Table 3: Sample Lesson Plan for Teaching Acute/Critical Care Nursing Concepts Using Simulation

Table 3: Sample Lesson Plan for Teaching Acute/Critical Care Nursing Concepts Using Simulation

Table 3: Sample Lesson Plan for Teaching Acute/Critical Care Nursing Concepts Using Simulation (continued)

Learning Activity #3 Nursing management of a patient with acute coronary syndrome with positive or negative patient care outcomes
Learning Objectives / Learning Outcomes
1. Assess students’ knowledge, skills, and attitudes surrounding the management of a high-acuity, acutely-ill, and complex patient
2. Enhance students’ critical thinking, clinical reasoning, communication, and leadership skills as they relate to solving or addressing complex patient care issues
3. Build students’ self-confidence related to “taking-charge” of patient care including delegating and working with a team /
  1. Implements nursing process effectively
  2. Uses SBAR system to communicate with peers, RN, MD, and APN
  3. Accurately documents assessment findings, interventions, and significant events
  4. Demonstrates leadership and teamwork
  5. Assesses individual, group, and leader’s performances.

Case Scenario / Student’s Preparation* / Simulation Process
A patient diagnosed with acute coronary syndrome (NSTEMI), with the following potential complications/clinical outcomes – VT/VF, acute pulmonary edema, or death / Students will review the following:
  1. Review the pathophysiology of acute coronary syndromes – STEMI versus NSTEMI
  2. Know the rationale of ST segment elevation and depression
  3. Differentiate stable from unstable angina, including expected symptoms/assessment findings
  4. Know the rationale of the following interventions/medications (What are the indications of these? Why are they being administered to patients with ACS/MI)?
  5. Fluid management bolus-what type of IV fluid, when to administer and when not to administer
  6. What does the acronym MONA stand for (Morphine, Oxygen, Nitroglycerine, and Aspirin)? When should you use this as a guide?
  7. Lidocaine and amiodarone
  8. Review VT, VF and Asystole - know how to identify these on a cardiac monitor and the appropriate interventions for these, including medications:
  9. Always remember A-B-C-D’s of life support when confronted with these types of patients.
  10. When should you transfer these patients to the ICU?
  11. Review acute heart failure/pulmonary edema:
  1. What is the typical presentation of a patient experiencing an acute pulmonary edema? What are the physical examination findings?
  2. What nursing interventions should be employed by the nurse? (Know how to prioritize these)
  3. Know the rationale of the following interventions and medications: positioning; oxygen; diuretics; nitrates; inotropes; ACE/ARB; and others
  4. Measurements of preload, afterload, and contractility
  5. Direct versus indirect/derived measurements of hemodynamics
  1. Review SBAR system for communicating urgent
situations /
  1. Instructor will use high-fidelity patient simulation to simulate patient problems
  2. Students will apply (and synthesize) their knowledge, skills, and attitude surrounding bedside head-to-toe assessment, environmental assessment, ECG and hemodynamic monitoring, pathophysiology, pharmacology, clinical reasoning, communication, leadership, delegation, teamwork, and appropriate caring practices

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Note.*Students are provided with study guide a week prior to the scheduled simulation activity

Abbreviations: ACE (angiotensin converting-enzyme), ACS (acute coronary syndrome), APN (advanced practice nurse), ARB (angiotensin receptor-blocker), ECG (electrocardiogram), ICU (intensive care unit), MD (physician),MI (myocardial infarction), NSTEMI (non-ST-segment elevation myocardial infarction), RN (registered nurse),SBAR (situation, background, assessment, response/recommendation), STEMI (ST-segment elevation myocardial infarction), VF (ventricular fibrillation), and VT (ventricular tachycardia)

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