SCENARIO OVERVIEW: Eric Vasos is a 42-year-old client admitted to

SCENARIO OVERVIEW: Eric Vasos is a 42-year-old client admitted to the Adult Behavioral Health unit with a diagnosis of Bipolar I with psychotic features. Client has no other significant past medical history. Scenario takes place at 0700 with change of shift nurse to nurse report. SCENARIO RUN TIME: 30 minutes MAPPING OF LEARNING OBJECTIVES: Didactic Course Objectives MET UNMET 1. Implement safe and effective nursing are to individuals experiencing mental health alterations to achieve desired patient and systems outcomes. ☒ ☐ 2. Evaluate the outcomes of evidence-based interprofessional care. ☒ ☐ 3. Engage in a therapeutic relationship aimed at achieving desired patient outcomes. ☒ ☐ 4. Prioritize nursing actions based on biopsychosocial assessment data to achieve desired patient and systems outcomes. ☐ ☒ 5. Plan safe and effective transitions of care for individuals experiencing mental health alterations. ☒ ☐ Lab Course Objectives MET UNMET 1. Provide safe, effective, evidence-based care to adults and older adults experiencing mental health alterations. ☒ ☐ 2. Choose the correct nursing action to ensure patient safety and promote quality care. ☒ ☐ 3. Administer prescribed therapeutics safely and effectively. ☒ ☐ 4. Adapt interprofessional plan based on data from all relevant sources. ☐ ☒ 5. Create a safe care environment for patients experiencing a spectrum of mental health alterations. ☐ ☒ 6. Perform nursing actions that manage and support coping. ☒ ☐ Scenario Learning Objectives 1. Perform a focused assessment on a client with increased agitation. 2. Demonstrate effective therapeutic communication techniques to de-escalate an aggressive client. 3. Safely administer medications according to the Six Rights. 4. Communicate pertinent assessment data to the healthcare provider in a timely manner using SBAR. 5. Evaluate client response to evidence-based interventions performed to manage aggressive behaviors. 6. Initiate appropriate transmission-based precautions for a client with latent TB. 7. Utilize information technology to coordinate care and accurately document assessments and client response to interventions. 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 The medication nurse is accountable for performing all aspects of medication administration and documentation. The learner fulfilling this role will ensure all medications are administered according to the Rights of Medication Administration and clarify related orders with the healthcare provider. The medication nurse will provide client education on the actions, expected effects, required monitoring, and adverse reactions for each medication administered during the simulation-based activity. Additionally, the medication nurse must be prepared to provide observational findings, including but not limited to changes in client status or psychosocial needs, and make recommendations for nursing interventions. Documentation Nurse The documentation nurse is responsible for recording all assessments, interventions, and client outcomes during the simulation-based activity, with the exception of medication administration. The learner fulfilling this role will validate all data entered into the electronic health record with team members. The documentation nurse should also be prepared to provide observational findings, including but not limited to changes in client status or psychosocial needs, and make recommendations for nursing interventions. PRE-SIMULATION ASSIGNMENT Directions: Complete the following pre-simulation assignment using the course textbook or other refereed resources. Answers to questions must be written using APA format with a reference page. The completed document is to be uploaded into the Canvas dropbox by the instructor assigned due date. 1. Describe therapeutic techniques to de-escalate a client with mania, aggression, and psychosis. 2. Describe the pathophysiology of latent tuberculosis. 3. Describe the pathophysiology of bipolar I disorder. 4. Describe clinical manifestations of a client with Bipolar I with psychotic features. 5. Describe the appropriate use of seclusion and restraints. 6. Complete the table below for use of the medication haloperidol in the management of a client with bipolar I disorder. Haloperidol 1. Expected Pharmacological Action 2. Therapeutic Use 3. Contraindications/ Precautions 4. Interactions 5. Evaluation of Medication Effectiveness 6. Nursing Interventions 7. Client Education

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