uses and limitations of simulation technology in nursing programs

uses and limitations of simulation technology in nursing programs

Notice of Proposed Rule
 
DEPARTMENT OF HEALTH
Board of Nursing
RULE NO.:           RULE TITLE:
64B9-2.022          Clinical Training
PURPOSE AND EFFECT: The rule is being created to establish the uses and limitations of simulation technology in nursing programs.
SUMMARY: Establish the uses and limitations of simulation technology.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:
The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.
ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW
The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: During discussion of the economic impact of this rule at its Board meeting, the Board, based upon the expertise and experience of its members and the substance of the rule, determined that a Statement of Estimated Regulatory Costs (SERC) was not necessary because the rule does not impose additional rights, obligations, or duties on any persons or businesses, and that the rule will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
RULEMAKING AUTHORITY: 464.006, 464.019 FS.
LAW IMPLEMENTED: 464.019 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Joe R. Baker, Jr., Executive Director, Board of Nursing, 4052 Bald Cypress Way, Bin #C02, Tallahassee, Florida 32399; Joe.Baker@flhealth.gov.
 
THE FULL TEXT OF THE PROPOSED RULE IS:
 
64B9-2.022 Clinical Training.
(l) Clinical learning experiences shall be an integral part of the total curriculum plan and show relationship to concurrent theory.
(2) Clinical training must be in the United States, the District of Columbia, or a possession or territory of the United States.
(3) Clinical training must include experience in:
(a) Acute Care:  where a patient receives active but short-term treatment for a severe injury or episode of illness, an urgent medical condition, or during recovery from surgery.
(b) Long Term Care: a continuum of medical and social services designed to support the needs of people living with chronic health problems that affect their ability to perform everyday activities.
(c) Community-based Care:  Where health care is provided to the community as a whole, providing nursing care to individuals, families, and groups, to promote wellness, maintain health and prevent illness.
(4) Supervision:
(a) A clinical instructor is a faculty or staff member responsible for an assigned cohort of students in a clinical environment.   
(b) A clinical preceptor is a registered nurse supervising a student in the clinical setting.   The preceptor provides oversight of the student’s patients and gives feedback to the student and the clinical instructor.  The clinical preceptor may be a licensed practical nurse if supervising students for a practical nursing education program.
(c) The clinical instructor must directly supervise no more than 12 students, unless, by written agreement the clinical training site allows more, not to exceed 18 students.
(d) Direct supervision means the clinical supervisor is within the health care facility while the students are providing care to the patients.
(e) Indirect supervision is allowed in a hospital setting if:

There is no more than 18 students.
There is direct supervision by an assigned clinical preceptor.
The clinical instructor is available by telephone.
The arrangement is approved in writing by the clinical training site.

(f) Indirect supervision is allowed for community-based clinic experiences when the clinical instructor is available by telephone, unless the clinical experience is an invasive or complex nursing activity.  Supervision for invasive or complex nursing activities must be approved by the community-based clinical site.
(5) Up to 50% of each clinical training category: acute care, long-term care, and community-based care may be simulated when accompanied by traditional clinical experience. 
(a) Traditional clinical experience consists of activities that include observation, hands-on experience with patients, and interaction with an interdisciplinary team.
(b) Simulation consists of activities or events replicating clinical practice using scenarios, high-fidelity manikins, medium-fidelity manikins, standardized patients, role playing, skills stations, and computer-based critical thinking situations. 

High-fidelity simulation is experience using full scale computerized patient simulators, virtual reality or standardized patients that are extremely realistic and provide a high level of interactivity and realism for the learner.
Medium-fidelity simulation is experience using two-dimensional focused experiences to problem solve, perform a skill and make decisions, or the use of mannequins more realistic than static low fidelity ones having breath sounds, heart sounds, and/or pulses.

(c) Debriefing is a part of the simulation that follows the experience.  Participants’ reflective thinking is encouraged, and feedback is provided regarding the participant’s performance in the simulation experience.   The purpose of debriefing is to move toward assimilation and accommodation in order to transfer learning to future situations.
Specific Authority 464.006, 464.019 FS Law Implemented 464.019 FS History—New__________.
 
NAME OF PERSON ORIGINATING PROPOSED RULE: Board of Nursing
NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Nursing
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 8, 2017
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: December 26, 2017