Scenario&Prepquestions
NR442 Community Health Nursing Simulation Scenario
Scenario
A community is being evacuated due to an approaching category 4 hurricane. Several families and individuals are being taken and arriving at a shelter to whether the storm. However after the initial registration the healthcare providers (2 nurses) are completing a walk through when they noticed 3 individuals that appear to be suffering from possible illness. Simulation Prebrief and Debrief question guide * Prebrief- Discuss the following ; o Discuss common/frequent community diseases and why/how they are transmittable. o Discuss triage process and disaster planning.
Triage is identifying and separating individuals quickly according to injury severity and treatment needed. Disaster triage focuses on sorting the greatest number of people as fast as possible. Triage performed at the site and again at the treatment area is very different from triage that is routinely conducted in the emergency department. The focus of disaster triage is to do as little as possible, for the greatest number, in the shortest time. One triage system that is used by first responders is START. START stands for “simple triage and rapid treatment.” This system describes what to do when first arriving at a multiple casualty or mass casualty incident. Disaster triage of an injured person should occur in less than 1 minute. This system also describes how to use people with minor injuries to help. As a decision is made regarding the status of an individual, the person is labeled with a colored triage tag. Green on the triage tag is for the walking wounded or those with minor injuries (e.g., cuts and abrasions) who can wait several hours before they receive treatment; yellow is for those with systemic but not yet life-threatening complications who can wait 45 to 60 minutes (e.g., simple fractures); red is considered top priority or immediate and is for those who have life-threatening conditions but who can be stabilized and have a high probability of survival (e.g., amputations); black is for the deceased or for those whose injuries are is so extensive that nothing can be done to save them (e.g., multiple severe injuries). o Discuss shelter uses- emergency, homeless, and special needs. o Discuss assessment skills and their importance.
It is important to assess to potential risk and to assess the people so that we can triage accurately. o Discuss communication skills and their importance.
The DHS established its Homeland Security Advisory System to build a comprehensive and effective communication structure for disseminating threat information to public safety officials and the public at large.
Early identification of ill or exposed persons, rapid implementation of preventive therapy, special infection control considerations, and collaboration or communication with the public are essential in controlling the spread of cases.
Communication is recognized as a very significant problem during disasters. Misinformation and misinterpretation can occur when communication is ineffective. Reliance on telephone systems or cell phones should not be the sole planned means of communicating because these may not work or the systems might be overwhelmed. The communication section of the disaster plan should address how the authority figure will be notified of the disaster, how the emergency management team members will be notified, how the community residents will be warned about the incident, and what actions to take. This section needs to address how communication between relief workers and authorities will be maintained. Also, it should include information on the role of the media in keeping people informed and in letting people know what assistance and supplies are needed. o Discuss PPE.
Personal protective equipment (PPE) refers to protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or infection. The hazards addressed by protective equipment include physical, electrical, heat, chemicals, biohazards, and airborne particulate matter. o Discuss medication reconciliation- why it should be done and its importance.
It should be done so that everyone is aware of all the medication the client is taking and so that there are no mistakes made. o Discuss what are precautions, how many are there, what are they for?- droplet, airborne, and contact.
For contact wear gown and gloves before touching patient. For airborne wear an N-95 fitted mask, gloves, gown and goggles. For droplet, wear a mar, gloves, gown, and goggles.
JV10/2014
1
Scenario&Prepquestions
Simulation Prebrief and Debrief question guide
Debrief- discuss the following; o Communication skills used and why. o Completion of full assessment- importance, difficulty level, improvement that can be made, technique. o How did you decide on PPE used? o How did you decide on precaution signs/isolation if required? o Did you educate your patient? How and why? o Medication reconciliation; assessment, did your patient understand why they were on their medications? Did your patient demonstrate understanding of medication regimen and compliance. o Student to prepare a report as if providing a healthcare provider with a report on the patient.
