Promoting Safety in an Unfolding Simulated Public Health ...



Promoting Safety in an Unfolding Simulated Public Health Disaster

Course to Be Taught: Nursing 411 – Public Health Nursing

Learner Level(s)

Prelicensure BSN

Learner Setting: Learning Resource Center (Nursing Laboratory)

Strategy: Nursing laboratory simulation -Simulated infectious disease outbreak at an urban high school unfolds as the school nurse is performing a high-risk, low-frequency procedure. In the simulated health office, the school nurse is in the process of administering an intravenous antibiotic via a Peripherally Inserted Central Catheter (PICC) to a student with Lyme Disease when a large number of sick students and staff arrive at the health office.

QSEN Competency Categories:

a) Safety

b) Teamwork and Collaboration

c) Patient-Centered Care

d) Evidence-Based Practice

e) Informatics

Simulation Scenario Criteria: The learners will be able to demonstrate their ability:

a) To safety apply the nursing process to a vulnerable and underserved population during an unfolding public health crisis.

b) To synthesize concepts, principles, and methods from the public health science with nursing practice and standards during an unfolding public health crisis.

Simulation Scenario Objectives:

At the end of this simulation scenario the learner will be able to:

1. Recognize signs and symptoms of an infectious disease outbreak.

2. Identify essential assessment parameters for mass causalities during a gastrointestinal infectious disease outbreak.

3. Identify essential assessment parameters for mass causalities during a respiratory infectious disease outbreak.

4. Participate effectively in an interdisciplinary team during a simulated infectious disease outbreak.

5. Apply appropriate infectious control standards and safe care during a simulated infectious disease outbreak.

6. Demonstrate correct nursing actions to safely administer an intravenous antibiotic via a Peripherally Inserted Central Catheter using SAS protocol (Saline, Additive, Saline) procedure.

Application of QSEN Competency Categories to this Simulation

Promoting Safety in an Unfolding Simulated Public Health Disaster

|QSEN Competencies |Method Achieved |

|Safety |Simulation – actual hands-on learning: |

| |The school nurse was in the process of performing a high-risk, low-frequency procedure to a |

| |high school student with Lyme Disease. The simulated student was a high-fidelity human |

| |mannequin simulator. The school nurse was administering an intravenous antibiotic to the |

| |simulated student via a Peripherally Inserted Central Catheter (PICC) when a large number of |

| |ill high school students and staff arrive at the health office with various signs and symptoms.|

| | |

| | |

| |Simulated infectious disease outbreak: |

| |Students need to deliver safe care to the casualties |

| |Identify that they have a possible infectious disease outbreak |

| |Decide what isolation methods are needed and implement the correct isolation procedures |

| |Seek guidance from the public health department |

| |Identify casualties and assessment form identified with 2 pieces of personal information |

| |(example - name and birthday) |

| |Specimen (vomitus, diarrhea, respiratory secretions) should be handled with appropriate |

| |infectious disease protocol. |

| |Specimen should be labeled with 2 pieces of personal identification, date, time, and what type |

| |of specimen |

| | |

| |As the disaster exercise unfolds, the school nurse is performing a high-risk, low-frequency |

| |procedure (giving an IV antibiotic in a high school): |

| |Proper procedure should be followed r/t to administrating cefotaxime IV with saline/antibiotic |

| |saline flush via PICC line |

| |IV medication procedure should get completed even in the chaos of the unfolding infectious |

| |disease outbreak |

| |The patient who is in the nurse’s office to receive the IV antibiotic with no infectious |

| |disease symptoms should be protected from exposure |

|Teamwork and Collaboration |Hands-on learning r/t working as a high functioning team: |

| |Responders assigned team roles to assume during the emergency preparedness drill |

| |These roles included the lead school nurse, who assumed the leadership role during the |

| |emergency, two other school nurses assigned to the high school, the school principal, and the |

| |school security guard; and additional school nurses who are on-site attending a leadership |

| |conference at the school and are able to respond as the emergency unfolded |

| |Notification and assistance from Public health department should be requested |

| | |

| | |

|continue | |

|Teamwork and Collaboration | |

|Patient-Centered Care |During the simulation: |

| |Emotional reassurance and care should be delivered as needed |

| |The casualties were assigned to be either high school students or high school staff |

| |To include a high-risk population and a mental health component, the casualties included a |

| |pregnant teenager, a mother with a baby (a static mannequin), and a hyperactive, anxious |

| |teenager |

| |Additionally, all of the high school staff and some of the high school students had chronic |

| |conditions such as Diabetes, Cardiac Disease, Crohn’s Disease, or Asthma |

|Evidence-Based Practice |During the simulation the students have to assess and critically think and deliver care: |

| |Correct procedure should be followed when administering the IV antibiotic via the PICC line |

| |Fifty percent of the casualties had chronic illnesses as well as acute symptoms - The |

| |healthcare responders had to assess and think critically to decide if the symptoms were related|

| |to an unusual infectious disease outbreak, a mild infectious illness, a chronic illness, or |

| |adverse effects from medications |

| |Responders should deliver evidence-based care r/t to assigned infectious disease for the |

| |simulation |

| |During the morning simulation exercise, the scenario included a gastrointestinal (GI) |

| |infectious disease outbreak. |

| |On each day of a different GI infectious disease simulation occurred |

| |These three simulated GI Diseases were Shigella, E-coli 0157-N7, and Campylobacter |

| |The afternoon scenario on each of the three days was a more serious infectious disease. The |

| |casualties had respiratory signs and symptoms. The causalities may have been exposed to the |

| |H5N1 Avian Influenza |

|Informatics |20 minutes into each simulation the lead nurse or principal is notified that a chicken that was|

| |released early in the school had tested positive for the infectious disease assigned to each |

| |simulation scenario: |

| |Lead nurse will delegate to one of the other nurses to use informatics (computer) and access |

| |the CDC or WHO website to get evidence-based information on the infectious disease assigned to |

| |that scenario |

| |The nurse who accesses the information on the assigned infectious disease will present the |

| |information to the lead nurse during the simulation and to the classmates during the debriefing|

Schedule: N 411 - Promoting Safety in an Unfolding Simulated Public Health Disaster

Dates:

Time: 8 a.m.- 2:p.m: Each Clinical Group will participate on assigned clinical day

Location: Nursing Learning Resource Center – Simulated: High School Health Office

|Time |Topic |Presenter and Method |

|8 a.m.-9: 30 |Introduction to |LRC Staff |

| |Disaster Preparedness |Public Health Department Personal |

| |Role of Public Health Department | |

| |Volunteer Medical Reserve Corp |PowerPoint |

| |Point of Dispensing Emergency Respond Plan |Lecture Discussion |

| |Disaster Video: |Video |

| |Disaster Preparedness | |

| | | |

| | | |

| |Bioterrorism for Healthcare | |

|9:30 – 9:45 |Break | |

|9:45- 10:00 |Simulation Scenario 1 |Divide participants into two groups |

| |Pre Simulation Briefing |Healthcare Responders |

| | |Medical Casualties |

| |Role of Responders |Responders briefing Elliott |

| |Role of Casualties |Causalities briefing Morrison |

|10:00- 11:00 |Simulation Scenario 1 |Active Participation and Triage by Learners |

|11:00- 11:30 |Debriefing Simulation Scenario 1 |Active Discussion and Critique |

| | |Reflective Writing Activity |

|11:30-12:15 |Lunch will be provided for participants | |

|12:15-12:40 |Simulation Scenario 2 |Students that were responders this morning will now be |

| |Pre Simulation Briefing |victims and Students that were victims will be |

| | |responders |

| |Role of Responders |Adjunct faculty will be victims in both scenarios to |

| |Role of Casualties |promote student-centered leadership and learning |

| | | |

| | |Responders briefing Elliott |

| | |Causalities briefing: Morrison |

|12:40-1:30 |Simulation Scenario 2 |Active Participation and Triage by Learners |

|1:30-2:00 |Post Simulation Debriefing Simulation Scenario 2 |Active Discussion and Critique |

| | |Written Evaluation |

| | |Reflective Writing Activity |

Nursing 411 Simulation Disaster Exercise Supplies Needed

|Planning Phase |Supplies Needed | Comments |

| |5 by 8 inch Pink and Green Colored index cards for victim history and symptoms | |

| |5 by 8 inch Yellow Colored index cards for Assigning Roles to Healthcare Responder | |

| |3 white, 1- inch, 3-ring binders | |

| |Box plastic sheet protectors | |

|Pre Simulation |Handouts | |

| |2 Disaster Videos- Disaster Preparedness and Bioterrorism for Healthcare (Medifilm) | |

| |PowerPoint Presentation | |

|Supplies to Use During | | |

|Drill | | |

| |Medical Symptoms Triage Assessment Form | |

| |Surgical masks | |

| |Exam gloves | |

| |Contact Isolation gowns | |

| |Trash cans | |

| |Alcohol hand sanitizer | |

| |Specimen cups / specimen props for vomit/diarrhea/ sputum | |

| |Trash cans | |

| |Alcohol hand sanitizer | |

| |Facial tissues | |

| |Vital signs and Assessment equipment | |

| |B/P cuffs | |

| |Stethoscopes | |

| |Thermometers for temperature | |

| |Students need to wear watches with second hand | |

| |Pulse Oxmeter | |

| |Baby mannequin and bulb syringe | |

| |IV antibiotic scenario equip | |

| |Mannequin dressed as student | |

| |School medical record with HX (Sayed Khalifa) | |

| |PICC line with Luer lock dressing on mannequin | |

| |Six 50ml D5w (2 each day) & IV pole/ dummy IV collection bag | |

| |Six IV tubing -intermittent infusion | |

| |Twelve 12 cc syringes with NS | |

| |Six 12 cc Syringes with heparin | |

| |Gloves for PICC line chlorhexidine gluconate prep (Chlora Prep) or simulated jar w chlora prep| |

| |& gauze | |

| |N95 respirator masks Size small and medium |Enough for 1 mask each |

| | |participant |

|Post Simulation Briefing|Handouts | |

| |Simulation Evaluation Form | |

Student Handout

Scenario: Promoting Safety in an Unfolding Simulated Public Health Disaster

The purpose of mass casualty drill or mock disaster is to

• Promote confidence

• Develop skills

• Practice delivering safe care

• Coordinate activities

• Coordinate participants

Setting: the school nurse’s office of a large urban high school. School nurses from other schools and some public health officials are at the school for their quarterly district meeting.

Background Information: Francis Harper Watkins High School is a large, crowded school serving a vulnerable and underserved population of students. Sixty percent of the students live in families whose income falls below the Federal Poverty Limit. Thirty percent of the students come from families where English is not the first language in the home. In the last couple of weeks there has been a higher than normal absentee rate due to various viral and bacteria illnesses that seem to occur in the winter months.

School’s Social History: During the last month there have been several sporting events at the school that have brought together a large number of teams and fans from other high schools in the city and surrounding area. Students from the home teams and rival teams have been involved in an escalating series of pranks such as putting tires around the flag pole, releasing chickens in the school, and putting shaving cream under the locker handles.

The Event: Sayed Khalifa a 17-year-old junior with Lyme’s Disease arrives at the nurse’s office to have the school nurses administer the school dose of the intravenous antibiotic via his PICC line. While the nurse is preparing to administer the medication, a large number of sick students and staff from the school arrive at the nurse’s office. Realizing that there may be an unfolding public health crisis, the school nurse asks the other nurses and public health officials for help and the simulated public health crisis begins….

“A disaster is an event that causes human suffering and creates unmet needs and demands exceeding the needs of the community to cope without outside assistance” (Lundy & Butts, 2001, p 551))

Lundy, K.S., & Butts, J.B. (2001). The role of the community health nurse in disasters. In K. Saucier & S. Janes (Eds.), Community health nursing: Caring for the public’s health (p. 551). Boston: Jones and Bartlett Publishers.

Role Playing Prompts for Causalities:

Gastrointestinal Infectious Disease Outbreak

| | |

|Victim #A1 |Victim #A2 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: 12 weeks pregnant |Past Medical Hx: Hypertension, AODM |

| | |

| | |

|S & S: |S & S: headache, diarrhea, T 102 |

|severe nausea and vomiting | |

|abdominal cramping since last night | |

|Victim #A3 |Victim #A4 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: mother is healthy but has 6 month old baby in |Past Medical Hx: healthy |

|school daycare | |

| | |

|S & S: |S & S: c/o of stomach cramps, diarrhea |

|baby is dehydrated after several episodes of loose diarrhea, resp|T 101 4 |

|26 pulse 116 | |

|Mother is worried and hysterical | |

|Victim #A5 |Victim #A6 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: Crohn's disease x 3 years |Past Medical Hx: hypertension, angina |

| |on Norvasc, Diovan, Lopressor, Aspirin |

| | |

|S & S: severe loose watery diarrhea for the past 12 hours, GI |S & S: feels dizzy, c/o abdominal cramps, upset because bowel |

|upset and cramps, T 1024 |movement had blood in it. T 1008 |

|Victim #A7 |Victim #A8 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: Moderate Persistent Asthma |Past Medical Hx: Arthritis |

|Takes theophylline for asthma |On high dose NSAIDs |

| | |

|S & S: anorexia, nausea, vomiting, restlessness, and headache |S & S: vomited coffee ground material |

|Temp 102 |C/o abdominal cramps, T 101 |

|Victim #A9 |Victim #A10 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: healthy |Past Medical Hx: Asthma, Allergic to Penicillin, just finished 10|

| |days of PO prednisone uses cromolyn inhaler 2 puffs 4 times a|

| |day, and albuterol inhaler as needed, takes 10 mg singulair every|

|S & S: 6 hour history of abdominal cramping, just had a large, |day |

|loose black liquid stool with bright red blood in it | |

| |S & S: doesn’t feel well, “I feel like I am coming down with |

| |something” |

|Victim #A11 |Victim #A12 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: ADHD on Ritalin |Past Medical Hx: Hypertension |

| |Type-two diabetic |

| |Takes norvasc and glucophage |

|S & S: very nervous, feels jumpy, worried about what is happening| |

|at the school, hyperventilating, feels faint | |

| |S & S: feels lousy, generalized aches and muscle soreness, |

| |diarrhea, T 103 |

|Victim #A13 |Victim #A14 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: healthy |Past Medical Hx: healthy |

| | |

| | |

|S & S: color pale, skin cool and clammy, severe vomiting, severe |S & S: nausea, vomiting, diarrhea, skin cool and clammy, feels |

|diarrhea last 6 hours, T 104 P 136, B/P 80/48 |shaky |

|Victim #A15 |Victim #A16 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: Seizure Dx since age 4 |Past Medical Hx: Hypothyroidism on Synthroid |

|on Dilantin | |

|S & S: diarrhea, vomiting, headache, irritability since |S & S: headache, abdominal cramping, diarrhea T 102 |

|yesterday, has a tonic clonic seizure 15 minutes into simulation | |

|Victim #A17 |Victim #A18 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: healthy |Past Medical Hx: Gout just started on colchicines two weeks ago |

| | |

| | |

|S & S: 5 hour history of nausea and vomiting, now having |S & S: anorexia, nausea, vomiting, and diarrhea |

|diarrhea, T 101 | |

|Victim #A19 |Victim #A20 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: Type 1 diabetes x 3 years |Past Medical Hx:: Prosthetic mitral valve replacement 10 years |

|On insulin – blood sugar is usually well controlled |ago |

| |On coumadin |

|S & S: pale, tremors, nausea and vomiting, | |

|Finger Stick blood glucose 56 |S & S: 2 episodes of bloody diarrhea in last hour, T 101 |

|15 minutes into scenario – give this card to casualty |20 minutes into scenario- the health department cause the school |

| | |

|Instructions to casualty: |Health department tells you that several of the chickens has |

|Please walk around and say in a loud voice to the responders |tested positive for |

| | |

|“Oh my God does this have anything to do with the 50 chickens |Day 1 (Tues 2/26) Shigella infection |

|that were released in the school the other day” |Day 2 (Wed 2/27) E-Coli O157:H7 |

| |Day 3 (Thurs 2/28) Campylobacter |

| | |

| |At this point designed responders should look up infection on PDA|

| |or reference book |

Directions:

1. Cut up these prompts and use clear packing tape or laminate to an index card.

2. Assign each simulated casualty to a specific role-playing prompt.

3. Last two prompts are to be used in the scenario

Role Playing Prompts for Causalities:

Respiratory Infectious Disease Outbreak

|Victim #B1 |Victim #B2 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: 12 weeks pregnant |Past Medical Hx: Hypertension, AODM |

| | |

| | |

|S & S: “I feel achy” My Throat Hurts” Temperature 1032 |S & S: headache, sore throat, T 102 |

|Victim #B3 |Victim #B4 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: mother is healthy but has 6 month old baby in |Past Medical Hx: healthy |

|school daycare | |

| | |

|S & S: |S & S: c/o of stomach cramps, headache, eyes red and swollen, |

|baby coughing, seems congested, crying resp 22 pulse 96, T 100 |sore throat |

|Mother is worried and hysterical |T 101 4 |

|Victim #B5 |Victim #B6 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: Crohn's disease x 3 years |Past Medical Hx: hypertension, angina |

| |on Norvasc, Diovan, Lopressor, Aspirin |

| | |

|S & S: sore throat, cough, muscle aches, Temperature 1046, severe|S & S: feels dizzy, c/o abdominal cramps, sore throat, T 1008 |

|loose watery diarrhea for the past 12 hours, GI upset | |

|Victim #B7 |Victim #B8 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: Moderate Persistent Asthma |Past Medical Hx: Arthritis |

|Takes theophylline for asthma |On high dose NSAIDs |

|albuterol inhaler as needed | |

| |S & S Coughing, throat red and sore, severe headache, Temperature|

|S & S: sore throat, anorexia, nausea, vomiting, restlessness, and|1042:, |

|headache, lungs wheezes in small airway, Temp 102 | |

|Victim #B9 |Victim #B10 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: healthy |Past Medical Hx: Asthma, Allergic to Penicillin, just finished 15|

| |days of PO prednisone uses cromolyn inhaler 2 puffs 4 times a|

| |day, and albuterol inhaler as needed, takes 10 mg singulair every|

|S & S: doesn’t feel well, “I feel like I am coming down with |day |

|something” Temperature 1012 | |

| |S & S: “I can’t get my breath” Lungs tight -severe bilateral |

| |wheezing heard on auscultation, Pulse 140 B/P 160/102 |

| |Temperature 1042, |

|Victim #B11 |Victim #B12 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: ADHD on Ritalin |Past Medical Hx: Hypertension |

| |Type-two diabetic |

| |Takes norvasc and glucophage |

|S & S: very nervous, feels jumpy, worried about what is happening| |

|at the school, hyperventilating, feels faint | |

| |S & S: feels lousy, generalized aches and muscle soreness, T 103|

|Victim #B13 |Victim #B14 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: healthy |Past Medical Hx: healthy |

| | |

| | |

|S & S: color pale, skin cool and clammy, headache, flue-like |S & S: nausea, vomiting, skin cool and clammy, feels shaky, |

|symptoms for the last couple of days, T 104 P 136, B/P 80/48 |headache, muscles “hurt all over” 1042 |

|Victim #B15 |Victim #B16 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: Seizure Dx since age 4 |Past Medical Hx: Hypothyroidism on Synthroid |

|on Dilantin | |

|S & S: sore throat, headache, irritability since yesterday, T |S & S: headache, abdominal cramping, sore throat, wheezing T |

|101 |1022, |

|Victim #B17 |Victim #B18 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: healthy |Past Medical Hx: Gout just started on colchicines two weeks ago |

| | |

| | |

|S & S: 5 hour history of nausea now coughing, feels “sick”, T 101|S & S: anorexia, nausea, headache, sore throat, eyes red with |

| |yellow discharge, T 102 |

|Victim #B19 |Victim #B20 |

| | |

|You are a casualty in this scenario |You are a casualty in this scenario |

|You are a student at the High School |You are a staff member at the High School |

| | |

|Past Medical Hx: Type 1 diabetes x 3 years |Past Medical Hx:: Prosthetic mitral valve replacement 10 years |

|On insulin – blood sugar is usually well controlled |ago |

| |On coumadin |

|S & S: headache, pale, tremors, nausea and vomiting, | |

|Finger Stick blood glucose 114 |S & S: headache, muscle pain, sore throat, T 101 |

|15 minutes into scenario – give this card to casualty |15 minutes into scenario – give this card to casualty |

| | |

|Instructions to casualty: |Instructions to casualty: |

|Please walk around and say in a loud voice to the responders |Please walk around and say in a loud voice to the responders |

| | |

|“Oh my God does this have anything to do with the 50 chickens |“Oh my God does this have anything to do with the 50 chickens |

|that were released in the school the other day” |that were released in the school the other day” |

|20 minutes into scenario- the health department cause the school | |

| | |

|Health department tells you that several of the chickens has | |

|tested positive for the H5N1 Virus (Avian Flu) | |

| | |

|At this point give out the OSHA Protect Yourself from Avian Flu | |

|Quick Cards | |

Directions:

4. Cut up these prompts and use clear packing tape or laminate to an index card.

5. Assign each simulated casualty to a specific role-playing prompt.

6. Last two prompts are to be used in the scenario.

PICC and Intravenous Medication Administration Information

Patient Name: Sayed Khalifa

DOB 03/17/1990

Medication Order for Sayed Khalifa :

Cefotaxime (sef-ohTAX-eem) 1.5 grams intravenously every 6 hours (maximum, 6 g per day).

Sayed will receive three dose of his Cefotaxime IV per day at home and one dose per day at school administered by the school nurse at midday.

Flush Protocol (SAS) administer the medications in this order:

1. Saline: 3 ml normal saline IVP

2. Additive: Cefotaxime 1.5 grams in 50 ml of D5W administered over 30 minutes

3. Saline: 3 ml normal saline IVP

Physician:

Joan Barker MD

Infectious Disease and Internal Medicine

City Hospital

Philadelphia, PA.

Phone: 215-968-2234 (simulated number)

***Medication Administration Protocol – must use at least a 10 ml syringe size for flushes of this PICC Line (higher pressure generated by smaller syringes can rupture the PICC line)

Information on the PICC

Deltec Clinicath 16 gauge, 5 French, Single Lumen

Peripherally Inserted Central Catheter (PICC) - Single-lumen – Inserted 2/5/08

|Reorder Code |ID (mm) |OD (mm) |Length (mm) |Gauge |Catheter |

| | | | | |Size/Type |

|The purpose of unfolding simulated public health disaster| | | | | |

|drill was clear. | | | | | |

|The exercise was well organized and structured. | | | | | |

|The exercise scenarios were realistic: | | | | | |

|Participation in the exercise was an appropriate learning| | | | | |

|activity for the Public Health Nursing Course. | | | | | |

|The presentation “Introduction to Disaster Planning” | | | | | |

|helped me understand and participate in the simulated | | | | | |

|public health disaster drill. | | | | | |

|The Pre and Post simulation briefings helped me | | | | | |

|understand and participate in the simulated public health| | | | | |

|disaster drill. | | | | | |

|The importance of delivering safe care during a simulated| | | | | |

|public health disaster was stressed: | | | | | |

Comments: Please tell us what we did well during the exercise and any suggestions that will help us make this a better exercise in the future:

2008 © Agnes Morrison, EdD, RN; Ana Maria Catanzaro, PhD, RN @ La Salle University, Philadelphia, PA.

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