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INACSL Standards of Best Practice: Simulationsm: Operations

  • The INACSL Standards Committee
Published:October 31, 2017DOI:https://doi.org/10.1016/j.ecns.2017.10.005

      Keywords

      As the science of simulation continues to evolve, so does the need for additions and revisions to the INACSL Standards of Best Practice: Simulationsm. Therefore, the INACSL Standards of Best Practice: Simulation are living documents.

      Standard

      All simulation-based education programs require systems and infrastructure to support and maintain operations.

      Background

      Simulation operations encompass the infrastructure, people, and processes necessary for implementation of an effective and efficient simulation-based education (SBE) program. The interactions of these pieces must form a system that integrates with larger educational and health care entities to realize the goals of SBE. SBE is no longer an adjunct to health care training and/or professional development programs but an all-inclusive integrated program requiring business acumen and technically knowledgeable personnel that serve as team members providing leadership and support in the delivery of SBE. The required knowledge, skills, and attributes to implement evidence-based best practices for simulation experiences are evolving rapidly.
      • Huang Y.M.
      • Rice J.
      • Spain A.
      • Palagans J.
      Terms of reference.
      • Alexander M.
      • Durham C.F.
      • Hooper J.I.
      • Jeffries P.R.
      • Goldman N.
      • Kesten K.S.
      • Tillman C.
      NCSBN simulation guidelines for prelicensure nursing programs.

      Alinier, G., & Dobson, A. (2016). International perspectives on the role of the simulation operations specialist. In L. Gantt & H. M. Young (Eds.), Healthcare simulation: A guide for operations specialists (pp. 149-162). Hoboken, New Jersey: Wiley.

      These skills may be possessed by an individual or shared among a team. Specialists with business, education, and technical skills promote growth, sustainability, fidelity, and achievement of goals and outcomes.
      • Zendejas B.
      • Wang A.T.
      • Brydges R.
      • Hamstra S.J.
      • Cook D.A.
      Cost: The missing outcome in simulation-based medical education research: A systematic review.
      The need for defining simulation operations goes beyond any role or title. Successful simulation operations are curated as dynamic collaborations among leaders, educators, learners, and adaptive relationships between departments.
      SBE operations begin with a strategic plan which creates the structure and defines the function for a SBE program.
      • Johnson G.
      Writing and implementing a strategic plan.
      The guiding principle of this plan aligns with the program mission. The needs of the SBE program's stakeholders are supported by this strategic plan.
      • Jeffries P.
      • Battin J.
      Developing successful health care education simulation centers: The consortium model.
      A complete strategic plan has realistic goals and fits within the organization's capacity for implementation.
      • Gantt L.T.
      Strategic planning for skills and simulation labs in colleges of nursing.
      This plan also provides a foundation from which progress can be measured and establishes a mechanism for informing change when needed. This document creates a shared understanding that outlines the beginning state, desired outcomes, activities to meet those outcomes, and evaluation metrics to document outcomes of the SBE program.
      Personnel and financial resources are also an integral part of SBE programs. The largest barriers to growth in simulation centers worldwide is lack of financial support and technical (operations) staff.
      • Zhao Z.
      • Niu P.
      • Ji X.
      • Sweet R.M.
      State of simulation in healthcare education: An initial survey in Beijing.
      • Qayumi K.
      • Pachev G.
      • Zheng B.
      • Ziv A.
      • Koval V.
      • Badiei S.
      • Cheng A.
      Status of simulation in health care education: An international survey.
      • Bailey R.
      • Taylor R.G.
      • FitzGerald M.R.
      • Kerrey B.T.
      • LeMaster T.
      • Geis G.L.
      Defining the simulation technician role: Results of a survey-based study.
      The National Council of State Boards of Nursing study found that dedicated, trained simulation personnel are necessary to ensure consistent and reproducible SBE outcomes.
      • Alexander M.
      • Durham C.F.
      • Hooper J.I.
      • Jeffries P.R.
      • Goldman N.
      • Kesten K.S.
      • Tillman C.
      NCSBN simulation guidelines for prelicensure nursing programs.
      With formal simulation education beginning to materialize,
      • Drexel University - College of Medicine
      • University of Central Florida - College of Nursing
      • University of San Francisco - School of Nursing and Health Professions
      Master of science in healthcare simulation.
      it is necessary to recognize formal simulation education and training as the preferred requirement for hire; however, personnel with on-the-job training and relevant prior experience can be substituted when competency and proficiency can be demonstrated. The SBE program must also budget for, and use, appropriate fidelity, space, equipment, resources, and the expertise necessary to operate and meet all facets of the program.
      • Zendejas B.
      • Wang A.T.
      • Brydges R.
      • Hamstra S.J.
      • Cook D.A.
      Cost: The missing outcome in simulation-based medical education research: A systematic review.
      • DelMoral I.
      • Maestre J.M.
      A view on the practical application of simulation in professional education.
      The SBE budget and human resource requirements must foster and support expertise and professional development of SBE personnel. Proficiency, competency, and expertise in SBE
      • Jeffries P.
      • Battin J.
      Developing successful health care education simulation centers: The consortium model.
      • Osterman K.F.
      • Kottkamp R.B.
      Reflective practice for educators: Improving schooling through professional development.
      • Dongilli T.
      Professional development for the next generation of simulation operations specialists.
      pedagogy leads to improved outcomes in the regional and/or global delivery of health care.
      • Kim S.
      • Hewitt W.
      • Buis J.A.
      • Ross B.K.
      Creating the infrastructure for a successful simulation program.
      Well-designed SBE programs require a large investment of money, resources and time, often with limited capacity to yield equal immediate monetary return on investment.
      • Oswalt I.
      • Cooley T.
      • Waite W.
      • Waite E.
      • Gordon S.
      • Severinghaus R.
      • Lightner G.
      • et al.
      Calculating return on investment for U.S. Department of Defense modeling and simulation.
      • Global Network for Simulation in Healthcare
      Demonstrating the value of simulation based practice: Report from 2015 GNSH summit meetings.
      Ultimately, the goal is improved competency metrics among novice learners, clinicians transitioning to practice, licensed clinicians engaging in continuing education, and a positive effect on patient outcomes.
      As the evolution of SBE programs continues, administration, education, coordination, and technical implementation must be addressed.
      • Jeffries P.
      • Battin J.
      Developing successful health care education simulation centers: The consortium model.
      • Kim S.
      • Hewitt W.
      • Buis J.A.
      • Ross B.K.
      Creating the infrastructure for a successful simulation program.
      • Kyle R.R.
      • Murray W.B.
      Clinical simulation: Operations, engineering and management.
      Written policies and procedures will define role delineation, job requirements, accountability, safety, contingency, effectiveness, and efficiency,
      • Dongilli T.
      • Shekhter I.
      • Gavilanes J.
      Policies and procedures.
      • Society for Simulation in Healthcare
      while intentional systems integration will bring together multiple potentially disparate groups to achieve a common goal for a SBE program. These processes are continually evolving, requiring management and business knowledge to successfully support the needs of the SBE program, key stakeholders, and affected health care systems.
      • National Research Council
      Human-system integration in the system development process: A new look.
      • Smith M.
      • Saunders R.
      • Stuckhardt L.
      • McGinnis J.
      Best care at lower cost: The path to continuously learning health care in America.
      • Committee for Accreditation of Healthcare Simulation Programs
      Systems integration: Standards and measurement criteria.
      Potential consequences of not following this standard place programs at risk of not achieving SBE strategic goals and objectives. If expertise is not efficiently used or not accurately recognized, programs may fail to create an effective and efficient SBE program. If fiscal appropriations cannot meet the strategic needs of the SBE program, sustainability will also be at risk and/or growth stifled.

      Criteria Necessary to Meet This Standard

      • 1.
        Implement a strategic plan that coordinates and aligns resources of the SBE program to achieve its goals.
      • 2.
        Provide personnel with appropriate expertise to support and sustain the SBE program.
      • 3.
        Use a system to manage space, equipment, and personnel resources.
      • 4.
        Maintain and manage the financial resources to support stability, sustainability, and growth of the SBE program's goals and outcomes.
      • 5.
        Use a formal process for effective systems integration.
      • 6.
        Create policies and procedures to support and sustain the SBE program.
      Criterion 1: Implement a strategic plan that coordinates and aligns resources of the SBE program to achieve its goals.
      Required Elements:
      • Define a strategic plan independent of the governing institution, if one exists, that supports the mission and vision of the SBE program and larger organization.
        • Johnson G.
        Writing and implementing a strategic plan.
        • Jeffries P.
        • Battin J.
        Developing successful health care education simulation centers: The consortium model.
      • Develop plans for
        • Immediate strategic goals (less than a year)
        • Short-term strategic goals (1-2 years)
        • Long-term strategic goals (3-5 years)
      • Use an organizational chart that supports the goals and outcomes of the SBE program, identifying, at a minimum, roles for
        • Global Network for Simulation in Healthcare
        Demonstrating the value of simulation based practice: Report from 2015 GNSH summit meetings.
        • Simulation leadership
        • Simulation operations
        • Simulation education
      • Involve key stakeholders in the strategic planning process.
        • Dongilli T.
        Professional development for the next generation of simulation operations specialists.
        • Society for Simulation in Healthcare
        • Gantt L.
        Simulation operations specialists job descriptions composition, negotiation, and processes.
      • Incorporate an ongoing professional development plan for simulation personnel with associated competency validation (see also criterion 2).
        • Alexander M.
        • Durham C.F.
        • Hooper J.I.
        • Jeffries P.R.
        • Goldman N.
        • Kesten K.S.
        • Tillman C.
        NCSBN simulation guidelines for prelicensure nursing programs.
        • Jeffries P.
        • Battin J.
        Developing successful health care education simulation centers: The consortium model.
        • Dongilli T.
        Professional development for the next generation of simulation operations specialists.
        • Dongilli T.
        • Shekhter I.
        • Gavilanes J.
        Policies and procedures.
        • Parry S.
        Evaluating the impact of training.
        • Development plan should be program and personnel specific to meet identified needs and may include such things as
          • Attendance at local, regional, and/or national conferences
          • Completing online or in-person SBE-focused courses
          • Joining regional networks to share resources and skills
      • Implement a systematic plan for evaluation, with a prescribed review/revision cycle, allowing for more frequent review and/or revision as evidence, regulation, and/or programmatic changes occur; including ongoing review of simulation literature for best practices.
        • Parry S.
        Evaluating the impact of training.
        • Johnson G.
        Developing a systematic program evaluation plan.
        • Walvoord B.E.
        Assessment clear and simple: A practical guide for institutions, departments and general education.
      • Articulate the value proposition or return on investment of the simulation program.
        • Oswalt I.
        • Cooley T.
        • Waite W.
        • Waite E.
        • Gordon S.
        • Severinghaus R.
        • Lightner G.
        • et al.
        Calculating return on investment for U.S. Department of Defense modeling and simulation.
        • Global Network for Simulation in Healthcare
        Demonstrating the value of simulation based practice: Report from 2015 GNSH summit meetings.
      • Identify justifiable capital expenditures including
        • Zendejas B.
        • Wang A.T.
        • Brydges R.
        • Hamstra S.J.
        • Cook D.A.
        Cost: The missing outcome in simulation-based medical education research: A systematic review.
        • DelMoral I.
        • Maestre J.M.
        A view on the practical application of simulation in professional education.
        • Facility improvements and expansion
        • SBE equipment
        • Durable medical equipment
      • Plan to replace assets that have exhausted their useful life
      • Use a communication plan to report the progress of the strategic goals to key stakeholders.
        • Johnson G.
        Writing and implementing a strategic plan.
        • Moyer M.
        • Lopreiato J.O.
        • Peiris N.
        Simulation operations and administration.
        • Henderson J.
        • Venkartraman N.
        • In T.
        • Kochan T.
        • Useem M.
        Strategic alignment: A model for organizational transformation through information technology.
        • Lazzara E.H.
        • Benishek L.E.
        • Dietz A.S.
        • Salas E.
        • Adriansen D.J.
        Eight critical factors in creating and implementing a successful simulation program.
      Criterion 2: Provide personnel with appropriate expertise to support and sustain the SBE program.
      Required Elements:
      • Design job descriptions for the SBE program that align with the organizational structure.
      • Articulate scope of practice, educational requirements, and compensation for each role.
      • Ensure that personnel can meet the job skills, or be trained to meet expectations, as part of the hiring and ongoing employment processes.
        • Alexander M.
        • Durham C.F.
        • Hooper J.I.
        • Jeffries P.R.
        • Goldman N.
        • Kesten K.S.
        • Tillman C.
        NCSBN simulation guidelines for prelicensure nursing programs.
        • Society for Simulation in Healthcare Committee for Certification
        SSH certified healthcare simulation operations specialist handbook.
      • Accurately portray responsibilities within the SBE program. These roles may be held by one or more persons even with different titles:
        • Implementation role responsibilities may include
          • Bailey R.
          • Taylor R.G.
          • FitzGerald M.R.
          • Kerrey B.T.
          • LeMaster T.
          • Geis G.L.
          Defining the simulation technician role: Results of a survey-based study.
          :
          • Audiovisual
          • Information technology/systems
          • Manikin operation and programming
          • Standardized/simulated patient coordination, communication, and portrayal
          • Manages and maintains schedule
          • Set up/break down of simulated environment
          • Moulage
          • Data collection
          • Creation, manipulation, and revision of graphic and video content
        • Leadership, administrative, and/or management role responsibilities may include
          • Policy and procedure creation, oversight, revision, and enforcement
          • Program oversight and management of daily operations
          • Liaison with stakeholders
            • Bolman L.G.
            • Deal T.E.
            How great leaders think: The art of reframing.
          • Coordination of personnel and resources
          • Training
          • Hiring/firing
          • Onboarding
          • Ordering of supplies and capital equipment
          • Budget planning and oversight
          • Strategic planning
        • When education, credentialing, and competency are validated, personnel, regardless of title, may be extended responsibility for
          • Alexander M.
          • Durham C.F.
          • Hooper J.I.
          • Jeffries P.R.
          • Goldman N.
          • Kesten K.S.
          • Tillman C.
          NCSBN simulation guidelines for prelicensure nursing programs.
          :
          • Scenario design and development
          • Implementation and facilitation
          • Evaluation
          • Debriefing
      • Provide trained personnel with capabilities to set up, operate, and maintain equipment to meet the simulation-based objectives. This must include competency with the following, as appropriate for their job description
        • Jeffries P.
        • Battin J.
        Developing successful health care education simulation centers: The consortium model.
        • Gantt L.T.
        Strategic planning for skills and simulation labs in colleges of nursing.
        :
        • Computer networking and connection of simulation IT infrastructure
        • Audiovisual systems
        • Operation and troubleshooting of simulation typologies and modalities as they advance
        • Costuming and moulage
        • Media file usage, manipulation, access, storage, security, and destruction
        • Staging, scripting, and use of props
        • Simulation educational purpose and teaching methods
        • Applicable health care equipment and terminology
        • Implementation and training of standardized/simulated patients as appropriate for their program
        • Initial and ongoing development of skills for the simulation program as determined by needs assessment
      Criterion 3: Use a system to manage space, equipment, and personnel resources.
      Required Elements:
      • Identify roles, tasks, and expectations for the set up and break down of simulation-based activities (see INACSL Standard: Simulation Design).
      • Maintain a competency-based training program for personnel to operate applicable equipment,
        • Dongilli T.
        Professional development for the next generation of simulation operations specialists.
        • Gantt L.
        Simulation operations specialists job descriptions composition, negotiation, and processes.
        • Zigmont J.
        • Wade A.
        • Lynch L.
        • Coonfare L.
        Continuing medical education.
        which may include
        • Beds/examination tables, headwalls, patient monitors, and other health care equipment
        • Computer systems
        • Medication dispensing systems
        • Phone systems
        • Vital sign monitors
        • Task trainers
        • Manikins
        • Audiovisual or debriefing systems
        • Virtual reality or augmented reality training systems
        • Surgical/procedural simulators
        • Computer-based training programs
        • 3D printers
        • Electronic health records, documentation, and order entry programs
        • All additional simulation-specific equipment
      • Follow a written plan addressing the educational objective(s)/purpose(s) with an accessible list of supplies, equipment, and personnel required to support the activity (see INACSL Standard: Simulation Design)
        • All simulation-based activities must be piloted before implementation.
          • Pirie J.
          • Kappus L.
          • Sudikoff S.N.
          • Bhanji F.
          Simulation curriculum development, competency-based education, and continuing professional development.
          • Jeffries P.
          NLN/Jeffries simulation theory.
          • Alinier G.
          Developing high-fidelity health care simulation scenarios: A guide for educators and professionals.
        • Written scenario instructions must include expected time to set up, run, brief or prebrief, debrief and breakdown each simulation-based activity.
        • Adequate time must be accounted for and planned for training of standardized/simulated patients as appropriate.
          • Wallace P.
          Coaching standardized patients for use in the assessment of clinical competence.
        • Coordinate and plan transitions between sessions to minimize downtime.
          • El-Haik B.
          • Al-Aomar R.
          Simulation-based lean six-sigma and design for six-sigma.
      • Use a scheduled or periodic review process to ensure all simulation-based activities are feasible and appropriately designed based on programmatic resources.
        • Incorporate outcomes data, participant, facilitator, and staff feedback into this review process.
          • Johnson G.
          Writing and implementing a strategic plan.
          • Johnson G.
          Developing a systematic program evaluation plan.
      • Have a system and/or process and policy to prioritize requests, reserve rooms, equipment, and ensure personnel are available to operate and support each simulation-based activity.
      • Use an inventory control system to manage purchasing, shipping and receiving, tracking, storage, and reordering of equipment and supplies.
      • Ensure all SBE experiences and associated activities are in an environment that complies with institutional, national, international, or other regulatory occupational safety practices.
        • European Union-Occupational Safety and Health Agency [EU-OSHA]
        European Agency for Safety and Health at Work.
        • Occupational Safety and Health Administration
        OSHA law & regulations.
        For example:
        • Ventilation, if working with fumes or gases
        • Using correct ergonomic techniques for lifting heavy equipment to prevent injury
        • Prevention, identification, and reporting of needle sticks and other injuries
      Criterion 4: Maintain and manage the financial resources to support stability, sustainability, and growth of the SBE program's goals and outcomes.
      Required Elements:
      • Sustain a defined SBE budget with a quantified, formalized plan to analyze and control costs.
        • Finkler S.A.
        • Jones C.B.
        • Kovner C.T.
        • Louis M.O.
        Financial management for nurse managers and executives.
        • Williams S.
        • Helgeson D.
        How to write a thorough business plan.
        • Cook D.A.
        • Hamstra S.J.
        • Brydges R.
        • Zendejas B.
        • Szostek J.H.
        • Wang A.T.
        • Hatala R.
        Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis.
      • Plan an operating budget for the program's revenues and expenses on a year-to-year basis.
        • Consider program activities that may generate revenues through
          • Continuing education programs
          • Providing services to external clients
          • Donors, stakeholders, partnerships, alliances, grants, or loans

            Alinier, G., & Granry, J. (2014). Fundraising: A potential additional source of income for the research and educational activities of a clinical simulation center. In J. C. Palaganas, J. C. Maxworthy, C. A. Epps, & M. E. Mancini (Eds.), Defining excellence in simulation programs (pp. 321-328). Philadelphia, PA: Wolters Kluwer.

      • Prepare and execute an operational budget in consideration of the organization and the SBE program's environmental review, current and future goals/objectives, and priorities.
        • Lazzara E.H.
        • Benishek L.E.
        • Dietz A.S.
        • Salas E.
        • Adriansen D.J.
        Eight critical factors in creating and implementing a successful simulation program.
        • Identify fixed costs that do not change regardless of the number of simulations conducted.
          • For example, facility overhead, maintenance and service contracts, personnel, and professional development for all permanent staff.
        • Identify variable costs that change based on the number of SBE activities and participants.
          • For example, staffing for SBE activities such as the number of facilitators for debriefing, operations/technology specialists, standardized/simulated patients, and consumable items such as clinical and office supplies.
        • Incorporate the costs of identified capital expenditures from the strategic plan as a budgeted line item (see criterion 1).
        • Forecast for personnel roles and responsibilities, including professional development needs required to meet the SBE program's future participant outcomes, program objectives, and regulations.
          • Include workload, position and salary equity, job description, role expectations, and scope of practice in the forecast.
      • Report the correlation of the impact of SBE program metrics on the organization's costs and/or savings from, at a minimum, the following domains:
        • Buckner-Hayden G.
        Reduce turnover, increase productivity, and maximize new employee success.
        • Gesme D.H.
        • Towle E.L.
        • Wiseman M.
        Essentials of staff development and why you should care.
        • Edwards I.
        • Mitchell D.
        The challenges of health reform and simulated health management education.
        • Williams I.
        Organizational readiness for innovation in health care: Some lessons from the recent literature.
        • Educational effectiveness
        • Educational efficiency
        • Resource management
        • Patient safety
        • Quality of care
        • New employment efficacy
      Criterion 5: Use a formal process for effective systems integration.
      Required Elements:
      • Direct the program's simulation activities by the strategic needs of the larger organization.
        • Committee for Accreditation of Healthcare Simulation Programs
        Systems integration: Standards and measurement criteria.
      • Develop the program's mission and/or vision along with written policies and procedures to articulate the role of the SBE program in relation to other stakeholders and the larger organization or region.
      • Communicate with stakeholders about how the SBE program's mission, vision, and goals align with the overall improvement of health care education and eventually health care delivery.
        • Committee for Accreditation of Healthcare Simulation Programs
        Systems integration: Standards and measurement criteria.
        • Dong Y.
        • Maxworthy J.
        • Dunn W.
        Systems integration.
        • Dunn W.
        • Deutsch E.
        • Maxworthy J.
        • Gallo K.
        • Dong Y.
        • Manos J.
        • Brazil V.
        • et al.
        Systems Integration.
        • Stone K.P.
        • Huang L.
        • Reid J.R.
        • Deutsch E.S.
        Systems integration, human factors, and simulation.
        • SBE programs have access to and incorporate identified key performance indicators to improve simulation-based learning experiences related to outcomes.
          • Dong Y.
          • Maxworthy J.
          • Dunn W.
          Systems integration.
      • Actively participate and collaborate in bidirectional initiatives across organizations, contributing to the improvement of participant, health care, and/or program outcomes.
        • Committee for Accreditation of Healthcare Simulation Programs
        Systems integration: Standards and measurement criteria.
        • The SBE program is used by various groups to address quality, patient safety, interprofessional education, research, and risk management for the improvement of system activities.
      • Ensure ongoing systematic and programmatic improvement processes are in place for the SBE programs, including 
        • Committee for Accreditation of Healthcare Simulation Programs
        Systems integration: Standards and measurement criteria.
        • Johnson G.
        Developing a systematic program evaluation plan.
        • Dong Y.
        • Maxworthy J.
        • Dunn W.
        Systems integration.
        • Dunn W.
        • Deutsch E.
        • Maxworthy J.
        • Gallo K.
        • Dong Y.
        • Manos J.
        • Brazil V.
        • et al.
        Systems Integration.
        • Gordon S.
        Return-on-investment metrics for funding modeling and simulation.
        • Quality/performance improvement, dissemination, and sustainability plan(s) exist and are used
        • Clearly defined metrics using consistent data collection methods
        • Appropriate resources (e.g., human factors, systems engineering, psychometric, and informatics) are available to meet expected program goals.
      Criterion 6: Create policies and procedures to support and sustain the SBE program.
      Required Elements:
      • Consider and incorporate human resource factors regardless of employment status (e.g., full-time, adjunct, volunteer, student, etc.) such as
        • Workload and compensation equity are supported by the funding entity
        • Comparable educational, credentialing, and competency requirements for the role(s) undertaken
        • Planned and unplanned personnel leave are accounted for
        • Ongoing competency and proficiency validation for all SBE personnel
          • Alexander M.
          • Durham C.F.
          • Hooper J.I.
          • Jeffries P.R.
          • Goldman N.
          • Kesten K.S.
          • Tillman C.
          NCSBN simulation guidelines for prelicensure nursing programs.
        • An expectation that applicable standards of best practice for simulation will be followed
          • Alexander M.
          • Durham C.F.
          • Hooper J.I.
          • Jeffries P.R.
          • Goldman N.
          • Kesten K.S.
          • Tillman C.
          NCSBN simulation guidelines for prelicensure nursing programs.
      • Identify how prior experience and nonformal training are recognized, appraised, and viewed while making employment and advancement decisions.
      • Define data collection, storage, access, destruction, and reporting processes such that it is performed and aligns with institutional and accrediting bodies' expectations.
      • Describe safe management of supplies including how they are handled, secured, stored, and maintained. These may be supported by institutional, national, international, or other regulatory protocols as appropriate.
        • Committee for Accreditation of Healthcare Simulation Programs
        Systems integration: Standards and measurement criteria.
        Examples include
        • Solvents
        • Moulage supplies and materials
        • Expired and simulated medications
        • Defibrillators
        • Sharp containers
      • Provide safety information for any chemical, medication, or other hazardous supplies and how they can be accessed by personnel.
      • Create clear guidelines that
        • Address duplicated, conflicting, and/or confusing requests.
        • Prioritize the use of space, equipment, and personnel.
        • Establish deadlines for scheduling based on prioritization of use.
        • Identify reorder points for consumable resources.
      • Specify guidelines for equipment storage, locations, security, and access, including
        • Use and maintenance of simulation equipment
        • Planned downtime and periodic maintenance schedules
        • How user and system manuals for simulation equipment are to be maintained and organized
      • Establish audiovisual capture, retention, and use policies
        • Policies may be variable by the type of activity and planned use but must be consistent and delineated
        • Confidentiality
      • Articulate psychological safety and learner expectations for learning activities
      • Establish contingency plans for unanticipated events, participant accommodations, or simulator downtime, etc.

      About the International Nursing Association for Clinical Simulation and Learning

      The International Nursing Association for Clinical Simulation and Learning (INACSL) is the global leader in transforming practice to improve patient safety through excellence in health care simulation. INACSL is a community of practice for simulation where members can network with simulation leaders, educators, researchers, and industry partners. INACSL also provides the INACSL Standards of Best Practice: Simulationsm, an evidence-based framework to guide simulation design, implementation, debriefing, evaluation, and research.

      References

        • Huang Y.M.
        • Rice J.
        • Spain A.
        • Palagans J.
        Terms of reference.
        in: Palaganas J.C. Maxworthy J.C. Epps C.A. Mancini M.E. Defining excellence in simulation programs. Wolters Kluwer, Philadelphia, PA2014: xxi-xxiii
        • Alexander M.
        • Durham C.F.
        • Hooper J.I.
        • Jeffries P.R.
        • Goldman N.
        • Kesten K.S.
        • Tillman C.
        NCSBN simulation guidelines for prelicensure nursing programs.
        Journal of Nursing Regulation. 2015; 6: 39-42
      1. Alinier, G., & Dobson, A. (2016). International perspectives on the role of the simulation operations specialist. In L. Gantt & H. M. Young (Eds.), Healthcare simulation: A guide for operations specialists (pp. 149-162). Hoboken, New Jersey: Wiley.

        • Zendejas B.
        • Wang A.T.
        • Brydges R.
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