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ABSTRACT: S.U.M.M.I.T (Simulation Utilized for Mentoring and Measuring Integrative Thinking) to practice is a summative advanced practice nurse (APN) evaluation model using virtual simulation to assess clinical decision-making competencies of APN students. Students engage as grand round participants in an unfolding recorded patient encounter. Competence is assessed through their application of evidence-based rationales for diagnosis, diagnostics, interpretation, and care plan. S.U.M.M.I.T incorporates an objective competency-based rubric and concurrent feedback. Results demonstrate clear details of clinical reasoning, communication, diagnosis-focused care plan, patient safety, and education, allowing specific competency need mentoring by faculty.
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INTRODUCTION: It is widely acknowledged that nurses are crucial components in healthcare system. In their roles, nurses are regularly confronted with a variety of biological, physical, and chemical hazards during the course of performing their duties. The safety of nurses themselves, and subsequently that of their patients, depends directly upon the degree to which nurses have knowledge of occupational hazards specific to their jobs and managerial mechanisms for mitigating those hazards. The level of occupational safety and health training resources available to nurses, as well as management support, are critical factors in preventing adverse outcomes from routine job-related hazards. This study will identify gaps in self protective safety education for registered nurses working in emergency departments as well as for nursing students. Furthermore, this study reviews the nature and scope of occupational nursing hazards, and the degree to which current nursing education and position descriptions (or functional statements) equip nurses to recognize and address the hazards inherent in their jobs. METHOD: This study has three parts. First, a literature review was performed to summarize the nature and scope of occupational nursing hazards. Second, the safety components of position descriptions from 29 Veterans Affairs (VA) hospitals across the United States were obtained and evaluated by an expert panel of occupational health nurses. Finally, an expert panel of occupational health nurses evaluated the degree to which nursing accreditation standards are integrated with OSHA's list of known emergency department hazards; and a separate expert panel of occupational health nurses evaluated the degree to which current VA emergency department nursing position descriptions incorporated hazard recognition and control strategies. CONCLUSION: Ultimately, prevention of job-related injuries for nurses, and subsequently their patients, will depend directly on the degree to which nurses can identify and control the varied occupational hazards specific to jobs. Neither accreditation standards nor position descriptions adequately integrate common occupational hazard recognition and control strategies, nor do they adequately prepare nurses to identify and control hazards specific to nursing. A research approach that specifically addresses the current lack of formal on-the-job training for nurses regarding job-related hazard recognition and avoidance strategies is presented.