Improving Nursing Experiences

Nurses often play a crucial role in caring for individuals with altered mental status, focusing on safeguarding their well-being and ensuring a safe environment. As you journey through the Oxford Medical Simulation (OMS) scenario, you will use existing nursing knowledge, clinical reasoning, and professional guidelines to address the complex needs of an individual. This immersive experience allows for a safe space to practice skills and communication strategies as you assess varying factors influencing an individual’s overall health. Note: Each scenario is confidential, including your performance and activities. Sharing information denies peers the opportunity to develop their own clinical judgment and critical thinking skills. You are expected to keep scenario details classified.

After you have completed the OMS scenario, you will engage in a debrief activity to help you reflect on your personal experience. This debrief, which is different than the optional reflection questions in the OMS scenario, will take you through a nurse’s thought process of noticing, interpreting, responding, and reflecting. Through this process, you can improve skills that result in the improvement of health outcomes.

Scenarios are time-limited and displayed on the wall clock behind the patient or on the computer in the room. For additional information, please see the Oxford Medical Simulation Student Guide found in the Oxford Medical Simulation area of the course.

Simulation Attempt Policy:

You may complete the simulation up to two times.
Your highest score will be recorded, provided both attempts are completed in good faith.
A good-faith attempt means you take time to fully work through the scenario, make thoughtful clinical decisions, and actively participate. Simply clicking through or spending minimal time will not count as good faith.
If your first attempt is not in good faith, that score will be recorded as your final grade for the scenario element of the rubric.
This policy ensures your score reflects your own reasoning and engagement, supporting your growth as a safe and effective nurse.

Scenario
OMS prebrief

Case Title: Wilfred Price [SNR105]

Time Limit: 20 minutes

Your role: Primary nurse

Scenario: Confusion

Report: In this scenario, you will assess and manage an older adult patient presenting with confusion and signs of sepsis secondary to a urinary tract infection. The patient is pyrexial, tachycardic, and hypotensive, with suprapubic tenderness and a positive urine dip test. Blood tests confirm a diagnosis of urosepsis.

Directions
In addition to the standards of care needed to ensure patient quality and safety, complete the following as you engage in the OMS simulation:

Review the patient’s chart.
Establish a history of present illness.
Perform a focused physical assessment, including vital signs.
Record the early warning score (EWS).
Initiate appropriate interventions and administer appropriate medications as ordered by the medical team.
Communicate with interprofessional team members if appropriate for the scenario.
Deliver a situation, background, assessment, recommendation (SBAR) report to the provider.
When you have completed the OMS scenario, complete the debrief. Use at least three scholarly, current (within the last 5 years) references to support your work.

Specifically, you must address the following rubric criteria:

Scenario Score: Complete the Oxford Medical Simulation (OMS) scenario. The score you receive on your scenario will be factored into your overall grade for this assignment. See the rubric for details.
Clinical Scenario: Summarize the clinical scenario you completed. Discuss your initial thoughts on the individual’s complaint, including pertinent pathophysiology and psychopathology.
Include a nursing theory that applies to the clinical scenario. Use a scholarly, current (within the last five years) resource to support this theory.
Background: Explain any previous experiences regarding SDOH that helped support your clinical reasoning in the clinical scenario. Include at least one example of the following in your response:
Nursing knowledge
Previous clinical situations
Personal experience
Interventions and Outcomes: Describe interventions and outcomes related to the scenario.
Include the following in your response:
How you prioritized the specific interventions you performed
Outcomes you expected from the interventions
Use a scholarly, current (within the last five years) reference to support your explanation.
Analysis: Considering the holistic care of the patient and SDOH, provide a specific example of how one of the following categories can improve care in the scenario:
Patient and caregiver education
Cost considerations
Available resources and support
Diet and activity recommendations
Use a scholarly, current (within the last five years) reference to support your explanation.