College of Nursing

Pediatric Nursing Department

2011

Simulated Clinical Experience (SCE)

Edited By

- Dr. Afkar Ragab

- Dr. Laila Abu Salem

- Dr. Ahlam Hussien

- Dr. Ahlam Hussien

Pediatric Nursing Course (MDNU: NURS431)

First Semester Academic year 2010-2011G 1431/1432 H

Skills Lab. Protocol of Work

Training of pediatric nursing students in skills lab is necessary before starting the

clinical experience in different clinical settings. Skills lab training will support students’

psychomotor skills in real situation in the hospital clinical settings and increase student's self

confidence during caring with children

Setting of Practice: Neonatal & Pediatric skill Laboratories

Length of Practice: 2 weeks (2 days/ week)

Number of students: 10-15 students/ group

Learning Objectives:

At the end of this rotation (6 days) the student nurse will be able to:

Perform physical assessment.

Measure weight, length, height, circumference of the head, chest, and mid-arm for

infants and children

Measure vital signs

Bathe infant

Restraint infants and children

Feed infant and children (nasogastric tube and bottle feeding).

Administer oxygen through mask, nasal cannula, and oxygen hood.

Demonstrate care of newborn in incubator.

Practice care for infant with colostomy.

Administer medication by different routes of administration.

Insert peripheral venous access to pediatric model and demonstrate care of

intravenous line.

Apply principles infection control in all pediatric procedures.

Resuscitate newborn

Collect specimens (sputum, urine , stool)

Student’s Activities

1. Prepare and discuss the assigned topic presentation.

2. Create and prepare learning audiovisual material.

Methods of evaluation:

- Observational check lists.

- Assignment preparation and presentation

- Preparation of audiovisual material

- Post clinical examination

- Attendance

Topic presentations for lab experiences are

- Incubator care

- Infection control in pediatric settings (neonatal unit(

- Collection of specimens

NB

Post clinical exam held in the last day of skill lab experience.

Pediatric Nursing Skill Practice Lab

Academic Year 1431/1432 H 2010/2011 G

Students’ Guidelines:

Pediatric nursing skill laboratory is established along many years ago. It is equipped with

the most recent educational tools including appliances and models. Students are trained on

simulators, to simulate the actual management on infants and children. Emphases also will

focuses on pediatric nursing skills commonly practiced with pediatric patients.

Goal:

The students will be able to utilize basic scientific principles and concepts to provide safe

and accurate care to infants and children with deferent medical / surgical conditions

Objectives

The student will be able to:

1- Provide proper physical assessment for children

2- Measure Vital Signs for an infant/ child simulator accurately and safely.

3- Perform growth measurement accurately and record them on growth chart.

4- Provide proper cannula care

5- Administer medication safely and accurately for children simulator.

6- Provide proper bathing for a bed ridden child

7- Perform proper ostomy care.

8- Provide proper Naso-gastric Tube Feeding.

9- Perform CPR. Accurately for older children

10- Apply proper types of restraints

Pediatric Nursing Skill Practice Lab. Procedures

1. Complete physical assessment for Children

2. Vital Signs

3. Colostomy Care

4. Growth measurement

5. Breast Feeding Techniques/ bottle feeding

6. Gastrostomy feeding

7. CPR.

8. Iv therapy

9. Cannula care

10. Oxygen Therapy

11. Suctioning

12. Drug administration

13. Restraining

Neonatal Skill Practice Lab

Academic Year 1431/1432 H 2010/2011 G

Students’ Guidelines:

Newborn skill laboratory is established along many years ago. It is equipped with the most

recent educational tools including appliances and models. Students are trained on

simulators, to simulate the actual management on the newborn babies as well as infants.

Emphases also will focuses on pediatric nursing skills commonly practiced with newborn

infants.

Goal:

The students will be able to utilize basic scientific principles and concepts to provide safe

care to newborn baby.

Objectives

The student will be able to:

1- Measure Vital Signs for a newborn simulator accurately and safely.

2- Perform growth measurement accurately and record them on growth chart.

3- Provide proper eye care, cord care.

4- Identify the indications of sponge bath.

5- Provide proper sponge bath for a newborn.

6- Perform infant bathing.

7- Provide deferent methods of newborn and infants' feeding

8- Perform neonatal CPR. Accurately and safely

b. ProceduresNeonatal Skill Practice La

1- Complete physical assessment for neonates.

2- Assessment of Gestational Age.

3- incubator care

4- Vital Signs

5- Sponge bath

6- Infant bath ( Table Tub Bath)

7- Eye & Cord care, diaper care

8- Growth measurement

9- Breast Feeding Techniques

10- Feeding baby with Gastrostomy

11- Neonatal CPR.

12- Infant CPR

13- Iv therapy

Pediatric Nursing Course (MDNU: NURS431)

First Semester Academic year 2010-2011G 1431/1432 H

Student's Skills Lab Evaluation Sheet

Student's Name: ……………………………….. ID: ……………….

Group No.: ………………. Date: from ………. to ………….

Procedure Performed: ………………………..

Items Maximum

Marks

Student's

Marks

1- Nursing procedure (25 Marks) 25 Marks

- Preparation of equipment/environment and child 3

- Carry out procedure accurately 20

- Returning equipment 2

II- Knowledge (10 Marks) 10 Marks

III- Preparing Audio visual Materials (10 Marks) 10 Marks

- Clear 2

- Colored 2

- Relevant 4

- Submitted on time 2

VI- Professional Behavior (5 Marks) 5 Marks

- Eager to learn 1

- Show punctuality 1

- Complete uniform 1

- Communicate effectively with instructor / colleagues 1

- Respects rules, regulations, and constructive criticism 1

Total 50

Total Marks obtained: Date:

Instructor signature:

Roles and Regulations for Using Skill Labs.

Students have the right to demonstrate procedures with her own based on written

request from lab. Coordinator.

Students should have the right to re-demonstrate procedures in the front of instructor

once, twice, or more to master the skills

Students are forbidden to enter the lab. Without wearing uniform and lab. Coat.

An evaluation tools and lab objectives should be explained prior actual conduction of

Training.

Students are not allowed to be in the lab without instructor or staff member from the

pediatric department.

Students are not allowed to handle Sim Baby or other sensitive equipment without the

presence of assigned pediatric Nursing staff

Students are not allowed to take any drinks or food in the lab.

Students are not allowed to take any bags inside the lab during training.

Any accidental damage in equipment or simulator must be recorded and reported to

labs. Coordinator to take an action.

Equipment list should be prepared prior any procedure by the lab technician or

assigned instructor

Each student should come with her checklists and procedure manual.

Skill labs can be used by other specialty staff after filling request from the lab

technician and acceptance from lab. Coordinator.

Students have the right to accept or reject to be a model taking picture in the Lab.

Universal infection control measures are used for students' safety in skill Labs.

In case of accidental injuries student should be referred to the nearest facilities to take

vaccine and proper management.

Occupancy of Newborn & Pediatric nursing labs along the academic year

Time Newborn Lab Pediatric nursing lab

1st. Semester Newborn master students

Newborn master students

Pediatric nursing undergraduate

students

Pediatric nursing undergraduate

students

2nd. Semester Obs/ Gyne undergraduate

students

Pediatric Nursing Master Students

Under graduate M. S. Students

Pediatric Nursing Skill Practice Lab

Sample of Performance Checklists

Performance Check List for Naso / Oropharyngeal suctioning

Student’s name : Area : Group : Date :

Action Yes No Comments

1. 1-Wash hands.

2. 2-Turn on suction apparatus and set vacuum regulator

to appropriate negative pressure.

3. 3-Select appropriately sized suction catheter.

4.Secure one end of connecting tube to suction machine

and place the other end in a convenient location within

reach.

5.Open sterile catheter package on a clean surface using

the inside of the wrapping as a sterile field.

6.Set up the sterile solution container or sterile basin on

the sterile field. Be careful not to touch the inside of the

container. Fill with approximately 100 ml of normal

saline or sterile water.

7.Open lubricant and squeeze on to sterile catheter

package without touching package.

8.Provide 3 hyperinflation, hyperoxygenation breaths

with a bag valve mask connected to a manual

resuscitation bag attached to 100% oxygen.

9.Don sterile glove.

10.Pick up suction catheter, being careful to avoid

touching the nonsterile surfaces. With the nondominant

hand, pick up connecting tubing and secure the suction

catheter to the connecting tubing.

11.Check equipment for proper functioning by

suctioning a small amount of sterile saline from the

container.

12.Coat the appropriate length of suction catheter with

water-soluble lubricant or sterile water,

13.Leave catheter air vent open.

15.Slowly withdraw the suction catheter while rotating it

back and forth between dominant thumb and forefinger.

Apply intermittent suction of the air vent during

withdrawal.

16.Rinse catheter and connecting tubing with sterile

water or saline.

17.Suction both sides of mouth and pharynx.

18.Repeat steps 14 through 17 to clear nasopharynx and

oropharynx.

19.Monitor patient’s ECG tracing and heart rate between

suction passes.

21.Reposition patient.

22.Reassess patient’s respiratory status.

23.Discard remainder of supplies in appropriate

receptacle.

24.Wash hands.

25.Dispose of suction cannisters and connecting tubing

every 24 hours and set up new system.

Performance Check List For Endotracheal Suctioning

Student’s name : Area : Group :

Date :

Action Yes No Comments

1- Explain to the child and the family the need for

endotracheal suctioning, as time permits.

2-Note the child’s cardiac monitor and pulse

oximetry readings.

3-Wash your hands thoroughly with Betadine, don

gloves and mask.

4- Connect suction catheter to the tubing of the

suction device and set the suction pressures to the

desired negative pressure.

5- Ventilate the child with

100 % oxygen for 3 hyperinflation, hyper

oxygenation with a bag valve device.

6- Lubricate the appropriate size of catheter with

sterile water.

-Auscultate anterior lungs bilaterally.

7-Without applying suction, quickly and gently

insert catheter into the endotracheal tube and apply

suction while rotating the catheter between the

thumb and forefinger. and use a septic technique.

8 –Apply suction by occluding the on / off port, and

gently withdrawing the catheter with a twisting

motion.

-limit suction not more than 5 seconds.

9- After withdrawal of catheter, rinse it with sterile

water.

10-Ventilate child in-between and after attempts

with 100 % oxygen.

11 –Monitor child’s heart rate, color throughout the

procedure.

12- Repeat steps 7-11 as needed.

13- Return child to previous oxygen setting,

auscultate anterior lungs bilaterally.

14- Comfort child during and after procedure.

15- Discard reminder of equipment according to

institution policies.

16- Document the child’s response to suctioning,

the type and amount of suctioned secretions, any

changes in heart and respiratory rates.

Oxygen Therapy

Performance Check list for simple face mask

Instructor ‘s name : Area :

Student’s name : Group :

Date :

Action Yes No Comments

Simple face Mask

1. Wash hands.

2. Attach humidifier to flowmeter .

3. connect flowmeter to oxygen source,

and check operation of flowmeter and

humidifier . Set prescribed oxygen

flow .

4. Attach oxygen mask to connecting

tubing and then to humidifier and

flowmeter .

5. Turn on oxygen .

6. Place mask on patient’s mouth and

nose, adjust elastic or tubing for a

snug fit .

7. Check oxygen flow .

8. Stress fire hazards involved with

oxygen administration .

9. Wash hands.

Performance Check list for nasal cannula

Instructor ‘s name : Area :

Student’s name : Group :

Date :

Action Yes No Comments

Oxygen therapy through

nasal cannula

1. Wash hands .

2. Attach humidifier to flowmeter .

3. connect flowmeter to oxygen source,

and check operation of flowmeter and

humidifier .

4. Open cannula package and attach to

humidifier with care to avoid

contamination of cannula nasal tips .

5. turn oxygen flowmeter on to

prescribed liter flow/ oxygen

concentration prior to applying cannula.

Observe that water in humidification

container is bubbling .

.

6. Insert the nasal tips into the nares.

Direct prongs posteriorly .

7. Loop the two plastic tubes of the

cannula over the ears and under the chin,

or place elastic band around the head .

8. Gently adjust the plastic slide until

cannula is secure .

Table Tub BathPerformance Checklist for

Comment No Yes Nursing Action

Explain the procedure to the child’s mother.

Check room temperature and free from drafts (close

windows and doors).

Assemble the equipment.

Fill the baby tub half to two third full of warm water

Assess water thermometer (37.8C°) (40.68C°)

Spread the bath towel on the bed or table.

Wash hands.

Place the infant still dressed on the bath towel.

Wash the infant eye, starting from the far eye, wipe the eye

with moist cotton, then dry it with clean dry cotton in one

direction. Water only.

Wipe the infant’s face, forehead, cheeks and mouth (clean

inside the mouth if needed and nose with a moist cotton).

Soap the scalp; support the infant using the football hold.

Close ears with your fingers

lather your hand with soap then apply it to the scalp

Soap the scalp; support the infant using the football hold (the

baby is supported under the nurse’s arm and no her hip) first

lather your hand with soap then apply it to the scalp

Rinse the soap off the infant quickly.

Again lift the infant from the tub back to the towel and dry

well.

Dress the infant, comb his/her hair gently.

Clean all used equipment and return to its place.

Wash hands.

Record time and observations.

Performance Checklist for Colostomy Care

Comment No Yes Nursing Action

Explain procedure to the mother/ child

Prepare Equipment

Place tray to be easily accessible

Place mackintosh and towel well tucked under the patient.

Wear disposable gloves to remove soiled dressing,

Assess the stoma output for volume, consistency and odor in

relation to the type and location of the stoma.

Gently and thoroughly wash the skin using warm water and

mild soap (not irritant) or any solution.

Assess the stoma and surrounding skin by using gauze or

wash cloth.

When the stoma became clean, repeat with gauze or wash

cloth soaked in clear water.

Wipe the peristoma skin with mild soap and water and dry it

put zinc oxide, or any soothing cream

If bag is used: -

Measure the circumference of stoma and choose appropriate

bag size.

Fix bag on skin applying even, firm pressure tight to stick

bag.

If bag is not used: -

Apply a folded wash cloth over the stoma and secure it with

long gauze or a tape (Tape must be not irritant if available).

Remove and clean all used equipment.

Wash hands.

Record condition of dressing and stoma color of stools and

character, time and signature.

Reassure child, and mother, praise him for co-operation.

INVENTORY OF PEDIATRIC SKILL LAB.

&

NEWBORN SKILL LAB.

New born care LABORATORY

SIMULATOR / MANIKIN

CLA Hospital Training Baby 1 2004

Flexible baby female 1 MS5275290504/RU

Flexible baby male 1 MS 53-4782.8.04 FK; new

Infant Airway Management Trainer 1 LF 03623U; new

Infant ECG Crisis Manikin 1 old; w/ accessories

Infant ECG Crisis Manikin 1 new ; w/ accessories

Infant Arterial Training Arm 1 2006

Intubation Phantom of NB 1 Old

Intubation Phantom of NB 2 CLA 8/58-262.3.04/FR; new

Kevin Infant CPR 1

Kim NB CPR manikin 1 2004

Kim NB CPR manikin 1 Old

NB intubation training model 2 2004; 2008

Nita NB 1 2004

Pediatric Injectable Training Head 1 2004

Premature baby-female 1 2004

Premature baby-male 1 2004

Resusci Baby 1 Old

FURNITURE QTTY REMARKS

Model 34200 Baby care crib trolley w/ 1

double locker accessible through doors

complete w/ baby crib, mattress

Steel Cabinet w/ glass door 5

Swivel chair (lab) 16 1 broken

Table (lab) 5

Patient's screen (white) 1

Bedside table 1 Returned from CCL2 01/11/08

Incubator 2 1 donation from KFHU & 1 2006

Infant warmer (Hill-Rom Airshields) 1 2006

ELECTRONICS QTTY REMARKS

TV (colored; JVC 29") 1 Model:AV-29WX11;

SIMULATOR / MANIKIN

SN/ 09981100; w/ RC

Video cassette recorder (JVC) 1 Model: HRV-401AS

SN/: 10970085; w/ RC

Data Show 1 Eiki model; w/ RC; 30775

Ip 3000 Primax Canon Printer 1 feb. 2007; w/ CD & manual

Dell CPU Optiplex GX520 1 SN:H3LBJ2J; SC 37222508107

LCD Monitor 1 67I-4KRU

Keyboard 1 71616-697-11N9

Mouse 1 HC622QA036T

CD (Neonatal & Pediatric Assessment) 4

IP Fast Dome Camera 1 13/11/07

INSTRUMENTS REMARKS

Ambu bag 1 pedia size; old

Laryngoscope 1 w/ 3 straight blades

Physical Assessment kit 1 03/05/08 1 missing penlight

Oxygen hood, transparent 1

Stethoscope (Riester) 1

Stethoscope (Allgaier) 1

Rectal thermometer 1

Thermoscan 1

Urine bag stand 1

Portable suction machine 1 2006

OTHERS QTTY REMARKS

Bath basin 1

Compiled Catalogue for manikins 1

Mounted / piped in O2 & suction 1

Filing trolley 1 29/10/07

Draw sheet yellow 3

Bath towel 4 3 yellow; 1 white

Children gown blue 2

Children suit 4 2 blue; 2 pink

NEW DELIVERIES:

Koken baby boy/girl 2 12/11/2007

Baby IV head Laerdal 1 12/11/2007

ALS baby 200 1 12/11/2007

Multivenous trng. Arm 1 12/11/2007

Special needs infant female 1 12/11/2007

IV baby arm Nasco 1 12/11/2007

Pediatric injection head Adam 1 12/11/2007

SIMULATOR / MANIKIN

Nita Newborn 1 12/11/2007

Alaris IV pump 1 02/03/2008

Thermometer electronic suretemp plus 1 10/11/2008

Balance baby scale digital 1 10/11/2008

Balance baby scale 1 10/11/2008

Sphymomanometer miniature 3 10/11/2008

Stethoscope littmann classic II 7 10/11/2008

Ambu bag resuscitator w/ connector 1 10/11/2008

Trolley w/ 1 drawer 2 shelves 1 10/11/2008

Pulse oximeter audio & visual 2 10/11/2008

Abdominal colostomy model 1

IV Arm, Laerdal 1

Pediatric care LABORATORY

ITEM # EQUIPMENT / SUPPLIES QTTY. REMARKS

A SIMULATOR / MANIKIN

1 Child Crisis Manikin 1 old

2 Child Nursing Doll 1 w/ accessories

3 Infant model for nursing practice 1 2004

4 Kyle 3y/o child CPR 1 04

5 Kyle 3y/o child CPR 1 old

6 Mike/Michelle 1 old; R-lower leg removed

7 Mike/Michelle 5y/o 1 old

8 Mike/Michelle infusion leg 1 old; worn out

9 Mike/Michelle injection arm 1 old; worn out

10 Laerdal Sim Baby: 1 14/11/07

11 Dell Laptop gray 1 SN: 3ZG3F1

12 HP iPAQ Bluetooth 1

13 Logitech webcam 1

14 Entuitive monitor 1

14 link box 1 new, replaced on 14/07/2009

15 Compressor 1

16 Dell CPU Optiplex 745 1 3GNJFDI

17 Dell keyboard 2 759-GBIW;7BE-ODJM

18 Dell mouse 2 ODJ301; G1401JL0

19 Virtual IV 1 SN: 33070082-C

20 Laerdal mega-code vitalsim w/ RC 1 12/11/2007

21 Little Junior 1 11/09/2008

22 Disposable lungs 25 11/09/2008

23 Resusci Junior w/ skillguide 1 11/09/2008

24 Disposable lungs 25 11/09/2008

25 Manikin face shields pk/6 11/09/2008

B FURNITURE

1 Bed (electronic) 1 from KFHU

2 Child Bed 1

3 Bedside locker 1

4 Computer table 2 from KFHU; from Comp. Lab.

5 Laboratory table 4 from KFHU

6 Swivel chair 17

7 Steel cabinet w/ glass door 4 2006; 3 big; 1 small

8 Steel cabinet w/ glass door 1 from KFHU

9 Filing trolley 1 29/10/07

ITEM # EQUIPMENT / SUPPLIES QTTY. REMARKS

C. ELECTRONICS

1 Dell Optiplex GX520 CPU 1 SN: 36VBT1J

2 Dell monitor 1 67I-1YUU

3 Dell keyboard 1 6AB-A1GU

4 Dell mouse 1 ODJ301

5 Dinamapp 1 from KFHU

6 Terumo IV pump 1 from KFHU;in Store room

7 EIKI data show w/ RC & manual 1 11/11/2007; 39719

8 Alaris IV pump 1 02/03/2008

D INSTRUMENTS

1 Laryngoscope 1 2006; w/ 3 blades curved

2 Physical Assessment kit 2

3 Oxygen hood 2

4 Stethoscope (Spectrum) 2

5 Thermoscan 1

E OTHERS

1 Screen projector 1 from KFHU

2 Footstool 1 from KFHU; store room

3 Patient's screen white 1

4 Piped in O2 & suction (mounted) 1

5 Bedsheet (blue) 2

6 Draw sheet (yellow) 2

7 Bath towel 18 16 yellow; 2 white old

8 Hamper 9 2006; 1 old

9 Pillow 2

10 Bed cover blue 4 11/11/2007

11 Bed cover white 2 11/11/2007; 3 old

12 Bed sheet white 8 11/11/2007; 4 old

13 Bed sheet w/ design cream 3 11/11/2007

14 Pillow case (blue) 17 11/11/2007; 12 old; 5 new

15 Face towel white 15 11/11/2007

16 Flannel sheet white 12 11/11/2007

17 Children gown 8 11/11/2007;3 blue, 5 pink

18 Children suit blue 1 11/11/2007

NEW DELIVERIES

1 Thermometer electronic 1 11/10/08 missing probe

2 Weighing scale electronic 1 10/11/2008

3 Balance baby scale digital 1 10/11/2008

4 Balance baby scale regular 1 10/11/2008

ITEM # EQUIPMENT / SUPPLIES QTTY. REMARKS

5 Sphygmomanometer miniature 2 10/11/2008

6 Stethoscope (Littman) 3 10/11/2008

7 Ambu bag resuscitator 1 10/11/2008

8 Trolley w/ 1 drawer 1 10/11/2008

9 Automatic Voltage Regulator 2 23/11/08

List of Equipment Requiring Maintenance

- One swivel chair (broken).

List of Equipment to Be Purchased

1- Gastrostomy Manikin.

2- Colostomy Manikins

3- Gastrostomy feeding tubes.

4- Napkins.

5- Different types of baby feeds.

6- Educational Stethoscopes