Simulation Scenarios 43
Communication with the L&D team regarding the time elapsed in resolving the SD should be
included as part of the process.
It is recommended that participants perform this
scenario twice in the same training session so
that learning and re-enforcement of
communication and teamwork skills can be
applied to their clinical practice.
Throughout the scenario, the facilitator will need
to provide data for the following: elapsed time,
dilation status, FHR data, and SD presentation
(see “Scenario Steps” on page 45). The FHR
data should be displayed on a strip or paper
model near the monitor. If an actual monitor is
being used, program the FHR data according to
the “Scenario Steps.”
Additionally, to facilitate the time needed for the
scenario session, the facilitator has the option to
compress (speed up) time as needed. Make the
participants aware of the time by either
displaying the time in a visible location or stating
the time throughout the scenario.
Manual setup for the L&D process requires moulage (simulated body fluids), including mild
vaginal bleeding and meconium. See “Scenario Setup” for more details. Moulage recipes and
instructions can be found on the Internet.
• Hospital bed (birthing bed preferred) and bed sheet
• Mattress pad/chuck pad/blue pad
• Plastic tarp/covering, if using moulage
• Step stool for nurse
• Stool for provider
• Clear plastic bag for baby (amniotic sack — this is helpful if adding meconium as part of
the scenario)
• Umbilical cord/plastic tubing (secured to baby)
• Umbilical cord clamp
DEFINITIONS
• CUS is a tool to use when a conflict of
information is identified that warrants a
team member voicing his/her Concern,
that he/she is Uncomfortable, and a
Safety issue exists. Each facility or
practice may develop a unique word,
phrase, or signal to alert the other
team members without alarming the
patient/family.
• The two-challenge rule is a tool to
use when a conflict of information is
identified that warrants a team
member speaking up, alerting, and/or
questioning other team members at
least twice before proceeding any
further with a task or intervention.