The observer (Buddy nurse) would check off the skills as the Graduate nurse performs them.

As a reminder, let the graduate nurse independently rehearse the skills without the observer's help.

• You will check the medication and conduct three checks on the medication or infusion solution, verifying any calculations related to the medication or infusion and confirming the patient details with the patient.

• Take this time to practice completing all the skills without coaching and to check your recall of what you know and to prepare for the CSSA.

For students playing the role of the Buddy RN (Observer): 

• Please observe the simulation and note areas where the student performed well and where they could improve.

• Document how the Graduate RN completed the IV medication administration using the ANSAT tool.

• You will share your feedback with the Graduate RN during the debrief session.

• Please refrain from offering any prompts or suggestions throughout the simulation.  

• What do we need to practice more? 

• Did we maintain the aseptic field throughout preparation and administration? 

• Did we experience interruptions during the medication preparations phase? 

• How did we go about calculating infusion rates? 

• Were we able to complete the clinical documentation with ease? 

1. IV fluids (1 Litre of 0.9% NaCl)

2. IV Injection of Ondansetron 4mg/2mL

3. IV flush.

1. Look up IV Ondansetron in the eMIMS

2. Look up med in the Australian Injectable Handbook.

   • Check compatibility with 0.9% NaCl

   • Review administration

3. Complete 2nd 7 Rights + Med Check with RN for both IV fluids and IV Ondansetron.

• Performing a Bed Safety/environment check as they are commencing their shift.

• Review IV fluid orders.

• Verify the patient's ID (name, DOB, and URN) and listen for the patient to state their name and DOB, comparing it to the patient's ID band and chart.

• Explain the plan to the patient.

Use the ANSAT tool: Buddy RN to observe and add notes.

• Image:https://www.sssaustralia.com.au/Images/ProductImages/Original/1487000_1.jpg

• stoma

• laceration

• staples and sutures

• covered in a surgical dressing or a cast

How does the nurse assess a wound that is covered in either a surgical dressing and/or cast?

What findings should we assess?

What are the signs and symptoms of infection?

When should we assess the wound?

• Resp: 16

• O2 Sats: 98%

• BP: 120/76

• HR: 70

• Temp: 37.1

• AVPU: Verbal

Neurovascular Obs (upper limb)

Warmth: Warm

Cap refill: < 2 seconds

Radial Pulse: strong

Sensation: pins and needs

Movement: unable due to local block

Swelling: mild

Bleeding: small serosanguineous drainage present on dressing

1. Signs of infection: erythema, oedema, exudate, malodour, warm to touch, elevated temperature, increased pain 

2. Circulation – assess tissue viability - the tissue is alive and has adequate circulation.

I – Identification 

Joe, a 62-year-old Italian-Australian male, who sustained a left femoral fracture following a fall and underwent left hip surgical repair (Open Reduction and Internal Fixation - ORIF) under general anaesthesia with a local nerve block.

S – Situation 
Joe is 2 hours postoperative following left hip surgical repair and requires ongoing monitoring. He currently remains drowsy and responds to verbal.

B – Background 

Joe sustained a left femur fracture following a fall associated with dizziness while walking his dog. 

Relevant history includes: 

• Hypertension (recent antihypertensive ceased due to hypotension) 

• Osteoarthritis 

He lives with his wife Isabella and is normally independent.

Postoperative Orders:

- Complete the postoperative observations, including the PQRST pain assessment and wound assessment

- Administer 1400 IV medication.

Student 2: Play the role of the senior RN (observer)

1400hrs Postoperative Orders:

4-hourly neurovascular assessment.

Provide postoperative education.

Graduate RN:

1. Introduce yourself (Buddy RN plays the patient's voice) and complete an ID check using the MAR.

2. Perform a postoperative assessment.

3. Check PIVC - complete VIP score charting.

4. Administer 1400 - IV SSI Prophylaxis antibiotic.