Methods_of_Skill_Teaching Dr.Susila.pptx

SKILL TEACHING IS A CORE METHOD FOR NURSING EDUCATION

1. Dr.Susila.C Principal Billroth College of Nursing Chennai Methods of Skill Teaching- Demo

2. Learning outcomes Understand the methods of skill teaching Demonstrate skill

3. Skills teaching and practice

4. Sk BRIDGING THE GAP?

5. Ideal skills teaching is What the teacher teaches = what the student learns Skills must be practiced as per standards Use checklist(CL) CL is a shortened version of the standards, formatted for ease of use Skills teaching/training

6. Skill & Clinical Skills A skill is defined as the ability to perform a task through the application of knowledge and experience. Clinical skills (skills necessary in encounters with patients) are usually divided into psychomotor (manual skills that require coordination between brain and body, hands in clinical settings, such as stitching a wound), cognitive (skills of thinking, such as decisionmaking as in making a diagnosis or deciding to do a surgical operation) and communication (transferring information and skills to the others, including taking a history, explaining a procedure, breaking bad news or encouraging life style changes ).

7. "The mental and psychomotor activities required to perform a manual task." Procedural skills can range from simple tasks, such as draining an abscess, to complex tasks, such as endotracheal intubation. "(Sawyer et al (2015); Foley & Spilansy (1980)) Ability to apply knowledge to solve problems and tasks. There are different types of skills - cognitive, practical, creative and communicative skills (NOKUT the Norwegian Agency for Quality Assurance in Education ) What is a skill?

8. Concept Mapping Jigsaw Puzzle Debating Problem Based Learning Case Study Role Playing Games Simulation Methods of Skill Teaching

9. Components of Skill Competency

10. Tips for teaching Clinical skills

11. - Demonstration-is a method of skill teaching Demonstration teaches by “Exhibition & explanation ” • It trains the students in the art of careful observation

12. Types Planned Involves preliminary preparation, introduction, procedure and follow up Unplanned Uncommon treatment occur in the ward that can be demonstrated if not emergency

13. Peyton’s Four-step Approach

14. Deliberate Practice

15. Using checklists… # Action/ step Rationale Done/ Not done Remarks 1 Close doors and/or use a screen. Maintains client’s privacy     2 Make the client's position comfortable, preferably sitting or lying with the head of the elevated 45 to 60 degrees.   To ensure clear view of chest wall and abdominal movements. If necessary, move the bed linen.     3 Prepare count respirations by keeping your fingertips on the client’s pulse. A client who knows are counting respirations may not breathe naturally.     4 Counting respiration: 1) Observe the rise and fall of the client’s (one inspiration and one expiration). 2) Count respirations for one full minute. 3) Examine the depth, rhythm, facial expression, cyanosis, cough and movement accessory.   One full cycle consists of an inspiration and an expiration. Allow sufficient time to assess respirations, especially when the rate is with an irregular Children normally have an irregular, more rapid rate. Adults with an irregular rate require more careful assessment including depth and rhythm of respirations.     5 Replace bed linens if necessary. Record the rate on the client’s chart. Sign the chart.   Documentation provides ongoing data collection. Giving signature maintains professional accountability     6 Perform hand hygiene To prevent the spread of infection     7 Report any irregular findings to the senior staff. To provide continuity of care    

16. Checked out to maintain the skill on a simulator? When is someone checked out to do the skill on you or your relatives?  When is someone good enough? 

17. MPS done on a simulator, before you are allowed to do the skill on a patient. Objective  Measurable Fair Minimum passing standard

18. Exercise: Run session with peyton’s skills training approach, as facilitator… Reflect: What you did? Why? What was the outcome? We want you to practice and reflect

19. Blood Transfusion Demo on

20. Checklist

21. S.no Steps of procedure Score 1/0 Remarks 1 Identifies the patient with three verifiers – ID band, asks patient to tell his name and from the case sheet. 2 Verifies the physician’s order for the transfusion 3 Explains the procedure to the patient and get informed consent form signed by the patient. 4 Information about the side effects to the patient ask him/ her to report to the nurse. 5 Obtains baseline vital signs.

22. 6 Assembles the articles near the bedside: tray containing blood, blood administration set, 18G IV cannula, IV tubing, a pai of sterile gloves, kidney tray, alcohol swab, blood form, thermometer ,BP apparatus and stethoscope. 7 Verifies and counter checks the following. Patient’s name, blood group, and Rh type Cross-match compatibility Blood group and Rh type on the bag, unit and hospital number. Ensure that the blood is tested negative for blood bore pathogens like HIV, HBV, HCV, Microfilaria and Malarial parasite. Expiry date and time on the blood bag Compares the type of blood product with the physician’s order. Prescence of clots, air bubbles or precipitates in the blood bag. Ensures that the blood is rewarmed to temp above 10°C and started within half an hour after receiving it from the blood bank. 8 Performs two independent verification herself with charge nurse/nurse/another medical provider.

23. 10 Performs hand hygiene and puts on the gloves. 11 Opens blood administration kit/ set and move roller clamps to a closed position. 12 Administer prescribed medications if any. 13 Spikes blood unit and squeeze the drip chamber to allow the filter to fill with blood to half level. 14 If patient is receiving IV infusion, ensures that the fluid is compatible (NS is compatible with blood) Or if no IV access perform cannulation with large bore needle 18G for adults. 15 Opens the roller clamps and allow the tubing to full with blood.

24. 16 Attaches tubing to venous catheter using sterile precautions and open roller – clamp. 17 Infuses blood/ component at a rate of 5-10 drops/min initially for first fifteen minutes and check the vital signs every five minutes. 18 If no reaction, then increases the flow rate to 1-4 ml/minutes. 19 Ensures that the whole unit of blood is transfused within maximum of 4 hours. Incase of components transfuses within the specified time Plasma 30-60 minutes Cryoprecipitate – 30 minutes Platelets- 30-60 minutes RBCs- 1.5- 2 hours

25. 20 Monitors vital signs every half an hour till 1 hour post procedure. 21 After the blood has been infused allows the tubing to clear with normal saline. 22 In case acute reaction with signs such as chills, low back pain, hypotension, vomiting, restlessness, breathlessness, stop the blood immediately and start normal saline. 23 Appropriately disposed off the bag, tubing and gloves and other articles 24 Performs hand hygiene. 25 Documents the procedure Student Score

26. Demo on IV Cannulation Removal of IV Cannula Use of Infusion Pump Group Activity