The application of high fidelity emergency nursing simulation to investigate perceptions towards simulation education and documentation practices after the transition to a digital health record system

Rikki Stanton1, Christie Harding1, Emily Cooper1, Mary Boyde1, Hannah Putland1, Jade Porter1, Clare Thomas1, Ben Learmont1, Elisabeth Fraser1, Lousie Nicholls1

1Princess Alexandra Hospital Emergency Department, Brisbane, Australia

Over the last eighteen months, our Queensland tertiary Emergency Department (ED) has been transitioning to a digital health record system. With this large organisational change, staff have been faced with many challenges including maintaining accurate documentation for deteriorating patients. Within nursing education, simulation has been recognised as an effective learning strategy providing an opportunity to develop verbal and written communication skills, psychomotor skills, and critical thinking skills. Simulation has enabled learning objectives to be met by using realistic scenarios in a safe learning environment. The nursing education team identified that high fidelity nursing simulations were underutilised within the ED, and staff were reluctant to participate as previous experience often related to simulation as an assessment tool. The perception of simulation as a useful education strategy was poor. The education team decided to commence a research project to evaluate an innovative simulation experience for nurses in ED focusing on patient assessment and documentation. A high-fidelity simulation was developed from current incident trends within the ED. This scenario was based on a gradually deteriorating Australian Triage Scale Category 2 toxicology overdose patient. The study, SImulation for EmeRgency Nurses (SIREN), aims to evaluate anxiety levels, self-efficacy in clinical practice and clinical documentation pre and post simulation together with overall satisfaction with the simulation experience. The 15 minute simulation  is followed by a short debrief utilising the advocacy/ inquiry model. This is followed by education of participants on the documentation procedure and individually optimising digital ‘shortcuts’ for mandatory notification. This single centre, prospective study commenced in November 2016, and aims to recruit 50 Registered Nurses. Preliminary results of the 36 participants who have been recruited have been extremely encouraging.


Rikki graduated from Australian Catholic University with a Bachelor of Nursing in 2010. She has worked in the Princess Alexandra Hospital Emergency Department for 6 and a half years. During this time she has completed her Graduate Certificate in Emergency Nursing and Masters of Emergency Nursing. Rikki has a passion for education and has spent the majority of her career working in education including Clinical Facilitator, Clinical Nurse and Acting Nurse Educator.

Christie graduated from James Cook University in 2008 with a Bachelor of Nursing Science. She has worked in Plastics, Burns and ENT, then moved into Emergency nursing working in remote, metropolitan and international hospitals. Furthering her education in a Diploma of Midwifery and studied a Post Graduate Certificate in Emergency Nursing. She currently works as a Clinical Facilitator/ Clinical Nurse at the Princess Alexandra Hospital.