Though simulation training is most commonly associated with acute care emergency scenarios, it is also ideally suited for many long-term care programs. In fact, simulation is becoming increasingly important as patient acuity in assisted living and skilled nursing facilities has surged over the past few years (1,2). Long-term care simulation labs are now essential components of RN, LPN and nursing assistant programs, as they enable students to safely practice skills in a controlled environment under the close supervision of instructors. There is no risk to patients and students have opportunities for clinical decision-making that are not possible in clinical settings. Continue reading below to learn more about how educators can use simulation to better prepare students to provide safe patient care in every type of extended care setting. 

Current Limited Clinical Practice Opportunities 

Currently, healthcare training programs across the U.S. are dealing with a shortage of available clinical sites, resulting in limited opportunities for students to practice hands-on care to patients. All levels of nursing education are being impacted, including RN, LPN, and nursing assistant programs that prepare students to work in long-term care settings. As a result, new graduates in these fields risk entering the workforce without the proper preparation they need to provide clinically competent care. Not only does this jeopardize the health and well-being of patients, but it also requires facilities to implement remedial training programs to correct staff performance deficiencies (3,4). 

Using Simulation for Long-Term Care Training

Studies have suggested that integrating simulation training with long-term care clinical hours can improve student knowledge and critical thinking abilities after graduation. This can be attributed to the opportunities for clinical decision-making during simulation exercises that are not possible with real patients, combined with careful debriefing with instructors. Simulation also allows instructors to more readily identify student knowledge deficiencies and adapt their teaching strategies accordingly. Ultimately, participation in simulation training increases skills competency, fewer clinical errors, and better patient outcomes at a lower cost for facilities (4-8). 

Transforming Skills Validations

Simulation scenarios can be used to bring long-term care skills validations to a higher level of student engagement, knowledge acquisition, and retention. This approach challenges students to adjust their implementation of interventions depending on the patient’s individual needs (9,10). For instance, performing ostomy care on a Geri nursing skills manikin takes on a deeper meaning for students when fecal odor is added to simulated effluent and the patient’s family member is watching at the bedside. This context for care requires students to utilize verbal and non-verbal communication skills in addition to the procedure for cleaning the patient’s stoma. Educators can also simulate bariatric patient care using a Sim-U-Suit obesity trainer and the new Lynacare HC107 Hi-Low Bed, which has an expandable sleep surface. 

Promoting Clinical Decision Making

Simulation settings can also be used to help RN and LPN students sharpen their critical thinking skills for clinical decision making during patient care. These more advanced scenarios can promote students to prioritize their actions based on their assessment findings, communicate effectively with physicians, and evaluate patient responses to their interventions (3,4). For long-term care instructors who are new to simulation, the Geriatric Simulation Toolkit from the University of Wisconsin-Madison is an essential resource. Each of the four scenarios in the toolkit mentioned has complete instructions for implementation. This includes a patient profile with medical record and provider orders, student learning goals, debriefing questions, and more. 

Key Takeaways

As clinical sites become increasingly limited, educators must create alternative methods to ensure that students are ready to provide safe patient care after graduation. Simulation is an ideal option as students can hone their critical thinking and clinical decision-making skills without any risk to patients. To accomplish this, educators need to have the appropriate equipment and supplies conducive to a realistic simulation environment for students. With that goal in mind, the DiaMedical team is ready to help educators balance cost and functionality in order to create simulation labs that demonstrate best practices for long-term care. All types of hospital beds, bedside furniture, manikins, and patient care supplies are available to create complete training solutions. For more information, reach out to a DiaMedical expert at 877-593-6011 or info@diamedicalusa.com. 

References

1. PointRight.(2022). Do increases in patient acuity present a problem for SNFs? Retrieved from https://pointright.com/increases-in-patient-acuity-a-problem-for-snfs/ 
2. Hua, C. (2021). Trends in acuity of residents in assisted living. Innovation in Aging, 5(S1), 526. 
3. Olaussen, C., Steindal, S., Jelsness-Jorgensen L., Aase, I., Stenseth, H., & Tvedt, C. (2022). Integrating simulation training during clinical practice in nursing homes: An experimental study of nursing students’ knowledge acquisition, self-efficacy and learning needs BMC Nursing, 21(1), 47. 
4. Gerovac, T. (2019). Development and evaluation of a long-term care skills simulation program. Doctoral dissertation: Walden University, ScholarWorks Publishing. 
5. Bridge, P., Adeoye, J., Edge, C., Garner, V., … Sharp, J. (2022). Simulated placements as partial replacement of clinical training time: A Delphi consensus study. Clinical Simulation in Nursing, 68, 42-48. 
6. Das, K. Curl, E., Smith, S. & Chisholm, L. (2016). Effectiveness of integrated simulation and clinical experiences compared to traditional clinical experiences for nursing students. Nursing Education Perspectives, 37(2), 72-77.
7. Sullivan, N., Swoboda, S., Breymier, T., Rutherford-Hemming, T., Budhathoki, C., & Kardong-Edgren, S. (201). Clinical Simulation in Nursing, 30, 34-41. 
8. Cant, R. & Cooper, S. (2017). The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis. Nurse Education in Practice, 27, 45-62. 
9. Ku, Y., Chao, H., Lee, P., Cheng, W., & Wu, H. (2017). Developing five simulation skills of the long-term care course. Primary Health Care, 7(3), Supp. 
10. Reid-Searl, K., Mainey, L., Bassett, J., & Dwyer, T. (2019). Using simulation to prepare neophyte nursing students to deliver intimate patient care. Collegian, 26(2), 273-280. 
11. Hirvela, K., King, B., & Woywod, P. (2017). Geriatric simulations toolkit. Retrieved from https://care.nursing.wisc.edu/wp-content/uploads/sites/628/2017/04/Geriatric-Simulations-Toolkit-March-2017-Update_Edit.pdf