March 26, 2018By Dr. Kim Baily

Planning a Community College Simulation Program? Where To Start, Part 2

This exclusive HealthySim article is the second in a three part series which highlights some of the decisions that will be required when a healthcare simulation program are built with emphasis towards a Community College Program. This article focuses on space design, IT, AV, equipment, and more! Read Part 1 of How to Start a Community College program.

Sim Center Room and Lab Designing

The size and design of any simulation lab (s) will of course depend on the budget available and the square footage available for the lab. Visit a number of sim labs with spaces similar to the one being built. Pay close attention to the setup of all IT and AV systems in the sim lab, control room and debriefing room. If possible take representatives from IT and AV along so that they can see a finished lab.

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A single room for a simulation lab is not ideal however, simulation can still work effectively.  Some kind of partition must be made to separate the controller from the scenario area. Panels are available with one way mirrors which facilitate this separation. Ideally the ceiling lights should be on separate circuits because the one way mirrors work best when the lights are out on the controller side.

Colleges with small budgets are reluctant to pay for outside vendors to either help design simulation suites or to do the actual building. These colleges may feel building and designing in house can save the college money. The Board of Governors will need to approve expenditures so enlist administration support early on in the build. Labor costs for construction consume a significant portion of any build. Even though facilities crews work in house there is a cost associated with their time and all departments involved in the project will have to provide cost estimates.

If outside help is available for design and building a bigger budget is needed. Make sure all the stakeholders are involved from the beginning. Take your facilities, IT, and AV staff to visit a sim lab to show them the many components required. Make sure they understand how all the pieces of equipment talk to each other, the cabling required, the gas lines, compressors if used, the video recording and playback etc., etc. Some manikin vendors have systems that integrate many of these components but they cost money.

Issues to Consider When Starting a New Sim Program

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  • Timeline for each step of the project.
    • Could construction noise interfere with classes? Can the noisy work be completed in summer months when possibly less classes are on campus.
      • Plan for cabling to be installed while studs are exposed and before walls are finished.
  • One lab or many?
  • Location of control room (s).
  • One way mirrors
    • Will observers and operators be able to see directly into the sim lab or only remotely via cameras and TV screens.
  • Storage, there is never enough! This is particularly true if you have more than one manikin or have large pieces of equipment such as crash carts, isolation carts, med carts, baby cribs, IV poles and pumps etc.
    • Always keep the boxes and cases that manikins are shipped in. Unless a very expensive service policy has been purchased, the manikin will need to be shipped across country for service or repair. Allow adequate storage space for these very large boxes.
      • Some manikin companies offer certification courses for sim techs which allows them to conduct some maintenance and repairs without voiding warranties.
    • Separate storage for manikins not being used. Transfer to gurneys using a slide board. This not only prevents injury to lab personnel but also prevents injury to the manikins. The neck of manikins is fairly delicate and they can break easily. Allow only trained personnel to move manikins. Store manikins flat if possible. Manikins sitting in wheelchairs around the edge of the room should be avoided.
  • Access: Extra wide doorways for moving beds or gurneys. If the doors are too small, beds will have to be broken apart and moved sideways.
  • Preparation space e.g. to make blood bags, dressings, meds, staging.
  • Sink for preparation and clean up
    • This is often an expensive item because of plumbing requirements, however simulation labs need large sinks for preparation and clean up. A small hand basin will not work.
    • Sinks in the sim lab. Hand gel can be used for hand hygiene, but functioning sinks are useful.
  • Compressors/Gases. Many of the new tetherless manikins have compressors inside the manikin however, compressors are still needed for suctioning and simulated oxygen or air supply. If there is a respiratory technician program, real gases may needed for ventilators to work.
    • Note, compressors are noisy so if possible, locate compressors outside the sim lab with a hose going through the wall to the headwall above the bed.   When designing a new sim lab, configure compressor installation ahead of time. Some centers have a compressor on the roof.
    • Gas supplies such as tanks for ventilators will need a safe storage place and or a method of piping gases into the sim room (respiratory tech programs).
  • Consider how individual scenario props will be stored.
    • A central supply where equipment is gathered for each sim
    • Individual storage bins with ID bands, dressings, meds, NG etc
      • Where will the bins be stored.
  • Electronic Health Records
  • IT system
    • Networking linking manikins, displays, control computers etc
    • Cabling between equipment in control room, sim lab and debriefing room
    • Wireless networks.
    • Cloud based systems
    • Manikin vendor systems
    • Laptops
    • Computer storage if keeping scenarios.
  • AV system
    • Recording and playback equipment including cameras, microphones, speakers
      • Feedback needs to be eliminated because learners cannot hear what is being said.
  • Debriefing room with TV and capability to playback scenarios.

Equipment – Assess Then Buy 

  • Many simulation programs start out backwards with the purchase of a very expensive manikin or perhaps several manikins but no room setup or debriefing room.
    • These high-end manikins are often unnecessary for a community college program.
      • For example, many OB courses in community college ADN programs run for 6-8 weeks and typically do not go into complex obstetrical emergencies in great detail. Purchasing an $80,000 birthing manikin that can mimic these emergencies is really unnecessary although delivering babies for would-be donors or board of governors is pretty impressive. There are quite a few sophisticated medical-surgical nursing manikins that will be much more useful and coast one third of the price.
        • Consider a female manikin that can be used for OB and med-surg.
      • If there is only one manikin, select one that can be male/female.  Some of the manikins are big with very masculine features which makes them difficult to use in scenarios with female patients.
      • Who will operate and maintain new equipment. For example, while the simulation coordinator or sim ops personnel is away on a conference, the dean purchases an automated medication dispenser with computer on wheels that can be used at the bedside to scan patient and meds. This sounds wonderful but there are some serious practical considerations to such a purchase
        • Does the machine only work with proprietary medications which must be purchased from the vendor? If yes, how much do the medications cost? Will there be ongoing money to buy these medications?
        • How many students will use the machine? Is the cart just for the sim lab or will it be used for the fundamentals class with 50 students all expecting to use the cart? How many meds will you need and what is the cost?
        • Will homemade meds with bar codes work on this machine?
        • Does the electronic medication dispenser work with existing electronic health records?
        • Who will set up the machine including stocking and making sure the reconciliation is correct? Some machines will not dispense if the reconciliation is incorrect.
        • Will faculty be trained how to set up and operate the med cart?
        • Will this responsibility be part of the sim ops person?
  • Crash cart
  • Isolation Cart
  • Linen hampers
  • Headwall with or without functioning gases and suction.
  • Furniture (beds, chairs, over bed table)
  • IV pumps, poles and other medical equipment.
  • White boards.
  • Code blue button
  • Patient call system – this should be way down the list of priorities because they are often expensive and not used all that much.
  • Transfer board
  • Gurneys
  • Isolet
  • Storage shelving for manikins and equipment
  • Linens

Planning a new sim space is both fun and challenging. Visit as many sim labs as possible.  See what other schools have done. See how well their plans either work or do not work. Find out how they operate their sim. Consider whether your sim will be conducted the same way or different. If different will a different design be needed.

Ask other programs what would they do differently. Many times lack of storage is an issue. If building and cabling in house, make sure that everyone involved understands how sim works. If funds allow, consider using an outside consultant to help plan the space. In any case, providing simulation experiences will enhance student learning and ultimately improve patient safety outcomes.

Today’s article was guest authored by Kim Baily PhD, MSN, RN, CNE, Simulation Coordinator for Los Angeles Harbor College. Over the past 15 years Kim has developed and implemented several college simulation programs and currently chairs the Southern California Simulation Collaborative.

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Learn more about Planning a Community College Simulation Program? Where To St!

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Posted In
Administration, Education, Faculty / Supervisors, Simulation Centers
Tags
community college, design, development, nursing education, program, rpx, sim center, Simulation Design
community college, design, development, nursing education, program, rpx, sim center, Simulation Design