21. References Bloom, B. S., Engelhart, E. J., Hill, W. H., & Krathwohl, D. R. (1956) Taxonomy of Educational Objectives, Handbook I: Cognitive Domain (McKay, New York). Retrieved from http ://epsilonlearning.com. Decker, S., Utterback, V., Thomas, M., Mitchell, M., & Sportsman, S. (2011). Assessing continued competency through simulation: A call for stringent action. Nursing Education Perspectives , 32(2), 120-125. doi:10.5480/15365026-32.2.120 D'Amico, M., & Jaffe, L. (2011). Lighten up your classroom. In M. J. Bradshaw & A. J. Lowenstein (Eds.), Innovative teaching strategies in nursing and related health professions ( 5th ed., pp. 96-98). Sudbury, MA: Jones and Bartlett Publishers. pp.55-68). Sudbury, MA: Jones and Bartlett Publishers. ICU Medical, Inc. (2011) Oncology preparation & delivery systems . Retrieved from http://icumed.com/oncology/index.asp#TechSpecs
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Editor's Notes
This unit is focused on providing students with a better understanding of the risks of exposure to hazardous drugs and how to implement a CSTD to eliminate those risks (ICU Medical, 2011).
The National Institute for Occupational Safety and Health (NIOSH) accumulated a sample list of major drugs that are considered hazardous in order to establish standard precautions for safe handling. Furthermore, NIOSH recommends healthcare professionals and support staff utilizes precautions such as a CSTD while preparing, transporting, administering and disposing of hazardous drugs (NIOSH, 2004). Please go to the following website to read the full NIOSH alert Pre-Read NIOSH The National Institute for Occupational Safety and Health (NIOSH) accumulated a sample list of major drugs that are considered hazardous in order to establish standard precautions for safe handling. Furthermore, NIOSH recommends healthcare professionals and support staff utilizes precautions such as a CSTD while preparing, transporting, administering and disposing of hazardous drugs (NIOSH, 2004). Please go to the following website to read the full NIOSH alert http://www.cdc.gov/niosh/docs/2010-167/pdfs/2010-167.pdf Utilize web technologies for instructional tools on safe handling of hazardous drugs.
Cognitive learning addresses the students understanding of facts but not the student’s feelings (D'Amico & Jaffe, 2011). When the group first meets I would create a circular style classroom so students can face each other throughout discussions and allow sufficient time for students to reflect on emotions and experiences during the discussion. In order to prevent distractions I will speak with enthusiasm and be sure that I am prepared for the presentation. Using eye contact, humor, smiling and creating movement by walking away from the podium towards students will help to convey friendliness and acceptance. Finally, the use of electronic capabilities such as integration of power point visual aids, survey monkey, and having students walk up to list things on charts or graphs would encourage active participation (Woodring, B. C., & Woodring, R. C., 2011). Cognitive learning addresses the students understanding of facts but not the student’s feelings (D'Amico & Jaffe, 2011). When the group first meets I would create a circular style classroom so students can face each other throughout discussions and allow sufficient time for students to reflect on emotions and experiences during the discussion. In order to prevent distractions I will speak with enthusiasm and be sure that I am prepared for the presentation. Using eye contact, humor, smiling and creating movement by walking away from the podium towards students will help to convey friendliness and acceptance. Finally, the use of electronic capabilities such as integration of power point visual aids and having students walk up to list things on charts or graphs would encourage active participation (Woodring, B. C., & Woodring, R. C., 2011). Incorporating the affective taxonomy I will encourage participants to actively learn by taking part in class discussions (McKeachie & Svinicki, 2006). I will ask the participants to join in group discussions involving how they feel about implementation and effectiveness a CSTD in their practice.
Guidelines for handling hazardous drugs (HDs) have changed a little over the past twenty years but information regarding probable health risks for occupational exposure has changed greatly. Numerous published studies provide evidence of hazardous drug residue contaminants are in areas where drugs are compounded or administered and potential health risks exist even when personal protective equipment is utilized. This teaching/learning plan will be designed to explain the guidelines that have been established by the Oncology Nursing Society (ONS), the Occupational Safety and Health Administration (OSHA), and the American Society of Hospital Pharmacist (ASHP) for Registered Nurses (RNs) and Registered Pharmacists (RPh) who wish to implement the use of a closed system transfer device (CSTD) in a clinical setting(Jacobson et al., 2009).
Nurses, Pharmacist and HCW who mix, administer or around chemotherapy can be exposed to aerosols or droplets of drugs generated during preparation, transportation administration, or disposal (ICU medical, 2011). Body fluids of patients receiving hazardous drugs are a potential source of exposure. Gloves and gowns are recommended to protect nurses against splash contamination during drug administration and handling patient wastes (Jacobson et al., 2009).
The plan will be specific to the ChemoClave, defined by the ONS as a drug transfer device that mechanically prohibits the transfer of environmental contaminants into the system and the escape of hazardous drug or vapor concentrations outside the system (Jacobson et al., 2009). In addition to meeting NIOSH and ASHP guidelines, ChemoCLAVE is an intuitive, easy-to-useneedlefree system that is preferred by nurses, helping ensure compliance from beginning to end. >As a 100% needefree system, ChemoCLAVE eliminates the risk of hazardous needlesticks—competing systems have a needle shown to pose a potential hazard to clinicians. >Competing systems are cumbersome and require the assembly and disassembly of multiple complex parts in order to be effective. >Some hospitals that have implemented our competitor’s system have had the nursing staff refuse to use it and switched to ChemoCLAVE for the transportation, administration and disposal. >Key Take-Away:ICU Medical’s ChemoCLAVE CSTD system is the best choice, providing me with a safe, simpleand secureway to enhance the safety of pharmacists, nurses and patients.
The cognitive domain (Bloom, 1956) encompasses knowledge and the growth of intellectual skills. Using these skills the participants will state three reasons why guidelines have been implemented for the use of a CSTD. Next the participants will state the proper use of a CSTD and lastly will list the different parts and pieces that make up a CSTD. The affective domain (Krathwohl, Bloom, Masia, 1973) takes into account that people cope with things emotionally, for example; feelings, morals, thankfulness, excitement, inspirations, and outlooks. Encompassing the affective taxonomy the participants will take part in class discussions in regards to how they feel a CSTD will be useful in their practice. The psychomotor domain (Simpson, 1972) utilizes motor skill areas and requires physical effort, and dexterity. After attending a workshop and demonstration on the proper use of a CSTD system, the participants will simulate the proper use of the parts of a CSTD in a role play scenario.
The psychomotor domain (Simpson, 1972) utilizes motor skill areas and requires physical effort, and dexterity. After attending a workshop and demonstration on the proper use of a CSTD system, the participants will simulate the proper use of the parts of a CSTD in a role play scenario.
The domain of adaptation requires skills to be well developed so the individual can adjust parts for specific situations. Therefore, the student will demonstrate how to properly place the correct parts and pieces of the CSTD for their specific needs, for example an RN for administration and an RPh for compounding.
The psycho motor domain of adaptation requires skills to be well developed so the individual can adjust parts for specific situations (Simpson, 1972). After attending a workshop and demonstration on the proper use of a CSTD system, the participants will simulate the proper preparation and proper placement technique of the parts of a CSTD in a role paly scenario.
Further, developing the domain of adaptation the participants will be required to properly select and place the parts and pieces of the CSTD for their specific needs, and in a role play scenario for example an RN for administration and an RPh for compounding.
Learning principles that I will utilize in my classroom are described in The Principles of Adult Learning established by Malcom Knowles (1984). Knowles’ theory of andragogy focuses on adult learners needs in regards to the process and not as much on the content being taught. This theory resonates with me because as a clinical nurse consultant with a medical device company much of my role involves facilitating and acting as a resource rather than a lecturer or grader. I take into account what each person’s role is and how they will be involved in the process while assessing their level of experience. When I am demonstrating to a group of nurses or pharmacists how to use a closed system transfer device I provide instruction and allow learners to discover things for themselves then provide guidance and help when mistakes are made. The learning programs are adapted to the limitations or strengths of the participants based upon their experience and will allow me to provide as much choice as possible in the availability and organization of learning programs.
The ChemoClave meets The National Institute for Occupational Safety and Health (NIOSH)a guidelines, is an intuitive, easy-to-use needlefree system that is preferred by nurses, helping ensure compliance from beginning to end (NIOSH, 2004). >As a 100% needefree system, ChemoCLAVE eliminates the risk of hazardous needlesticks—competing systems have a needle shown to pose a potential hazard to clinicians. >Competing systems are cumbersome and require the assembly and disassembly of multiple complex parts in order to be effective. >Some hospitals that have implemented our competitor’s system have had the nursing staff refuse to use it and switched to ChemoCLAVE for the transportation, administration and disposal. >Key Take-Away:ICU Medical’s ChemoCLAVE CSTD system is the best choice, providing me with a safe, simpleand secureway to enhance the safety of pharmacists, nurses and patients (ICU Medical, 2011).
Play this video to help emphasize the pharmacy aspect. The Genie is a needle-free vial access device that decreases aerosolization, vapors or leaks that automatically equalizes vial pressure inside a vial, see video (ICU Medical, 2011)
Play this video to emphasize the nursing aspect. The Spiros is a closed male luer connector that will remain permanently attached to any female luer device, prevents tubing or syringes from disconnect thus eliminating the risk of exposure to hazardous drugs, see video (ICU Medical, 2011).
Jacobson, J. O., Polovich, M., McNiff, K. K., LeFebvre, K. B., Cummings, C., Galioto, M.,... McCorkle, M. R. (2009). American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards. Oncology Nursing Forum, 36(6), 651-658. doi:10.1188/09.ONF.651-658 National Institute for Occupational Safety and Health (2004). Preventing occupational exposure to antineoplastic and other hazardous drugs in health care settings. Retrieved from http://www.cdc.gov/niosh/docs/2010-167/pdfs/2010-167.pdf
The evaluation must be based on competencies or predetermined outcomes and the instructors role is to develop a supporting role that is not biased with his/her own values, attitudes or beliefs. Formative evaluation in clinical practice provides feedback to the student about their progress throughout the course so the student can meet the course outcomes. Formative evaluation is diagnostic and should be graded, the goal is to improve subsequent performance and not grade how well the student carried out a procedure (Obermann & Gaberson, 2009). Simulation allow students to gain problem-solving skills, thinking skills and has the potential to be used as a method to validate critical and reflective thinking skills and continued competency of the registered nurse (Decker, Utterback, Thomas, Mitchell, & Sportsman, 2011). Self-assessment based upon simulation is closely linked to reflection therefore can help students develop plans for personal growth. When the self-assessment is shared with faculty it provides the instructor an opportunity to observe students’ thinking. Furthermore, that self-assessment promotes learning from experience, more effective functioning and pledge to competency.
Classroom discussion, case studies, clinical simulations, appropriate care plans will be developed in this course. Formative evaluation in clinical practice provides feedback to the student about their progress throughout the course so the student can meet the course outcomes. Formative evaluation is diagnostic and the goal is to improve subsequent performance and not grade how well the student carried out a procedure (Obermann & Gaberson, 2009). Simulation allow students to gain problem-solving skills, thinking skills and has the potential to be used as a method to validate critical and reflective thinking skills and continued competency of the registered nurse (Decker, Utterback, Thomas, Mitchell, & Sportsman, 2011). Observation is the predominant strategy for evaluating clinical performance therefore; the method of validation in the clinical setting will be observation (O) and return demonstration/simulation (RD/S). The rating scale is used to record judgments about the students’ performance in clinical practice in regards to defined clinical behaviors therefore the instructor will also rate the experience of chemotherapy administration as:1 = Competent 3 = Observed Only 2 = Needs Experience 4 = Never done/observed
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