Jill Ford, RN, and Sarah Leon, RN, are among 450 nurses at Queen of the
Valley Medical Center being trained to fine-tune their stroke assessment
skills using a very special “patient.” This training is critical
because early detection of stroke may minimize its long-term effects and
even prevent death. Funding for the training was provided through an $88,020
grant from
The Doctors Company Foundation.
In this training session, Hal®—an advanced medical simulation
mannequin—is a middle-aged man who rarely visited a doctor. He presents
to the ER and is placed in an exam room with a bed, fully equipped medicine
cart, and vital signs monitor. The nurses ask Hal to describe his symptoms.
“I feel okay now, but I keep getting headaches that come and go,”
he says in a garbled voice. “I’m having a pins-and-needles
sensation, but only on the right side of my face.”
“Can you lift your arms?” Leon asks.
“I can only move my left arm,” Hal responds.
The caregivers identify the warning signs of a stroke, which occurs when
blood stops flowing to the brain. They identify facial drooping, arm weakness,
and speech difficulty. Ford shines a light in Hal’s eyes, but his
pupils remain dilated. He then suffers an apparent seizure.
“If you’ve had a stroke, you’re at a 30 percent greater
risk of seizure,” trainer Karen Canepa, RN, informs the five nurses
in the training—Ford and Leon, who do the initial assessment, and
three others who observe the scenario.
“Hal, we think you may have had a stroke and a seizure,” Leon
says as they wrap up the scenario. “We’ve paged a neurologist
and called the Rapid Response Team. We’re going to take you to have
a CT scan so we can take a closer look at your brain.”
According to the Agency for Healthcare Research and Quality, simulation
training allows healthcare providers to apply theoretical knowledge in
a controlled environment without risks to patients.
“Simulation training supports our goal of providing patients with
the highest quality of care,” said JoAnn Munski, RN, nursing director
of orthopedic, neuroscience, and rehabilitation services at the Queen.
Many aspects of a real-life situation can be simulated, according to trainers
Suzy Banuelos, RN, and Nancy Stump, RN. Hal breathes and blinks. His pupils
react to light. He can talk through pre-programmed or real-time speech
controlled by a trainer. Trainers can add a bluish tint to his skin tone
to show lack of oxygen. They can change his body temperature, blood pressure,
pulse, and respiratory rate. Nurses can inject medicine into his veins
and perform a tracheotomy.
“This training ensures that all of our nurses—whether they
are in the ER, intensive care unit, or elsewhere in the hospital—are
proficient at finding risk factors so they can make safer and faster assessments,”
said neurohospitalist Matthew Ho, MD, stroke director at the Queen.
Queen of the Valley nurses (left to right) Nancy Stump, Suzy Banuelos,
and Jill Ford assess Hal for stroke.
Jill Ford (left) and JoAnn Munski, nursing director of the hospital’s
neuroscience program, care for Hal.