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Simulated IV Bypass System (SIVBS)

  Submitted by: Jeanne Carey on March 01, 2018
  HomeGrown Solution Number: 296
Identification of the Problem
Increased enrollments in undergraduate nursing programs lead to larger course rosters in skills lab, requiring additional stations for learning/practicing skills. The low-fidelity manikins available in our lab have no IV capabilities and therefore do not allow for the administration of IV fluids and/or IV medications. Having students move to an IV task trainer arm positioned near the manikin disrupts the continuity of the skill. Setting up stations so that the IV fluids empty into a milk jug or trash can, significantly impacts the fidelity of the skill and this practice can lead to the development of unsafe habits and/or faulty clinical reasoning. The simulated IV bypass system (SIVBS) allows for practice of IV skills on low-fidelity manikins, as well as Standardized Patients (SPs). Using the SIVBS, IV access can be provided on both arms of the manikin, allowing for additional practice stations that are realistic and easy to set-up.
Unique Idea
Inserting IV catheters into IV trainer arms and/or manikins can be cumbersome and time consuming if the desired outcome is simply to allow for infusion of IV fluids or IV medications in a scenario or skills-based activity. Manufacturers of high-fidelity manikins recommend the administration of distilled water only in the vasculature of their simulators; this practice can be restrictive for simulation staff and an additional expense for the budget. Bypassing the vascular system eliminates any concern regarding damage to the internal components of an advanced manikin or mold development in the tubing inside an IV arm task trainer. With the creation of the Simulated IV Bypass System (SIVBS), the time required to prep a room full of IV med administration stations or manikins for scenario-based sim activities is dramatically reduced. Another time-saving aspect of the SIVBS is that the system can stay in place for extended periods of time, with no adverse effects, such as mold/mildew growth or degradation of the manikin's internal structures.
• Identify obstacles when simulating IV administration with manikins in skills-based and scenario-based simulation activities. • Describe process for assembling a system to bypass a manikin’s vasculature to simulate IV administration. • Identify ways to enhance the basic system and expand use of the SIVBS with Standardized Patients (SPs).
1. Female-to-Female Luer Connector
2. Microbore IV Extension Set
3. Secondary IV Tubing or any IV Tubing that allows for the backflow of fluids
4. Drainage Bag - Empty 1 L IV bag
5. Occlusive/Transparent IV Site Dressing
6. Compression sleeve or bandage in color similar to skin tone of manikin or Standardized Patient
Steps to Creating the Solution
1. Insert slip tip of the microbore IV extension set into one end of the female-to-female luer connector.
2. Insert distal end of IV tubing into other side of the female-to-female luer connector.
3. Insert IV tubing spike into empty IV bag which will serve as collection unit.
4. Attach the SIVBS to the manikin’s arm at an appropriate site and apply secure with the transparent, occlusive dressing over the female-to-female luer connector.
5. Use compression sleeve or bandage materials, in a color similar to that of the manikin or SP's skin tone, to secure/conceal the IV tubing to the manikin or SP's arm. Conceal drainage bag under patient's pillow or in some other manner.