The clock is ticking: Using an escape room for nursing skills pass-offs

Six years ago, the Mary Jane Rawlinson Geertsen Nursing Learning Center (NLC) transformed as a facility with a $4 million gift from the Fritz B. Burns Foundation and established a higher level of learning within the BYU College of Nursing program. Through nursing simulation with computerized manikins and video cameras, the students gain skills, rehearse understanding, and build self-confidence. The lab experiences enhance their learning and improve their decision-making skills.

As we conclude Healthcare Simulation Week 2020, I am reminded of a scenario recently completed by our fifth-semester nursing students. The activity is an “escape room” where students practice the appropriate care for their patients while creating a little competition with their peers.

Unlike some commercial escape rooms, the NLC-sponsored simulation does not lock participants inside a room until they solve a series of puzzles. Instead, five students began their shift on a unit that finds itself without internet, access to electronic health records, an incomplete shift report, and orders for future meds.

The patient is continuously thirsty and light-headed and thinks she needs medicine and oxygen. The problem is that there is a lock on the flow control valve, the nasal cannula is in a secured toolbox, and the patient’s purse has a padlock on it.

The group of students must work together to realize that they must find the purse lock key that is hidden in the room. Once found, the medicine bottles are examined and compared with the provider’s orders. Additional insight comes from the shift report, the number of consumed water cups, and the delivered IV solution bags.

Without giving away the scenario to future nursing students, the group must solve three puzzles based on the flow of oxygen and the IV rate. These numbers open the combination locks for the nasal cannula and, eventually, the flow valve.

The patient receives the treatment she needs, and the group’s completion time is compared with their peers. Of course, bragging rights are available to students that solve the treatment plan within the allotted time.

The gem of completing the pass-off is the debriefing opportunity that follows. It is led by a facilitator, allows dissemination of active learning to every member of the group in a safe environment, and enables participants to more fully think through and discuss what has transpired.

Simulation within the NLC varies by class and type of lab. This activity was an excellent review for the students as they begin the semester and their adults in crisis clinicals. The scenario was developed for the college by teaching professor Sondra Heaston and NLC staff RN Kristen Painter.

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