Healthcare Simulation Center Handbook

Table of Contents

• Section I: Code of Conduct
• Section II: Tours
• Section II: Attendance
• Section IV: Simulation Equipment
• Section V: Simulation Scenarios
• Section VI: Resources and Social Media
• Section VII: Ethics and Safety
• Section VIII: Teaching Family
• Section IX: Leadership

Code of Conduct

Purpose: Provide participant guidelines for conducting themselves in a professional respectful manner to maintain a safe and productive environment.

1. Participants must sign a multi-wavier release form within the EXXAT platform that includes agreement to engage with the mannequins/partial task trainers/standardized patients and simulated environment as if they were real, conduct themselves in a professional manner during simulation, provide feedback to peers with respect and professionalism and maintain strict confidentiality about the details of simulated experiences, the simulation scenarios and the performance of any participant(s) either at the start of their educational program or the beginning of the simulation experience. See compliance requirements in the Nursing Student Handbook.
2. Disrespect toward students, faculty, staff, the space or resources will not be tolerated.
3. Nursing student participants will adhere to policies and procedures in the Nursing Student Handbook related to clinical attendance, punctuality and confidentiality. [Undergraduate nursing student handbook] [Graduate nursing handbook]
4. All participants are expected to come prepared having completed assigned preparatory work with a professional attitude and a desire to actively participate in the learning experience.
5. The HCSC is a shared space. As such, users are expected to clean up after themselves.
   1. Simulation space, control rooms and debriefing rooms should be cleared of all supplies, papers and equipment that are not part of the standard room set up by the end of each day.
   2. Return all equipment to its appropriate location.
   3. All consumable supplies that can be reused should be left neatly where they were set up.
   4. Garbage should be disposed of properly.
6. Any damage to equipment or operating problems must be reported to the HCSC staff immediately by e-mailing or calling the simulation site coordinator at the appropriate site.
7. Use pencils when in the simulation space. NEVER use ink pens, felt-tipped markers, iodine or betadine near the mannequins or task trainers. These items will PERMANENTLY stain the equipment.
8. Do not use the equipment for any purpose other than specified.
9. Food and chewing gum are not permitted, and drinks must have a lid on them in the HCSC.
10. Participants in educational and performance assessment activities will adhere to the same clinical dress code as they would for their respective discipline.
11. A visible identification badge is always required of all participants (excluding simulation actors or standardized patients).
12. A stethoscope should be brought to all standardized patient and high-fidelity simulation sessions.
13. The HCSC simulation site coordinator and HCSC director/assistant director must be notified of cancellations within 24 hours of the scheduled session.

A copy of this code of conduct is displayed on a wall in each facility. Violations of the code of conduct are handled at the discretion of the respective HCSC director.

Complaint Resolution

Purpose: The policy addresses how faculty and/or student issues will be addressed per SDSU University guidelines.

Process:

1. Course faculty, simulationists and/or students must notify the South Dakota State University College of Nursing HCSC director of any site simulation issues or personnel/faculty issues.

2. Individuals that would like to submit a complaint or feedback anonymously may submit via Question Pro. This route is viewed by the HCSC director only. Alternatively, you may use the button.

   Question Pro

Tours

Purpose: Interested third parties, donors and perspective community agencies request to view simulation space or be present during simulation activities to understand the complexity of the learning environment and the use of the equipment and supplies.

Process:

1. Tours are scheduled with the simulation site coordinator at each site. Tours may be scheduled Monday through Friday between 0800-1630 unless other arrangements have been made through the HCSC director.
2. Observers must follow the guidelines of the confidentiality and respect (HIPAA and FERPA) in the participant guest waiver release form.

Attendance

Purpose: This policy lists which nursing events are considered excused absences and how simulation make-up is arranged.

SDSU’s general class attendance policy, as stated in the SDSU undergraduate catalog and policy and procedure manual, will be followed. Here is the specific link to the undergraduate students policy.

• College of Nursing Excused Absences: A excused absence will follow the circumstances discussed in the above policy and procedure manual. Any absence from clinical/simulation will required that the student make up the missed clinical hours and assignments.
• College of Nursing Unexcused Absences: An unexcused absence will initiate a Performance Improvement Plan as identified in the College of Nursing accountability performance standards statement within syllabus. Any absence from clinical/simulation will require that the student make up the missed clinical hours and assignments. For an unexcused absence, the student will be billed by the College of Nursing for payment for the makeup clinical/simulation hours as outlined in the billing procedure for an unexcused clinical absence/simulation/community experience. It is the responsibility of the student to initiate the process of scheduling clinical/simulation makeup via jacks’ e-mail within twenty-four hours (M-F) after the absence. Undergraduate students should contact the semester coordinator and the simulation site coordinator. Graduate students should contact the simulationist assigned to that experience. The unexcused absence will be noted on the clinical evaluation tool.

Event Cancellation of Simulation

Purpose: This policy will provide safe and uniform cancellation of simulation. Refer to the South Dakota Board of Regents policy.

Process:

1. In case of severe weather or other unanticipated events, the HCSC will follow SDSU University policy regarding delays or cancellations.
2. For non-weather or university emergency concerns, the simulationist assigned to the simulation will notify the simulation site coordinator. The simulation site coordinator will notify the HCSC director of the issue. The simulation site coordinator or director will contact all faculty and participants assigned for simulation to cancel the scheduled simulation.
3. The simulation site coordinator will work with faculty to reschedule the event.

Simulation Equipment

Storage and Maintenance of Equipment and Supplies

Purpose: Proper maintenance of supplies and equipment is required for safe use and handling. Appropriate maintenance of equipment, timely repair and service must be ensured for the longevity of equipment within the HCSC. Equipment that is out of service interferes with scheduled training and disrupts curricula.

Process:

1. All and supplies will be secured within locked areas of the HCSC.
2. If equipment or software is not functioning properly, a simulation technician will trouble shoot and when possible, resolve the issue(s). This may required contacting the equipment vendor to determine appropriate actions. If the problem is not resolved, the HCSC director is to be notified. Maintenance/replacement records will be documented.
3. Maintenance of equipment will be performed according to manufacturer recommendations. Laerdal and other software should be completed biannually, or as they become available.
4. Consumable supplies, equipment and simulator components will be managed and replaced by the simulation technician, as necessary, following the HCSC equipment ordering guidelines. Any request for new equipment will be send to the HCSC director, using the new equipment request form.
5. Annual equipment needs assessment is completed on each site for necessary replacement upgrades related to program growth. The simulation and experiential learning committee reviews and prioritizes requests based on program needs. The HCSC director communicates these needs through the appropriate channels to ensure adequate operations of the HCSC.
6. Task trainers and other simulation equipment should be cleaned after each use, and prior to storage, following manufacturer guidelines and current public health concerns.

Simulation Scenarios

Validation of Healthcare Simulation Center Scenarios

Purpose: This policy will provide steps to ensure simulation scenario validation for use in the SDSU CON Healthcare Simulation Center. To provide simulation participants with current evidence-based practice, scenarios will be developed and reviewed according to this policy.

Process:

1. The course team will complete the Simulation Scenario Request Form to propose a simulation scenario to meet a gap in the curriculum or course outcome. The HCSC director will be review requests and bring any pertinent items to the simulation and experiential learning committee.
2. Simulation scenarios developed by SDSU CON faculty/staff for use in the HCSC will utilize the approved simulation scenario template. Template includes resources to follow the Healthcare Simulation Standards of Best Practices^SM using evidence-based practice and for a content expert review.
3. It is strongly recommended that all scenarios developed by SDSU CON faculty/staff for use in the Healthcare Simulation Center are reviewed for current and evidence-based practice by an independent content expert. Independent content expert may be based at SDSU or the community.
4. Simulation scenarios will be provided to Healthcare Simulation Center personnel at least two weeks prior to scheduled simulation. This will ensure that Healthcare Simulation Center personnel have the appropriate technologies, equipment and disposable supplies to successfully run the simulation.
5. Simulation scenarios used by SDSU CON simulation facilitators will be reviewed for current evidence-based practice annually by the simulation and experiential learning committee.

Resources and Social Media

Prioritization of Simulation Resources

Purpose: This policy will outline the scheduling and use of simulation resources.

Process:

1. The use of simulation mannequins, equipment and supplies conducted by the HCSC will take precedence over outside community agencies for contracted use.
2. Any equipment taken out of the HCSC space must be signed out using the SDSU check-out form. If there are multiple items needed for a community event or clinical experience then the equipment request form should be filled out and sent to the site simulation tech to allow proper prep and planning. Capital equipment can only be removed from the SDSU HCSC upon prior approval from the HCSC director in accordance with SD law and university policies.
3. Scheduling of simulations will be completed by the simulation site coordinator.
4. When courses overlap within the College of Nursing, the simulation site coordinator and HCSC director will review the course calendar, number of students involved, room availability, facilitator availability and equipment needs to determine the best solution for each simulation activity overlap/

Video Recording and Data Retention in Simulation

Purpose; This policy will provide steps to ensure safe use and storage of data and video within the HCSC.

1. All data, student evaluation and audio-visual recording are kept on SimCapture Software that can only be accessed through a secure password. Only SDSU simulationists have access to the SimCapture record database.
2. Participant consent for video recording for educational and research use, students with the College of Nursing will sign the undergraduate multi-waiver release form or the graduate multi-waiver release form at the start of the program. All other participants will consent using the HCSC participant guest waiver release form before the simulation activity.
3. Consent for media or other non-education needs, participants will sign the HCSC media, photo and video release waiver.
4. All data is electronic and stored on a secure cloud system.
5. All data is backed-up on the secure cloud system.
6. If there are technology issues with the system and paper data and evaluation are collected, they will be kept in a locked file on the simulation site coordinators office and destroyed once the student graduate from the College of Nursing program.
7. All student and educational partners simulation records, and video recordings will be kept until the student graduates from the College of Nursing program and destroyed/deleted by the HCSC director within 7 years of program completion. Research data with IRB and signed consent will be destroyed/deleted from the system with seven years or according to IRS documents if stated differently.

Social Media and Electronic Communication in Simulation

Purpose: To describe the appropriate use of social media and define inappropriate use and associated reporting requirements. Consequences for misuse of social media are provided.

1. Appropriate Use of Social Media
   1. Participants have ethical and legal obligations to maintain privacy and confidentiality at all times. Participants must not post any identifiable participant, facilitator or standardized human patient information. Removing the individual’s name does not necessarily protect the person or patient’s identity, and sharing information, even with names removed, may be enough to constitute a violation of The Family Educational Rights and Privacy Act (FERPA) and/or the Health Insurance Portability and Accountability Act (HIPAA) and may have academic, employment and legal consequences (American Nurses Association, 2011).
   2. When using social media, participants should only post content that reflects positively on them and the institution or discipline from which they are representing. If participants post content regarding the institution or discipline, it should be clear that it does not represent the institution or discipline and that the content posted represents only the views of the participant. Participants must promptly report any identified breach of confidentiality or privacy.
   3. Future employers and educational institutions conduct web searches on prospective employees including online information and postings and may use that information to make hiring decisions. Remember that inappropriate online postings may impact future career options within the respective profession.
   4. When using social media and electronic communication, participants should follow the netiquette guidelines and adhere to SDSU's social networking guidelines.
2. Inappropriate Use of Social Media
   1. Participants must not post any personal or health related information associated with standardized human patients or others such as name, diagnoses, age, photographs or other images, injuries or treatments of patients or other information in regard to: procedures, surgeries, births, deaths or any incidents on any social media.
   2. Participants must not transmit, by way of any electronic media, any standardized human patient-related information or image that is reasonably anticipated to violate patient rights to confidentiality or privacy or to otherwise degrade or embarrass the standardized human patient.
   3. Participants must not refer to standardized human patients, instructor or peers in a disparaging manner, even if they are not identified.
   4. Participants must not take photos or videos of standardized human patients or peers during simulation on personal devices, including mobile devices.
   5. Participants must not make disparaging remarks about peers or instructors.
3. Reporting of Inappropriate Use of Social media
   1. Report any breach of confidentiality or privacy in social media committed by participants to a facilitator, adviser or supervisor.
   2. Participants who view content that violates ethical or legal standards should first bring the content in question to the attention of the individual who posted it so that this individual can take appropriate action.
4. Consequences
   1. Any student failing to adhere to the standards set forth in this policy is subject to administrative action, including any and all of the following: written reprimand, course failure, administrative withdrawal from the nursing major, and administrative withdrawal from the university.
   2. Any post that could be harmful or reflect negatively on other students, the College of Nursing, SDSU or any other persons, may result in liability for the individual sending the message. Posting photographs without permission from the individuals in the photographs may also result in legal consequences.

References

• American Nurses Association (2011). ANA’s principles for social networking and the nurse.
• National Council of State Boards of Nursing (2011). White paper: A nurse’s guide to the use of social media.

Ethics and Safety

Code of Ethics

The College of Nursing has adopted the Society for Simulation in Healthcare Simulationist Code of Ethics. Which include descriptions of the following topics. See the full SSH Code of Ethics for details.

• Integrity
• Transparency
• Mutual Respect
• Professionalism
• Accountability
• Results Orientation

Physical and Psychological Safety

Purpose: To define the College of Nursing’s requirements and expectations for creating a psychologically and physically safe learning environment and response to any unforeseen event within the HCSC.

1. Psychological safety impacts the participant’s ability to engage in simulation events and critical reflection. The nature of simulation can sometimes pose physical and/or psychological risks to the participant.
   1. To minimize these risks, simulation facilitators are responsible for pre-briefing which enables the participant to suspend disbelief so that they can immerse themselves safely in the simulation. Simulation facilitators are expected to provide a pre-brief that reminds participants of the objectives of the simulation and discusses the need for confidentiality, respectful communication and mutual support.
2. In the event that a participant is experiencing undo stress, anxiety or emotional distress, a simulation facilitator will intervene to assist the participant.
   1. The simulation facilitator will be responsible for determining the appropriate course of action including continuing or stopping the simulation.
   2. The participant’s emotional reaction to the simulation should be discussed in a private setting with appropriate support services.
3. Facilitator should provide additional support resources as needed.
   1. Mental health resources: SDSU Counseling Center: 605-688-5117
   2. Crisis Life-Line text: 988
   3. Crisis Care Center (Rapid City): 605-391-4863
      1. The HCSC director and site assistant dean should be notified within a reasonable time frame.
4. In the event that a participant’s physical safety is compromised, the simulation facilitator will stop the simulation, assess the participant, activate the emergency medical response system (if warranted) and then notify the appropriate HCSC director and site assistant dean.

Mechanisms to Appropriately Separate Simulation and Actual Patient Care Materials

Purpose: This policy will ensure the appropriate separation and safe use of simulation and actual patient care equipment, supplies and medications found within the HCSC.

Process:

1. Simulated medications may be purchased by a vendor or created by HCSC facilitators.
2. All medications that are used in the HCSC must be labeled “Not for Patient Use.” Individual demo medications used in simulation (i.e. pills, tablets, capsules) may be placed in small containers and labeled by HCSC simulationist.
3. All donated expired IV medications (bags or bottles, etc.) must be labeled “Not for Patient Use”. Empty containers may be filled with sterile or distilled water to simulate real medication. Addition of non-toxic materials may be added to the container to attain a more realistic appearance.
4. Expired medical supplies that have not been opened are often donated for use in the HCSC. After use of the expired supplies in simulation, they are discarded appropriately by the HCSC to ensure that they are not used for actual patient care.
5. All equipment in simulation is for SDSU College of Nursing HCSC use only and must be labeled "for simulation use only" and/or "for educational purposes only". SDSU does not loan any equipment to other facilities that provide actual patient care. Modifications are made to the equipment to ensure safe use by HCSC simulationists and participants. 
6. Equipment used during standardized patient simulations follow manufacturer’s recommendations.
7. Any capital equipment can only be removed the HCSC upon prior approval from the HCSC director.
8. All equipment, supplies, sharps and medications are secured within locked areas of the HCSC.
9. On-campus clinical equipment: The skills packs are purchased for use in the College of Nursing HCSC only. Supplies must remain on-campus for clinical experiences. Upon graduation or termination of the program, remaining supplies become property of SDSU. If a student transfers between SDSU College of Nursing sites, then faculty/staff will facilitate the equipment being moved. No equipment or supplies from the skills packs will be release directly to students.
10. Off campus clinical equipment:
    1. Graduate student skills bags and undergraduate community skills bags may be checked out by contacting the site lab coordinator or simulation technician and completing the appropriate forms.
    2. Any facility requesting assessment services must provide all equipment and supplies for the activity. Faculty will be responsible to ensure the agency has an affiliation agreement with SDSU College of Nursing and the appropriate equipment is rented for the experience.
    3. Unauthorized removal of equipment from the HCSC without approval will result in verbal warning for the first occurrence. For each subsequent unauthorized removal of supplies there will be a 5-point deduction from the total course grade.
       1. SDSU laboratory safety policy will be followed.
       2. In the event that there would be a clean needle stick, the exposure procedure policy needs to be followed.

Healthcare Simulation Center Leadership

• Director: Alyssa Zweifel, Ph.D., RN, CHSE
• Brookings simulation site coordinator: Annette Ray, M.S.N., RN, CNE, CHSE
• Aberdeen and Rapid City simulation site coordinator: Megan Watson, M.S., RN
• Sioux Falls simulation site coordinator: Takara Schomberg, M.S.N., RN, CNE, CHSE

The simulation and informatics committee created the SDSU College of Nursing "Healthcare Simulation Center Policy Handbook" in 2018, reviewed with minor edits in 2020. The simulation and experiential learning committee reviewed and made updates to the policy handbook in January 2022. This is located on InsideState and the College of Nursing page. It's free to review and download.

Updated December 2023 SELC Committee