Tuesday, March 1, 2011

TAGteacher Tale: Nursing Skills Practice

by Maggie Ouillette

Here's the latest on the tagging project I have been working on.

I needed more practice with placing long term IV catheters in home care patients, and wanted to set myself up for success. I decided to use TAGteach to help me to be successful.

The first step was to review the procedure and identify tag points. It's very tempting to want to have errorless learning by tagging everything.

A few months ago, I was working on developing tag points for teaching medication injections.I learned from that experience that tagging every individual step isn't practical or necessary.
My goal was to identify the tag points that were most important for me to perform the skill successfully.

In analyzing the previous practice session, it was very apparent that my anxiety played a role in my performance. I decided that the first tag point would address that issue.

Exercise One:

The first exercise involved a behavior that would enhance my ability to remain calm and focused.
Walk to doorway, stop, take two deep breaths before entering the room. My husband tagged me for this one.

The instructions " After you stop at the doorway, the tag point is TAKE TWO DEEP BREATHS".

Rationale:This behavior will help learner (me) to maintain focus and relax prior to interacting with the patient.

I practiced walking to the doorway, stopping and taking two deep breaths. My husband Jim tagged me. I repeated the exercise five time, was successful each time.

Applications for medical and nursing students.
This deep breath behavior could be used for the multiple 'first' experiences, such as hands on procedures. Students could work in groups in the classroom setting, taking turns tagging one another.

Exercise Two: 

The second exercise involved naming each of the items listed. I wrote a list of all the supplies (fourteen items) needed for the procedure, including extra items that might be needed.

The instructions: "the tag point is NAME AN ITEM ON THE LIST".

Rationale: Immediate recall of all items needed for the procedure will help the procedure to go smoothly.
My husband tagged me each time I named an item. If I hadn't named all listed items, my husband waited a few seconds, then said "try again"

I performed the exercise four times. By the third time I was naming all items on the list without hesitation.Its amazing how good I felt that I was able to rattle off the items on the list.

Applications for medical and nursing students.

This exercise could be used to help familiarize students with supplies needed for procedures. A hands-on version would be easy to set up in a classroom situation, with students tagging one another for retrieving specific items.

I realize that these exercise may seem oversimplified. They are valuable because they start the learner at a point of success which can be built upon. Tag points should always be individualized for the specific learners.

The other behaviors that I will work on will be: advancing the introducer into the vein, handling the catheter with sterile forceps, and removing tourniquet immediately after veinpuncture.

More to come

Maggie Ouillette
Whitmore Lake Michigan

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