical placement sites for students. Student nurses accustomed to direct patient care experiences at a hospital or clinic site were barred from these settings and redirected to learn skills exclusively in simulation labs and online environments. Initially unprepared to educate and account for all required clinical hours for multiple cohorts of students, faculty were forced to take stock of their resources, keep students safe, and prepare for the unpredictable and lengthy COVID-19 event. This project aimed to establish the evidence-based benefits of a dedicated sim lab coordinator/educator and describe the role and expectations of a dedicated sim lab coordinator for a rural-based nursing program. Procedure: A microsystem assessment of the Community College Nursing Program (CCNP) and a review of pertinent literature identified the value of a dynamic, well-managed, and expertly staffed clinical simulation lab as a possible solution. Results: This project addressed the need for simulation preparation training and implementation among faculty by utilizing the education outlined in the simulation handbook. This education provides a foundation for simulation implementation for faculty. In addition, the implementation of simulation with the National League for Nursing (NLN) simulation template is utilized by all faculty to provide consistent simulation methods for students at the CCNP. By using a standardized template and having faculty educated in the development and implementation of simulation, the nursing students will gain clarity regarding what to expect and how to prepare for the simulation. Ongoing assessments of the simulation program are conducted using faculty and student evaluations, thus allowing the CCNP to facilitate changes and improvements as deemed necessary. Conclusions: Expected outcomes include consistency in simulation education and implementation. A well-prepared simulation coordinator manages the lab, educates faculty and students, and creates an environment where academic and clinical learning confidence is nurtured. A coordinator guided by evidence-based best practices provides controlled, managed, and consistent clinical learning experiences for students and fosters readiness for practice as registered nurses.