Two of the most complex skills for nurses to master are prioritization and delegation. They must decide what needs to be done first and who is best suited for the task. There may be some instances when nurses have the time to make these choices thoughtfully, but quick decision making is usually what’s needed in today’s fast-paced healthcare environment. Medical simulation training is the best way for students to learn how to prioritize and delegate patient care tasks as it allows them to make these difficult decisions independently with no risk to patients. Continue reading to learn more about how educators can integrate these types of nursing simulation scenarios into their curricula. 

Determining Priorities

Simulation training is an ideal strategy in healthcare education to help students improve their patient prioritization and clinical decision-making skills. This creates an opportunity for students to decide which actions to take first for an individual patient or which patient(s) on the unit should be attended to first (1-4). Maslow’s hierarchy of needs is an excellent starting point in terms of patient prioritizing, as the patient’s psychosocial needs can be addressed after all of the essential physiologic needs are met. This hierarchy may not translate perfectly in practice, however, so students can be encouraged to consider the following questions: 

• Which intervention is going to help the patient the most right now? 
• What can I do right now to help this patient, and what is going to take a little longer?
• What can I do within my scope of practice and what do I need to get an order for? 

What can I delay safely so that I can get something more important done now?

As students progress through their programs, educators can introduce multiple patients with competing priorities to promote advanced decision-making and delegation skills. 

SimVS Nurse Call System

To help students prioritize care for multiple patients, the SimVS Nurse Call System allows educators to remotely trigger bed alarms and call light sounds for specific patient care areas. The tablet-based platforms are designed to be installed on any headwall or patient care area, enabling students to tend to the alarms right at the patient’s bedside. Additionally, students can use the push-to-talk communication feature to request additional help or speak directly with their instructor. The SimVS Nurse Call System helps students differentiate between the various types of alarm sounds that are common to healthcare facilities, especially when combined with the SimVS Hospital patient monitor and ventilator interfaces. 

Effective Delegation

Delegation is one of the most complex skills in modern nursing practice, as it requires sophisticated clinical judgment and interpersonal communication. Multiple research studies have also supported the use of healthcare simulation exercises to help students learn how to delegate patient care duties safely and effectively (1-10). Simulation allows students to practice implementing the five rights of delegation without risk to patients: 

• Right task ensures that complex tasks are handled only by those with proper experience, training, and certification
• Right circumstance requires that tasks be delegated to ancillary team members only when the patient is in stable condition
• Right person verifies that team members have the skills and knowledge to perform their assigned tasks safely and correctly
• Right directions using clear, precise communication, making sure that all instructions are easily understood by the rest of the team

Right supervision and evaluation to ensure that tasks are completely appropriately and in a timely manner, with feedback to improve future patient care

Ideally, delegation simulation scenarios should include team members with different skill levels so that the RN must decide which person is best suited for each task. Educators can also integrate patient care interventions into these scenarios in order to validate psychomotor skills such as administering medications and supplemental oxygen. In addition, students can be required to use SBAR (Situation, Background, Assessment, Recommendation) communication techniques to obtain new orders as needed from the patient’s physician. 

SimVS Nurse Call Simulation Scenario

Simulation practice has been proven to help students become strong, trusted leaders who are able to prioritize care for multiple patients. However, creating these types of realistic simulations and sourcing the required supplies can be challenging. To help meet these needs, the DiaMedical team offers the new, ready-to-use SimVS Nurse Call System Simulation Scenario with everything that educators need to run prioritization/delegation simulations with their students. This simulation requires a team of students to care for three patients who require attention simultaneously for a nosebleed, shortness of breath, and opioid-induced respiratory suppression. Educators are provided with comprehensive patient profiles, learning goals, debriefing questions, and a complete list of required supplies. Students must prioritize the patients’ needs, delegate tasks appropriately, administer medications, and obtain additional orders from the physician. To enhance the learning experience, students are also provided with worksheets to organize patient information and 5-minute nursing care plans that can be completed before the simulation begins. 

Final Thoughts

With healthcare settings being so fast-paced, there isn’t much time to master patient prioritization and delegation skills through years of practice. Instead, nurses must be ready to manage and lead on the very first day of professional practice after graduation. DiaMedical is ready to provide educators with the tools needed to create simulation scenarios that help students master these essential competencies. With innovative products like the SimVS Nurse Call System and the SimVS Hospital Virtual Diagnostic Platform, students can feel confident in patient prioritization and delegation situations. The DiaMedical SimVS Nurse Call System Simulation Scenario is also available to provide additional convenience for educators. For more information, reach out to a DiaMedical expert at 877-593-6011 or quotes@diamedicalusa.com.

References

1. Kilgore, R., Goodwin, M., & Harding, R. (2013).Adding context to a simulation module for leadership and management baccalaureate nursing students. Journal of Nursing Education and Practice, 3, 148–155. 
2. Sharpnack, P., Goliat, L., & Rogers, K. (2013). Using standardized patients to teach leadership competencies. Clinical Simulation in Nursing, 9, e95–102.
3. Warland, J. (2011). Using simulation to promote nursing students’ learning of work organization and people management skills: A case-study. Nurse Education in Practice,11, 186–191. 
4. Kaplan B. & Ura, D. (2010). Use of multiple patient simulators to enhance prioritizing and delegating skills for senior nursing students. Journal of Nursing Education, 49, 371–377. 
5. Smith, S. (2013). Integrating simulation in a BSN leadership and management course. Journal of Nursing Education and Practice, 3, 121–125
6. Hourican, S., McGrath, M., Lyng, C., McMahon, C., & Lehwaldt, D. (2008). Effectiveness of simulation on promoting student nurses management skills. International Journal of Clinical Skills, 2, 20–25.
7. Thomas, C., Hodson-Carlton, K., & Ryan, M. (2011). Preparing nursing students in a leadership/management course for the workplace through simulations. Clinical Simulation in Nursing, 7, e99–104.
8. Che'Reed, C., Lancaster, R., & Musser, D. (2009). Nursing leadership and management simulation creating complexity. Clinical Simulation in Nursing, 5, e17–21.
9. Gore, T., Johnson, T., & Wang, C. (2015). Teaching nursing leadership: Comparison of simulation versus traditional inpatient clinical. International Journal of Nursing Education Scholarship, 12, 55–63. 
10. Hasson, F., McKenna, H., & Keeney, S. (2013). Delegating and supervising unregistered professionals: The student nurse experience. Nurse Education Today, 33, 229–35.