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iRubric: RESP 3021 Final Simulation Rubric

iRubric: RESP 3021 Final Simulation Rubric

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RESP 3021 Final Simulation Rubric NUR 2320 Simulation Rubric Simulation Rubric for Neonatal/Pediatric Patients. Rubric Code: D2W6444 By robinsonjDSU Ready to use Public Rubric Subject: Health Type: Assessment Grade Levels: Undergraduate

Neonatal/Pediatric Simulation
	Novice Failure to meet desired learning goals. Response is off topic or largely incomplete and requires >4 verbal cues from the instructor. No critical thinking is evident. 0 pts	Emerging Some learning goals are met. Responds after 3-4 verbal cues from the instructor. Response lacks 1-2 important details. Shows some critical thinking. 1 pts	Proficient Adequate meeting of learning goals. Responds after 1-2 verbal cues from the instructor. Response is detailed and specific. Shows critical thinking. 2 pts	Accomplished Meeting or exceeding learning goals. Responds effectively without verbal cues from the instructor. Response is compelling and specific and enriched by critical thinking. 3 pts
Clinical Situation Assessment The student will assess the situation and be able to incorporate clinical clues to guide their assessment and interventions. The student will interpret and develop interventions and rationale.	Novice Confused by clinical situation; observation is not organized and key assessment errors are made. Only focuses on single assessment data; does not attempt to refine assessment. Has difficulty making appropriate interventions.	Emerging Overwhelmed by case scenario data but able to make accurate assessments. Correctly identifies patterns of deviation from expected patterns but does not incorporate knowledge in interventions. Is able to identify appropriate interventions but not unable to act on them without advice.	Proficient Observations reflect integration of subjective and objective data, but not subtle clinical clues. Recognizes most patterns in deviations and incorporates knowledge in interventions. Interprets and develops interventions with little guidance.	Accomplished Observations and assessments are accurate; able to incorporate subtle clinical clues. Discovers and uses subtle clues to guide assessment and interventions. Interprets and develops interventions and rationale without guidance.
SBAR Communication The student will communicate in their care plan using the SBAR framework. Situation (Recognize) What is the concern? Background (Reflect) What do you know? Assessment (Respond)What did you do? Recommendation/Request What do you need?	Novice Stressed and unorganized; unable to communicate details during SBAR. Did not utilize any of the SBAR framework.	Emerging Tentative, but able to complete SBAR with prompts. Accurately and effectively utilized a part of the SBAR framework.	Proficient Confident and organized with SBAR communication with minimal prompts. Accurately and effectively utilized most of the SBAR framework.	Accomplished Confident and organized with SBAR communication without any guidance. Accurately and effectively utilized all of the SBAR framework.
Delivery Preparation The student is competent to adequately prepare for the delivery of the infant of all gestational ages and known diagnosis's. Student uses the appropriate settings when setting up equipment. SEE ATTACHED	Novice Preparation is incomplete and largely lacking key steps and/or materials. SEE ATTACHED	Emerging Preparation included critical steps, however was incomplete and lacking 3-4 key steps and/or materials. SEE ATTACHED	Proficient Preparation included critical steps and was mostly complete, lacking 1-2 key steps and/or materials. SEE ATTACHED	Accomplished Preparation was complete and included all necessary supplies and steps. Performed skill and critical elements of the skill. SEE ATTACHED
NRP The student knows how to competently manage the needs of a neonate/infant after delivery including ventilation, cold stress, SpO2 limits, and NRP criteria. Student uses MRSOPA to address decreased chest movement and poor clinical appearance. Student recognizes need to increase the PIP to 26-28. Gastroschesis: wrap exposed bowel in saran wrap.	Novice Student does not respond to pathology. Student forgets to dry and stimulate the infant. Student does not recognize the need to provide PPV. Student does not recommend appropriate intervention.	Emerging Recognizes the pathology, but response is inadequate or greatly delayed. Needs excessive prompting to dry and stimulate. Needs prompting to provide appropriate rate and PIP. Needs excessive prompting to provide continued respiratory support.	Proficient Recognize and eventually respond to pathology. Appropriately dries the infant, AND appropriately provides tactile stimulation after minimal prompting. Successfully provides PPV with appropriate rate and PIP. Verbalizes the need to assure adequate chest rise. Student recommends appropriate intervention after minimal prompting.	Accomplished Immediately recognize and properly respond to pathology. Appropriately dries the infant, AND appropriately provides tactile stimulation. Successfully provides PPV with appropriate rate and PIP. Verbalizes the need to assure adequate chest rise. Student recommends appropriate intervention.
Intubation The student is competent in the indications and procedure required to intubate the neonate/infant including the proper equipment.	Novice Student does not position the neonate correctly. Student displays poor intubation technique demonstrating no knowledge of key areas like: patient position, proper laryngoscope technique, avoids causing harm to patient during procedure, proper tube insertion with correct tube at reasonable depth, and checking placement of tube. Student does not secure tube and continue PPV until connection to a ventilator.	Emerging Has to be prompted to position the neonate correctly. Student displays limited knowledge of proper technique and is lacking knowledge in 2-3 of key areas like: patient position, proper laryngoscope technique, avoids causing harm to patient during procedure, proper tube insertion with correct tube at reasonable depth, and checking placement of tube. Student does not secure tube and continues PPV sporadically until connection to a ventilator.	Proficient Student demonstrates an understanding of technique but is lacking in key areas like: patient position, proper laryngoscope technique, avoids causing harm to patient during procedure, proper tube insertion with correct tube at reasonable depth, and checking placement of tube. Student secures tube and continues PPV, mostly continually, until connection to a ventilator.	Accomplished Positions head and neck to open airway successfully. Student demonstrates proper hand position throughout duration of the exercise. Student demonstrate thorough knowledge in key areas like: patient position, proper laryngoscope technique, avoids causing harm to patient during procedure, proper tube insertion with correct tube at reasonable depth, and checking placement of tube. Student secures tube and continues PPV continually until connection to a ventilator.
APGAR The student is competent in assigning APGAR scores after delivery. SEE ATTACHED	Novice Student is unable to assign appropriate APGAR, even with > 4 verbal cues from instructor. Student demonstrable clinical knowledge base is inadequate for clinical practice. SEE ATTACHED	Emerging Student is able to assign appropriate APGAR, however with 3-4 verbal cues from instructor. Student demonstrates knowledge of basic relevant principles. SEE ATTACHED	Proficient Student is able to assign appropriate APGAR, however with 1-2 verbal cues from instructor. Student has a good understanding of APGAR process and demonstrates good relevant knowledge base. SEE ATTACHED	Accomplished Student is able to assign appropriate APGAR with no verbal cues from instructor. Student has thorough understanding of APGAR process and demonstrates exceptional relevant knowledge base. SEE ATTACHED
Surfactant Administration The student knows the indications for surfactant therapy and is competent in surfactant dose calculation and administration procedures. Student knows how to correctly calculate the dose of surfactant (2.5 X wt. in kg) and uses correct technique to administer surfactant. SEE ATTACHED	Novice The student requires prompting to consider the necessity of surfactant administration. Student is unable to determine the correct dose without prompts or does not know the correct formula. Student does not follow proper technique to administer surfactant even with prompting. PPV is not provided continuously. SEE ATTACHED	Emerging The student considers the indication but is unable to recommend surfactant without frequent prompting. Student is able to determine correct dose with prompting or is able to use the correct formula. Student does not remember the proper technique to administer surfactant and must be directed throughout the procedure. PPV is provided frequently but not at an acceptable rate for the situation. SEE ATTACHED	Proficient The student considers the indication and recommended surfactant with minimal prompting. Student is able to determine correct dose with prompting or is able to use the correct formula. Student remembers the proper technique for most of the procedure or needs minimal prompting, to administer surfactant. PPV is provided for the majority of the procedure, but there are large portions where no PPV was given when needed. SEE ATTACHED	Accomplished The student correctly identifies the indication for the medication is able to determine the correct dose of surfactant with no prompting. Student is able to administer surfactant using the proper technique and PPV is provided continuously and at the proper rate for the procedure. SEE ATTACHED
Ventilator Initiation The student is competent at ventilator initiation according to the most recently available NBRC procedures. Settings: PIP < 26 cm H2O, RR 30-40, PEEP 3-8, I time < 0.5, FiO2 30-60% or match current settings if known. Exhaled Vt should be 1.8-4.8 mL.	Novice Needed several cues. Unable to perform any of the initial steps required in the skill listed. Fails to perform at least 2 elements without intervention or correction. Unable to identify critical components (using safe ventilating pressures).	Emerging Did critical steps, however needed more than 3-4 verbal cues to perform skill, some hesitation noted. Uses inaccurate or unable to recall correct equation or to perform calculation for exhaled Vt. Performs a minimum of 3 elements with no correction/intervention or self-corrects non-critical aspects.	Proficient Uses correct equations to determine exhaled Vt. Able to perform all aspects of calculations with minor mistakes/self-corrects on non-critical aspects. Performs a minimum of 4 elements with no correction/intervention or self-corrects non-critical aspects.	Accomplished Uses correct equations to determine exhaled Vt, performs the calculation correctly. Performs ALL elements with no assistance and in a reasonable period of time.
Blood Gas Analysis & Patient Manage The student is competent at blood gas analysis and knows the correct ways to manage the patient and properly correct an ABG abnormality, based on currently known NBRC standards. ABG #1: pH 7.22, CO2 60, O2 54, HCO3- 21.8 Exhaled Vt 1.5 mL (2.5 mL/kg). To correct ABG, PIP should be increased until exhaled Vt is 3-8 ml/kg	Novice Responses exhibit substandard comprehension of the fundamental concepts of the values utilized in ABG analysis. Significant errors exist in analysis. Student is unable to provide interventions to address acid/base or oxygenation imbalances appropriate to situation or interventions are not therapeutic or are contraindicated.	Emerging Responses exhibit incomplete grasp of one or more fundamental concepts in ABG analysis and/or has significant errors in analysis. Explanations are shallow or inaccurate. Student displays a weak grasp of appropriate interventions or has conflicting interventions. The proposed interventions are not contraindicated, but need refinement or expansion. Interventions are inadequate in only one case study.	Proficient Responses display adequate grasp of ABG values and the effects of variables in simulation. Some fuzziness is apparent but not of a significant or substantial nature. Overall competency is displayed. Student relates adequate understanding of appropriate interventions to remedy acid/base imbalances and hypoxemia. Uses interventions which an entry level practitioner would reasonably be expected to employ in patient care.	Accomplished Student displays a complete grasp of the fundamental concepts of arterial blood gas values. Correctly explains effect of variables on pH, oxygenation and compensatory mechanisms. Displays a superior and above average grasp of appropriate interventions. Exhibits an understanding of ABG analysis and appropriate interventions which exceeds his/her student peers.
Blood Gas Analysis & Patient Manage The student is competent at blood gas analysis and knows the correct ways to manage the patient and properly correct an ABG abnormality, based on currently known NBRC standards. ABG#2: pH 7.34, CO2 40, O2 110, HCO3- 21.9. Infants fio2 should be decreased and PEEP should be 3-5 cm H2O.	Novice Responses exhibit substandard comprehension of the fundamental concepts of the values utilized in ABG analysis. Significant errors exist in analysis. Student is unable to provide interventions to address acid/base or oxygenation imbalances appropriate to situation or interventions are not therapeutic or are contraindicated.	Emerging Responses exhibit incomplete grasp of one or more fundamental concepts in ABG analysis and/or has significant errors in analysis. Explanations are shallow or inaccurate. Student displays a weak grasp of appropriate interventions or has conflicting interventions. The proposed interventions are not contraindicated, but need refinement or expansion. Interventions are inadequate in only one case study.	Proficient Responses display adequate grasp of ABG values and the effects of variables in simulation. Some fuzziness is apparent but not of a significant or substantial nature. Overall competency is displayed. Student relates adequate understanding of appropriate interventions to remedy acid/base imbalances and hypoxemia. Uses interventions which an entry level practitioner would reasonably be expected to employ in patient care.	Accomplished Student displays a complete grasp of the fundamental concepts of arterial blood gas values. Correctly explains effect of variables on pH, oxygenation and compensatory mechanisms. Displays a superior and above average grasp of appropriate interventions. Exhibits an understanding of ABG analysis and appropriate interventions which exceeds his/her student peers.
Ventilator Troubleshooting The student can competently troubleshoot the ventilator. PIP has been increasing with a decreasing exhaled Vt (from 5 ml/kg to 3 ml/kg). SpO2 and vitals are stable. Vent should be evaluated for obstruction. Patient should be assessed. Student should suspect a pneumothorax and recommend a CXR (+1 bonus point to recommend transillumination first).	Novice Needed several cues. Unable to perform any of the required skill.	Emerging Did critical steps, however needed more than 3-4 verbal cues to perform skill, some hesitation noted. Is unsure of how to diagnose the problem with the ventilator/patient or how to adjust one or more variables to achieve a specific outcome. Appears to be guessing. Rationalization of thought process is not correct.	Proficient Performed skill and critical elements of skill with 1-2 verbal cues by instructor. Student is able to diagnose the problem with the ventilator/patient with minimal prompting and knows how to adjust one or more variables to achieve a specific outcome. If first attempt is not correct and self corrects on the second attempt. Is able to rationalize the thought process.	Accomplished Performed skill and critical elements of skill no verbal cues by instructor. Student is able to diagnose the problem with the ventilator/patient and knows how to adjust one or more variables to achieve a specific outcome, in a timely manner. Student is able to rationalize the thought process.
X-Ray Interpretation The student can assess available information about the patient, and based on that assessment provide the correct diagnosis and treatment, for disease processes discussed in RESP 3020 & 3021. Student should recognize pneumothorax on the chest x-ray.	Novice Needed several cues to interpret. Unable to generate a relevant differential diagnoses for radiographic findings. Often unable to describe relevant pathophysiology. Fails to integrate clinical information or cannot discuss probable case management/prognosis. Is unable to integrate clinical information when interpreting images and demonstrable clinical knowledge base is inadequate to adequately apply imaging results to clinical practice.	Emerging Did critical steps, however needed more than 3-4 verbal cues to interpret. Identifies major differential diagnoses, but is incomplete or disorganized. Describes basic concepts of pathophysiology of disease process with minor omissions. Describes major implications of radiographic findings but sometimes incomplete, lacks detail or accuracy. Integrates relevant clinical information, with minor omissions, and demonstrates knowledge of basic relevant clinical principles.	Proficient Usually identifies most likely differential diagnoses for radiographic lesions or patterns. Using clinical and radiographic findings, describes most components of pathophysiology of disease process. Usually describes impact of radiographic findings on case management and prognosis. Integrates most relevant clinical information in interpreting images and demonstrates good relevant knowledge base	Accomplished Needed 0 cues to interpret. Consistently identifies and ranks relevant differential diagnoses for radiographic lesions or patterns. Using clinical and radiographic findings, consistently describes detailed pathophysiology of disease process. Consistently and accurately describes impact of radiographic findings on case management and prognosis. Thoroughly integrates all clinical information in interpreting images and demonstrates exceptional relevant knowledge base.
Assess Information & Recommend Tx The student can assess available information, and provide the correct diagnosis and treatment, for disease processes discussed in RESP 3020 & 3021. Students should recognize the pneumothorax and recommend needle aspiration and a chest tube.	Novice Needed several cues. Student fails to gather pertinent information. Inadequate assessment performed. Does not correctly identify pathology and does not select appropriate treatment.	Emerging Did critical steps, however needed more than 3-4 verbal cues to perform skill, some hesitation noted. Student performs marginally effective assessment. Student identifies pathology eventually and selects a marginally appropriate treatment.	Proficient Performed skill and critical elements of skill, however needed 1-2 verbal cues. Student performs efficient assessment with minor omissions in technique or performance. Student identifies pathology with minimal prompting and selects an adequate treatment.	Accomplished Performed skill and critical elements of skill, needing 0 verbal cues by instructor. Student performs efficient assessment covering all necessary steps. Student correctly identifies pathology with no help and correctly identifies appropriate treatment.
Assess & Treat the Patient The student can assess available information about the patient, and based on that assessment provide the correct diagnosis and treatment, for disease processes discussed in RESP 3020 & 3021. Student should recognize the possibility the patient has a CDH and that CPAP could be exasperating the patients condition. Students should recommend a CXR and be able to identify a CDH on CXR. Student should recommend intubating the patient, inserting an OG tube, and placing the patient on 100% O2.	Novice Needed several cues. Student fails to gather pertinent information. Inadequate assessment performed. Does not correctly identify pathology and does not select appropriate treatment.	Emerging Did critical steps, however needed more than 3-4 verbal cues to perform skill, some hesitation noted. Student performs marginally effective assessment. Student identifies pathology eventually and selects a marginally appropriate treatment.	Proficient Performed skill and critical elements of skill, however needed 1-2 verbal cues. Student performs efficient assessment with minor omissions in technique or performance. Student identifies pathology with minimal prompting and selects an adequate treatment.	Accomplished Performed skill and critical elements of skill, needing 0 verbal cues by instructor. Student performs efficient assessment covering all necessary steps. Student correctly identifies pathology with no help and correctly identifies appropriate treatment.
Blood Gas Analysis & Patient Manage The student is competent at blood gas analysis and knows the correct ways to manage the patient and properly correct an ABG abnormality, based on currently known NBRC standards. AGB #3. pH 7.30, CO2 50, O2 60, HCO3- 26.9. Student should recognize the the ABG does not require treatment and is typical of an infant with a CDH.	Novice Responses exhibit substandard comprehension of the fundamental concepts of the values utilized in ABG analysis. Significant errors exist in analysis. Student is unable to provide interventions to address acid/base or oxygenation imbalances appropriate to situation or interventions are not therapeutic or are contraindicated.	Emerging Responses exhibit incomplete grasp of one or more fundamental concepts in ABG analysis and/or has significant errors in analysis. Explanations are shallow or inaccurate. Student displays a weak grasp of appropriate interventions or has conflicting interventions. The proposed interventions are not contraindicated, but need refinement or expansion. Interventions are inadequate in only one case study.	Proficient Responses display adequate grasp of ABG values and the effects of variables in simulation. Some fuzziness is apparent but not of a significant or substantial nature. Overall competency is displayed. Student relates adequate understanding of appropriate interventions to remedy acid/base imbalances and hypoxemia. Uses interventions which an entry level practitioner would reasonably be expected to employ in patient care.	Accomplished Student displays a complete grasp of the fundamental concepts of arterial blood gas values. Correctly explains effect of variables on pH, oxygenation and compensatory mechanisms. Displays a superior and above average grasp of appropriate interventions. Exhibits an understanding of ABG analysis and appropriate interventions which exceeds his/her student peers.
Ventilator Management & Weaning The student is competent at ventilator management and weaning according to the most recently available NBRC procedures. PIP 20, RR 12, PEEP 5, FiO2 30%. Student should recognize patient is able to be weaned and placed on invasive CPAP. CPAP 5 cm H2O FiO2 40% (10% above ventilator FiO2).	Novice Needed several cues. Student is unable to determine whether patient is responding appropriately to ventilator settings.	Emerging Did critical steps, however needed more than 3-4 verbal cues to perform skill, some hesitation noted. Able to recognize that ventilator settings are not appropriate but unable to make changes accordingly.	Proficient Performed skill and critical elements of skill with minimal verbal cues. Student was able to assess patient on ventilator and make mostly appropriate adjustments.	Accomplished Performed skill and critical elements of skill with 0 verbal cues. Student was able to assess patient on ventilator and make appropriate adjustments accordingly.
Teamwork The student will work as part of an interprofessional team and can interact and discuss patient care with members of the healthcare team. Students will be engaged and rethink ideas when necessary while encouraging and supporting the ideas and efforts of their team members.	Novice Students did not interact, discuss, nor ask questions to each other. Students did not exchange, defend, nor rethink their ideas. Students did not encourage nor support the ideas and efforts of their team members.	Emerging Students did contribute to the activity some of the time. Some of the time students did interact, discuss, and ask questions each other. Some of the time students did exchange, defend, and rethink their ideas. Some of the time students did encourage and support the ideas and efforts of their team members.	Proficient Students were engaged in the activity and contributed most of the time. The majority of the time students were engaged, discussed , and asked questions to each other. The majority of the time students were engaged and did exchange, defend, and rethink their ideas. The majority of the time students did encourage and support the ideas and efforts of their team members.	Accomplished Students were engaged in the activity and contributed throughout the simulation. The entire time students were engaged, discussed , and asked questions to each other. The entire time students were engaged and did exchange, defend, and rethink their ideas. The entire time students did encourage and support the ideas and efforts of their team members.

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