Scenario: John Kearns: Care of a Client with Acute Coronary Syndrome
Student Pre-Simulation Guide
PURPOSE:
The purpose of this document is to provide an overview of the simulation-based education (SBE) activity
aligned with the course and guide your preparation activities. This document will review the required
foundational concepts related to pathophysiology, management of the disease process, and the clinical
skills that learners will be expected to apply during the scenario.
SCENARIO OVERVIEW:
John Kearns is a 68-year-old male who presents to the Emergency Department for evaluation of chest
pain. Client has no significant past medical history. The scenario takes place at 0900 with nurse to nurse
handoff report.
SCENARIO RUN TIME: 40 minutes
MAPPING OF LEARNING OBJECTIVES:
Didactic Course Objectives MET UNMET
1. Implement safe and effective nursing care to adults and older adults ☒ ☐
experiencing complex health alterations to achieve desired patient,
systems, and population outcomes.
2. Defend the choice of nursing therapeutics based on the best available ☐ ☒
evidence to achieve patient, systems, and population outcomes.
3. Revise the plan of care based on biopsychosocial assessment data to ☒ ☐
achieve desired patient and population outcomes.
4. Prioritize nursing actions across patients based on aggregate ☒ ☐
biopsychosocial assessment data.
5. Lead the development of the interprofessional plan of care. ☐ ☒
6. Defend decisions from a cost-effectiveness perspective. ☐ ☒
Lab Course Objectives MET UNMET
1. Provide safe, effective evidence-based care to a group of adult and ☒ ☐
older adult patients to achieve desired patient, systems, and
population outcomes.
2. Administer prescribed therapeutics safely, effectively, and cost ☒ ☐
effectively.
3. Transition patients safely to other levels of care to achieve quality and ☒ ☐
cost system and population outcomes.
4. Gather and report nursing sensitive patient and population data to ☒ ☐
improve outcomes.
5. Manage self in a manner that promotes patient safety and quality of ☐ ☒
, care.
6. Establish a therapeutic relationship with patients. ☐ ☒
Scenario Learning Objectives
1. Correlate assessment findings and diagnostic lab data with the pathophysiology of acute
coronary syndrome and cardiogenic shock
2. Prioritize interventions in the plan of care for a client with acute coronary syndrome.
3. Recognize a change in client status and communicate pertinent abnormal assessment and
diagnostic lab data to the healthcare provider using SBAR.
4. Provide appropriate and timely interventions in response to changes in the client’s
physiological status.
5. Correctly calculate the dosage of intravenous medications and safely administer according to
the Six Rights.
6. Utilize the electronic health record to document and coordinate client care with members of the
interdisciplinary team.
7. Provide developmentally appropriate education on rational for interventions and the need to
transfer client to a higher level of care.
8. Provide nurse to nurse handoff report using SBAR to transition client do a different level of
care.
LEARNER ROLES DURING THE SIMULATION-BASED ACTIVITY
The facilitator of the SBE activity will ensure that each learner is assigned to a specific nursing role.
While each of the roles represent a component of the responsibilities of a nurse providing client care, it is
important that learners function as a nursing team to successfully complete the SBE activity. This may
require delegation and/or learners to assume responsibilities aligned with other roles. The learner roles for
this scenario are as follows:
Charge Nurse
The charge nurse is the team leader, ensuring the client receives safe, organized, high-quality care. The
learner fulfilling this role may delegate duties to members of the nursing team as appropriate. The charge
nurse will be the primary point person for communicating with members of the interdisciplinary team to
coordinate client care. This role requires the learner to keep members of the nursing team updated with
changes in client status, healthcare provider updates, and new information learned throughout the
scenario. Additionally, this role will support the primary nurse with the implementation of orders as
needed.
Primary Nurse
The primary nurse is fundamentally responsible for maintaining effective communication with the client
and/or family member(s). The learner fulfilling this role will obtain the client’s health history, perform
initial comprehensive or focused physical assessments and follow-up reassessments, and implement non-
medication interventions included in the plan of care. The primary nurse will purposefully observe the
client for any changes in status. Additionally, the primary nurse will provide all clients and family
members with education, with the exception of medication administration.
Medication Nurse
Student Pre-Simulation Guide
PURPOSE:
The purpose of this document is to provide an overview of the simulation-based education (SBE) activity
aligned with the course and guide your preparation activities. This document will review the required
foundational concepts related to pathophysiology, management of the disease process, and the clinical
skills that learners will be expected to apply during the scenario.
SCENARIO OVERVIEW:
John Kearns is a 68-year-old male who presents to the Emergency Department for evaluation of chest
pain. Client has no significant past medical history. The scenario takes place at 0900 with nurse to nurse
handoff report.
SCENARIO RUN TIME: 40 minutes
MAPPING OF LEARNING OBJECTIVES:
Didactic Course Objectives MET UNMET
1. Implement safe and effective nursing care to adults and older adults ☒ ☐
experiencing complex health alterations to achieve desired patient,
systems, and population outcomes.
2. Defend the choice of nursing therapeutics based on the best available ☐ ☒
evidence to achieve patient, systems, and population outcomes.
3. Revise the plan of care based on biopsychosocial assessment data to ☒ ☐
achieve desired patient and population outcomes.
4. Prioritize nursing actions across patients based on aggregate ☒ ☐
biopsychosocial assessment data.
5. Lead the development of the interprofessional plan of care. ☐ ☒
6. Defend decisions from a cost-effectiveness perspective. ☐ ☒
Lab Course Objectives MET UNMET
1. Provide safe, effective evidence-based care to a group of adult and ☒ ☐
older adult patients to achieve desired patient, systems, and
population outcomes.
2. Administer prescribed therapeutics safely, effectively, and cost ☒ ☐
effectively.
3. Transition patients safely to other levels of care to achieve quality and ☒ ☐
cost system and population outcomes.
4. Gather and report nursing sensitive patient and population data to ☒ ☐
improve outcomes.
5. Manage self in a manner that promotes patient safety and quality of ☐ ☒
, care.
6. Establish a therapeutic relationship with patients. ☐ ☒
Scenario Learning Objectives
1. Correlate assessment findings and diagnostic lab data with the pathophysiology of acute
coronary syndrome and cardiogenic shock
2. Prioritize interventions in the plan of care for a client with acute coronary syndrome.
3. Recognize a change in client status and communicate pertinent abnormal assessment and
diagnostic lab data to the healthcare provider using SBAR.
4. Provide appropriate and timely interventions in response to changes in the client’s
physiological status.
5. Correctly calculate the dosage of intravenous medications and safely administer according to
the Six Rights.
6. Utilize the electronic health record to document and coordinate client care with members of the
interdisciplinary team.
7. Provide developmentally appropriate education on rational for interventions and the need to
transfer client to a higher level of care.
8. Provide nurse to nurse handoff report using SBAR to transition client do a different level of
care.
LEARNER ROLES DURING THE SIMULATION-BASED ACTIVITY
The facilitator of the SBE activity will ensure that each learner is assigned to a specific nursing role.
While each of the roles represent a component of the responsibilities of a nurse providing client care, it is
important that learners function as a nursing team to successfully complete the SBE activity. This may
require delegation and/or learners to assume responsibilities aligned with other roles. The learner roles for
this scenario are as follows:
Charge Nurse
The charge nurse is the team leader, ensuring the client receives safe, organized, high-quality care. The
learner fulfilling this role may delegate duties to members of the nursing team as appropriate. The charge
nurse will be the primary point person for communicating with members of the interdisciplinary team to
coordinate client care. This role requires the learner to keep members of the nursing team updated with
changes in client status, healthcare provider updates, and new information learned throughout the
scenario. Additionally, this role will support the primary nurse with the implementation of orders as
needed.
Primary Nurse
The primary nurse is fundamentally responsible for maintaining effective communication with the client
and/or family member(s). The learner fulfilling this role will obtain the client’s health history, perform
initial comprehensive or focused physical assessments and follow-up reassessments, and implement non-
medication interventions included in the plan of care. The primary nurse will purposefully observe the
client for any changes in status. Additionally, the primary nurse will provide all clients and family
members with education, with the exception of medication administration.
Medication Nurse
