simulation case study examples pdf

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Generic Case Studies for Manufacturing Simulation Applications

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Simulation Scenarios

The following is a list of simulation scenarios that CAN-Sim makes available to members.

You can browse through the list below to learn more or login to our member portal to access and download scenarios for use. Not a member of CAN-Sim? Click here to learn more about our memberships and apply online .

• Acute Critical Care Nursing
• Community Care Nursing
• Maternal Child
• Mental Health

Acute Exacerbation of Asthma in Adults (University of Regina/SaskPolyTech Saskatoon)

A 35-year-old female brought to the ED by ambulance. History of asthma with multiple emergency visits within the last year. Recent upper respiratory infection. Experiencing severe respiratory distress, struggling to breathe. She is unable to speak other than simple one-word statements.

Angina (Keyano College)

Doug Decker is a 64-year-old male FIFO (fly in fly out) worker. He was admitted to the medicine unit from the ER with c/o chest pain and shortness of breath. He has no general practitioner as he is from a different province. N/S 125 cc/hr running through a RT arm iv. Bloodwork pending. The student(s) will be required to assess and provide interventions in response to assessment findings.

Asthma-Pneumonia Leading to Respiratory Distress in a Child with Known (Markham Stouffville Hospital)

Recently admitted from ED, history of asthma. Admitted with pneumonia. On initial assessment, in respiratory distress. Starts to deteriorate from a respiratory standpoint. Antibiotics already started in ED, need to call POC/RT for increasing BPEWS score. POC and RT in ED with a sick child will be up soon. O2 needs increase, orders received to increase the frequency of assessment, back to back Ventolin and start mag sulphate considerations for thorough respiratory assessment, proper Ventolin administration, MgSO4 administration using Alaris pump, what to watch for with magnesium sulphate re: hypotension. The condition starts to worsen, physician and RT arrive. Plan for intubation, the scenario ends once nurses prepare RSI medications using a medication calculator.

Blood transfusion (University of Western Ontario)

The client is a 52 year-old male admitted to hospital for a bowel resection due to adenocarcinoma of the colon. He is one-day post-op. His hemoglobin is 74 g/L and the physician has ordered 2 units of packed red blood cells to be administered, each over two hours. He is very anxious about the transfusion. Once the transfusion commences, he develops hives on his chest. This causes his anxiety to increase. An order for IV Benadryl is obtained and the client’s condition stabilizes.

Brain Attack (Durham/UOIT)

The patient (64 year old male) was admitted to the medical unit yesterday with Stroke, CT scan reveals left sided ischemic brain attack. After treatment, the patient is transferred to a neurological stroke unit where the student provides care.  The student will be required to assess and provide interventions in response to post-treatment complications.

Care for a postoperative patient experiencing a blood transfusion reaction (Toronto Metropolitan, Centennial & George Brown Collaborative BScN Program Centennial Site)

This is a high-fidelity simulation scenario of a 70-year-old male who had undergone total right hip arthroplasty yesterday and had spent an uneventful night after surgery. Today is patient’s post-op day 1 and his vital signs are stable. His post-op morning blood work shows low Hgb of 76. Two units of packed red blood cells transfusion are ordered by physician. Consent form for blood transfusion has been signed prior to surgery. The learners are expected to safely initiate a blood transfusion according to protocol, monitor vital signs, recognize signs & symptoms of transfusion reaction, stop the blood, notify physician utilizing SBAR communication and administer IV Benadryl.

Care for patient with hip replacement surgery & pulmonary embolism (PE) (Toronto Metropolitan, Centennial & George Brown Collaborative BScN Program Centennial Site) ( Cloned )

Mr. Hart, a 60-year-old male, is in POD 2 following right hip replacement surgery. He is anticipated to be discharged home today. However, at the morning assessment, his right lower leg was found to be red and swollen, with calf pain. His discharge home was postponed, and a leg Dopplers test was promptly arranged. After returning from the leg Doppler test at noon, Mr. Hart experiences a sudden onset of dyspnea, chest pain, and restlessness. The learners are expected to recognize and respond quickly to keep the patient from deteriorating, communicate with physician, healthcare team, patient, and family.

Care of a Patient Peri-Brain Stem Herniation (Nova Scotia Health Authority)

The patient is a 22-year-old male who sustained a head injury after a motor vehicle collision (MVC).  The patient was found to have a GCS less 8 in the E.R and was intubated.  CT scan showed diffuse cerebellar edema.  AN ICP monitor /drain was placed by Neurosurgery and the patient was transferred to the Neurological ICU. The patient’s mother is at the bedside.

Care of the adult patient with a spinal cord injury (University of Calgary)

This is an introductory scenario for undergraduate nursing students who have been working to connect assessment findings with disease pathology, patient presentation, and potential complications. Participants in this scenario will have minimal to no experience with high-fidelity simulation, and this scenario will give each participant an introductory experience to a complex medical patient. This scenario involves a young adult male who is 8 weeks out from a skiing accident which has left him with a spinal cord injury (SCI) at the level of T1. This scenario takes place after a busy night shift in which the nurses have no been able to provide the usual standard of care, resulting in a very full bladder and the patient experiencing the medical emergency of autonomic dysreflexia. Participants will be expected to complete vital signs and a full head-to-toe assessment to determine what symptoms the patient is experiencing. Participants will then be expected to determine the root cause of the symptoms, contact the appropriate health care provider utilizing SBAR, and implement interventions.

Care of the Client with Unmanaged Pain (York University)

The client underwent surgery yesterday for an insertion of an intramedullary nailing of the right femur fracture. The learners are to assess a post-operative client, manage an aggressive client, recognize inadequate pain management, understand the difference between narcotic dependency, tolerance and addiction and consult with other health care providers to advocate for a need to change a client’s plan of care.

Care of the patient experiencing congestive heart failure (Trent University)

This is a standalone scenario for managing congestive heart failure. Pt. is an elderly women in hospital with progressive respiratory distress. In this scenario the students/learners are expected to recognize the patients increased level of anxiety and increased respiratory distress. Students are to conduct a focused cardiopulmonary assessment and apply appropriate interventions such as repositioning, apply O2, call for assistance using SBAR, and administer correct dosage of ordered medication. Patient improves with appropriate and timely interventions.

Care of the patient experiencing diabetic ketoacidosis – adult dka (Trent University)

49 year old male enters the ER with a glucose of 28 mmol/L. The learner will need to complete a full assessment, identify abnormal assessment findings and provide appropriate care for a patient experiencing DKA. Focus is on medication administration, communication, and assessment.

Care of the patient experiencing hypoglycemia (University of Western Ontario)

The client is a 66 year-old male admitted two days ago with an anterior myocardial infarction. He has numerous risk factors for heart disease, including diabetes. It is now 1130 hours. The nurse has been called by the client. The client complains of palpitations, nausea and is diaphoretic.

Care of the Patient Post CVA (Thompson Rivers University)

Juan Carlos presents to a remote community health care setting with symptoms of stroke. This is a 6 hour simulation and involves 5-8 students each session. This simulation is an unfolding case study and begins with Juan’s arrival to a larger heath care facility where a diagnosis of non hemorrhagic stroke is made. The simulation ends at his discharge 8 days later.

Care of the patient with liver failure (Loyola University, Chicago, Marcella Niehoff School of Nursing)

Alice Margin is a 61-year-old female who has just been admitted for increased confusion, vomiting, and weakness. She has a history of cirrhosis, alcohol abuse, coronary artery disease (CAD), and mild renal failure (RF). She just arrived in the ICU so she needs a complete admission history and physical assessment. Labs that were drawn in the Emergency Department (ED) are in the binder. Preliminary orders are in the binder; the hospitalist is supposed to be up to see her soon.

Chest Pain Assessment and Management (Laurentian University)

In this scenario, learners are expected to collect data in order to further evaluate the origin of her heartburn. Data collection should culminate in a call to the patients’ physician. Orders for Nitro spray will be received. Learners are expected to safely administer the medication and include all necessary assessments. Chest pain remains unrelieved with Nitro administration and learners will recognize need to transport patient to local hospital via ambulance for further evaluation and management.

Clinical Decision when Clients Experience a Complex Health Challenge (Vancouver Community College)

Mary Rodeo is an 87-year-old Caucasian woman who has been living in Long Term Care for the past 6 months, due to a decline in physical mobility. She has a history of colorectal cancer, peripheral vascular disease and coronary artery disease. Mary has recently been told that her cancer has returned with metastasis to the bone. She is refusing further treatment. Today she has complaints of abdominal discomfort 10/10. Her daughter is at the bedside and is struggling with her mothers’ failing health status. In this scenario, participants will be expected to perform the health assessments, administer medications and manage the care requirements as needed s per the practical nurses’ scope of practice.

Community care of patient with diabetes (Brock University)

Older adult with newly diagnosed diabetes being cared for in his home environment. Designed to challenge the year 4 students with completing a home assessment and health teaching about medications, diet, smoking, and exercise. Communication is needed with the physician, patient, family, and other healthcare providers. The students are also faced with a patient who is undergoing a significant life change with the recent admission of his spouse to long-term care.

Complications from oxygen therapy: The nursing process in action (University of Northern British Columbia)

This scenario centers on a 55-year-old female, Mrs. Halle Quinn, admitted to a medical unit with pneumonia secondary to acute bronchitis. She is receiving antibacterial therapy and oxygen therapy. The nursing process is utilized to manage and prioritized arising concerns.

De-escalation of the angry patient (McMaster University)

A young man becomes increasingly upset and agitated during what he feels is a lengthy wait time in the emergency department of a community hospital despite his frequent and anxious requests to be seen to “get straightened out”. His verbal and non-verbal cues appear to go unnoticed by the emergency department nursing staff. For example, no one has approached him to inform him of the duration of the additional wait time nor to inquire further about his urgent concerns.

Death and dying (York University)

7-year-old client diagnosed 11 months ago with a glioblastoma multiforme brain tumor. Her initial symptoms were headaches sometimes associated with early morning vomiting or ataxia. She was rushed to the local children’s hospital a week later experiencing a seizure. Several diagnostic tests concluded a brain tumor and a partial resection of the tumor and histology examination confirmed the diagnosis of glioblastoma multiforme. The child underwent daily radiation treatments for 6 weeks with minimal reduction of the tumor. Four weeks ago, Aaliyah experienced a prolonged seizure requiring hospitalization. The family has decided to provide end-of-life care at home with the support of the palliative care team from the oncology unit.

Décompensation systémique pédiatrique (Université de Saint Boniface)

Daniel a dix ans. Il est hémophile de type A léger. Il est tombé dans le bus scolaire quand celui-ci a ralenti un peu brutalement et s’est cogné la tête et les genoux à terre. Daniel s’est relevé tout de suite, a dit qu’il se sentait bien mais son nez saignait. À cause de son antécédent médical, l’école a appelé les services d’urgence et Daniel est arrivé aux urgences pour enfant en ambulance. . Ses parents ne sont pas encore arrivés mais il est accompagné de son enseignante qui a une feuille décrivant son problème médical et les médicaments qu’il prend. Elle dit que Daniel a tout de suite pris son DDAVP par voie nasal. Ce scénario suit Daniel lors de son hospitalisation aux urgences afin de permettre aux apprenants à distinguer les différents soins pertinents d’un enfant qui développe des signes de choc hypovolémique.

Differential Diagnosing in a Patient with Chest Discomfort – An NP Approach (Centre for Nursing Studies – Memorial University)

74 year old female, May Smith, presents to ER (rural hospital) complaining of chest discomfort for about 30 minutes. Mrs. Smith arrives in a private car and is accompanied by her husband who is in the waiting room. She describes the pain like nothing she has ever had before. It is sub-sternal, not radiating and rates it a 6/10. The pain is not exacerbated by movement. She reports nausea but no vomiting. Patient belching during the assessment. She took some Tums before coming in but that didn’t help. Patient becomes increasingly anxious, thinks she is having a heart attack. NP students will demonstrate the approach to formulating 3 priority differential diagnoses with the patient in the practice setting based on history and physical exam findings to accurately reassess the patient’s condition, and order appropriate diagnostic tests to diagnose the patient’s condition.

Disclosure of no harm patient safety incident (Pediatric) (Durham/UOIT)

Once student conducts safe dosage range, recognizes that error has been made; completes the patient assessment and then notifies preceptor; clinical leader (unit manager) and attending physician are informed. Preceptor and student discuss patient safety incidents and now begin a discussion about what needs to be done.

DVT to PE respiratory distress (Queen’s University)

A 67 year old male patient on an orthopedic unit, post-op day 2 with a DVT in R calf. Heparin protocol was initiated. Patient has a history of a previous anterior myocardial infarction (MI) 12 months ago with placement of 2 stents. V/S have been stable over the night shift with no complaints. Patient is mildly short of breath and complaining of mild chest pain. 02 saturation (sat) is 90% on room air. Heparin has been infusing at sub-therapeutic rate. Patient is diagnosed with PE and condition worsens to respiratory failure requiring placement of advanced airway and mechanical ventilation.

Elderly patient with urosepsis (Queen’s University)

82 year old male encountered in the ER department upon transfer from a long-term care (LTC) facility, with foley catheter in situ, and wrist restraints tied to bed/stretcher rails. PSW accompanying patient describes a 2 day onset of increasing confusion & agitation. Family member arrives as patient’s condition is deteriorating with worsening vital signs and decreased level of consciousness until patient unresponsive. Patient requires treatment for septic shock and transfer to ICU.

Elderly Person Experiencing a GI Bleed (Okanagan College)

An 80-year-old female was admitted to the medical unit from ER with a GI Bleed NYD. Past history of A. Fib., COPD, Rheumatoid Arthritis. The learner will receive a report over the phone from the ER nurse and will plan and prioritize care. When the participant completes the introduction, QPA, vital signs, the patient will request to use the commode (urgently) this happens prior to performing the abdominal assessment. The participants will complete a mobility assessment and safely transfer to the commode. The patient had large BRBPR with clots (cherry pie filling) with associated feelings of dizziness, lightheadedness, decreased BP, and increased heart rate. Learners will need to use SBAR to report this status change to the RN/Charge nurse and give a handover report to the RN.

End of life (Lakehead University)

In this scenario, learners are to assess the patient’s needs from a holistic perspective and apply a palliative approach to care. Learners are to respond with effective nursing interventions that may include  physical  (i.e. positioning, need for supplemental oxygen, mouth care, medications),  emotional/affective  (i.e. acknowledging grief and loss, responding to anger, appropriate use of humour),  mental/cognitive  social ,  spiritual/religious ,  cultural  aspects of care for the client and family.

End of life (University of Windsor)

Patient with stage four mesothelioma lung cancer that is being cared for in the home environment. Designed to challenge the year 4 student with doing an assessment and critically thinking next steps when caring for a patient who becomes hemodynamically unstable. Communication is paramount, with physician, EMS, and family. The patient is sent to the hospital and arrives obtunded. He goes into cardiac arrest, resuscitation is attempted but unsuccessful. The year 4 students are faced with a grieving family and preparing the body after death.

End of life: Breaking bad news (University of Ottawa)

This is the part B of a two part unfolding scenario that can be used as a single, stand-alone scenario.

Case A: Palliative patient – admitted to the oncology unit from the ER with end-stage lung cancer.

Case B: 55 year old male client is imminently dying of lung cancer with a Palliative Performance Scale (PPS). of 10%. DNR assigned. Client chose to die at home. He is married and his spouse is at the bedside. The client has 2 adult children and 3 grand-children who live out of town. One of which arrives at the home just after her/his father passes away. Nurses must provide comfort measures to the dying client and support the spouse during the final breaths of life, in addition to breaking bad news to the child who arrives too late to say goodbye.

Étude de cas : acidocétose diabétique pédiatrique

Garçon de 10 ans admis au service pédiatrique après avoir reçu un diagnostic de pneumonie. Il souffre de diabète de type 1 qui est bien géré. Pendant la nuit, le patient est devenu fiévreux, a eu des nausées et des vomissements. Son taux de glycémie était de 22 mmol/L à la maison. Lors de la simulation, les apprenants devront identifier et évaluer l’acidocétose diabétique, intervenir de manière efficace, effectuer une évaluation physique, adminstrer de l’oxygène, faire une analyse avec un glucomètre, préparer et administrer une solution d’insuline par IV.

GI bleed (Ryerson University)

A. Jones is a 76 year old widow who slipped and fell outside their home and fractured their left hip. A. Jones was admitted three days ago and had an internal fixation of her hip 2 days ago. The surgery was uneventful, recovery has been slow. A. Jones has a history of Hypertension, osteoarthritis, and “stomach problems”. A. Jones has a history of heavy drinking but states she has recently “cut back to 1-2 drinks per day” and currently smokes ½ to1 PPD.

Hearing Voices Adaptation (Cedar Crest College, PA, USA)

Based on Developing Empathy for the Lived Experience in Psychiatric Disability: A Simulation of Hearing Distressing Voices by Pat Deegan. This is a fully developed station-based simulation. One station involves students “hearing voices” while performing tasks. The other stations are adaptations on de-escalating an agitated patient (3 phases) and administering meds (they can’t at clinical for the mental health nursing course at this level) with SP’s in the other stations. The only direct connection to Deegan’s Hearing Voices is the intro by her, and the use of the MP3 players or an audio clip of auditory hallucinations. The tasks supported in this simulation activity are different from those suggested in the Hearing Voices program.

Hypertensive Disorder of Pregnancy – Clinical Renewal (Markham Stouffville Hospital)

A patient is admitted to Labour and Delivery at 36 weeks gestation for abdominal discomfort and headache. Primip Patient with HDP. As the scenario progresses, the patient’s blood pressure becomes more elevated and the patient develops eclampsia.

Hypertensive disorder of pregnancy (Ryerson University)|

Care of a 41 year old pregnant client. She is currently 26 weeks pregnant (G1 – T0 – P0 – A0 – L0). She is considered overweight with a pre-pregnancy BMI of 27.5 (5’4”/160lbs or 163cm/73kg). She was found to be newly hypertensive with a weight gain of 8 lbs over the last two weeks and mild edema. The client is admitted for observation and evaluation.

Hypovolemic Shock (Laurentian University)

In this scenario, learners are to assess the postoperative patient, recognize the signs and symptoms of hypovolemic shock; and intervene appropriately to minimize adverse patient outcomes and support recovery. Interventions should include: assessment and interpretation of vital signs (including pain); focused neurological and abdominal assessments, assessment of postoperative equipment (Jackson Pratt, dressing, intravenous, foley catheter), effective communication with physician; therapeutic communication and teaching with the patient and family and subsequent safe administration of blood product.

Infant Sepsis Scenario – External (University of Northern British Columbia)

Evelyn is a 2-month-old baby visiting the emergency department with her parent/caregiver and 3-year-old brother for increased fussiness and reduced feeding. You are a nurse in the Emergency Department and you are required to complete an assessment on the baby.

This scenario is designed to give students an experience of the patient journey from Initial assessment in the Emergency Department to discharge. Students are expected to work through the scenario with instructor support.

Management and discharge planning – Diabetic patient – (Lakehead University)

The patient is admitted to your unit with open sores on the first three toes of her right foot and anorexia x 3 days. She was diagnosed with Type 2 Diabetes 25 years ago and has a history of hypertension, peripheral vascular disease, and experiences intermittent claudication. She lives alone in a small house and has a son and daughter who both live out of town.

Mental health scenario (Lakehead University)

Student(s) are at the bedside of a client who expresses thoughts of self-harm. Need to establish a therapeutic relationship, conduct assessments, and collaborate with the client on priorities for care.

Motor Vehicle Crash with Burn (University of Windsor Ontario)

Patient arrives in the Emergency Department via ambulance post-motor vehicle crash (MVC). He was a restrained driver and was T-boned by another car on the driver’s side, the vehicle’s airbags were not deployed. During extraction from the vehicle by the firefighters, there was spontaneous combustion of the vehicle and the patient sustained partial-thickness burns to the lower extremities. The patient arrives in the ED in respiratory distress with severe pain to the upper chest and a pneumothorax. The year 4 students must prioritize the patient’s care which entails, prepping for chest tube insertion, pain medication, fluid resuscitation, dressing the burns, and setting up for intubation.

Multiple Patient Scenario (University of Windsor Ontario)

The scenario will involve four nursing students in total. Based on the report, the nursing students will be required to decide which of their three assigned patients (CHF, Diabetes mellitus, Renal) need to be seen first. The nursing students will need to decide on a plan of care based on the patient’s condition and status. All three patients will have needs that will require nursing intervention.

Multiple Patient Trauma (University of Ottawa)

This is a multiple patient scenario involving 3 patients in the Observation Unit following an MVC. Patient A: R/O fetal distress/injury Patient B: R/O Head Injury Patient C: Splenic Laceration

Neonatal/Newborn Resuscitation (National Reference Simulation Centre, SGT University, Gurugram, India)

This simulation scenario focuses on the newborn who is not breathing or crying after normal vaginal delivery. In order to prevent complications and save the life of the baby, the learners will have to identify and respond to the case as per the Newborn Resuscitation protocol. As the simulation progresses the baby’s condition will improve with appropriate interventions.

Night Shift on the Medical Ward (Conestoga College)

This is an introductory scenario designed for Internationally educated nurses who have already completed their training in their country of origin and are completing additional training in Ontario Canada. Participants for this scenario have minimal if any, experience with high-fidelity simulation, and this scenario will serve to give each participant a similar introductory experience through the progression of the client’s condition. This scenario involves an older adult female patient admitted to a medical ward with newly diagnosed congestive heart failure (CHF). This scenario takes place on the first nightshift of her admission as she slowly begins to experience more severe symptoms of CHF. Participants will be expected to complete a physical assessment to determine what signs/symptoms the patient is experiencing, initiate and titrate oxygen, contact the healthcare provider with concerns and recommendations, and implement any prescribed interventions.

Non Violent Crisis Intervention (Mount Royal University)

The purpose of this scenario is for students to recognize signs and triggers of escalating aggressive and confrontational behaviour from the family member and to practice implementing techniques of nonviolent crisis intervention strategies.

Normal labour and delivery (Brock University)

This is a multi option scenario representing the four stages of delivery. Scenarios can be run separately or as an entire labour and delivery process.

Nursing management of the Initial Home care visit – Community setting (St. Francis Xavier University)

Blake Edwards (he/him), 75 years old. Discharged to home yesterday following a 3-month hospitalization post left sided Ischemic stroke and rehabilitation. Blake’s daughter/son Alex lives with him and will be supporting him in his transition back to home. Blake has never been on any medications or treatments before his stroke, and he did not feel the need for medical check-ups or see his family physician regularly. Alex has always lived with Blake, and Blake has never required home care visits from the nurses. Alex is quite nervous about Blake’s new medications and states there are questions which need answering.

Patient with abnormal heart rhythm-nursing assessment priorities and interventions (UManitoba)

A 77-year-old male patient presents to an emergency department (ED) with sudden onset of SOB, dizziness, and chest discomfort. Pt. drove himself to the ED. The patient is a retired bus driver who lives in a bungalow with his wife. His past medical history includes mild Chronic Heart Failure, renal insufficiency, and implanted defibrillator (1 year ago). Pt was initially stable, but his condition deteriorates in a monitored treatment area (from abnormal heart rhythm asystole) and code blue is called.

Pediatric diabetic ketoacidosis (DKA) (Trent University)

Learners are to perform a physical assessment of a pediatric patient, with a focus on the respiratory system. Routine suctioning and tracheostomy care should be performed. Learners should anticipate risks to patient safety and have appropriate safety and emergency equipment for patients with an artificial airway/respiratory distress (suction, oxygen, Ambubag with tracheostomy connection & face mask, extra tracheostomy x2 at bedside), and appropriately respond and intervene when the tracheostomy is accidentally removed (rapid assessment of patient ABCs, call for assistance, cover tracheostomy and provide ventilation via Ambubag with face mask, attempt tracheostomy reinsertion by RN if the institutional policy allows -OR- call RT/MD for reinsertion).

Pediatric meningitis and medication calculation (Ryerson University)

A 12-year-old who presented to the Emergency Department (ED) approximately 5 hours ago. The patient has a 48 hr history of flu-like symptoms (low-grade temp (38.1OC), mild headache, generalized aches/pains). 2 hours before being brought to the ED, the patient voiced complaints of neck pain, increasing headache, photophobia, and had a temperature of 40.1OC. The patient’s Aunt reported that he may have had tremors in the left arm but lasted less than a minute and happened only once. The patient has been admitted with a diagnosis of bacterial meningitis to the Pediatric GIM Unit for further follow-up and treatment.

Pediatric pneumonia (McMaster University)

The patient is a 2-year-old, admitted with pneumonia. Mom has left to go home and to attend to the younger siblings. A grandmother is at the bedside and upset and concerned about her granddaughter’s condition. Nursing students (2-3) will need to manage the care of a child who begins to cough and describe shortness of breath, as well as a grandmother whose emotional state escalates to one of anger as she observes her granddaughter’s condition.

Pediatric Post-operative Tonsillectomy & Adenoidectomy (Brock University)

3-year-old Jaden has just returned from PACU post Tonsillectomy and Adenoidectomy.  She has been admitted to the pediatric unit overnight due to her age.  Perform an age-appropriate post-op assessment, health teaching and encourage her to meet her discharge goals.

Pediatric Seizure (Red River College)

A 4-month-old male is transferred from Children’s Hospital Emergency Department (CHED) to the ward. Has a 3-day history of fever, poor PO intake, lethargy, and fever of 40.1oC. The patient was noted to have “shaking movements” while in CHED. Movement resolved once lorazepam was administered, none noted since that time (6 hours previous). Lumbar puncture, Urine Culture and Blood Culture sent and waiting for results. The patient is on droplet-contact isolation precautions until the culture results are received. ID consulted but has not yet seen the patient. Has PIV running NS at TKO. Diagnosis – Query bacterial meningitis. The patient has subsequent seizures on the ward, witnessed by the student nurse, and requires acute and immediate intervention.

Pediatric Sickle Cell Exacerbation (Schoolcraft College)

Nursing care of a 5-year-old boy with Sickle Cell Disease experiencing a vaso-occlusive crisis. The child presents with a family member to the ER with severe pain. He is initially treated, then admitted, and transferred to the pediatric unit. He continues to experience severe pain the next morning and needs additional treatment.

Post-op complication TKA – pulmonary embolism (Nipissing University)

A 58 year old female patient admitted from recovery room postoperatively for a Left Total Knee Arthroplasty (TKA). She arrived on the floor 72 hours ago. She is now complaining of chest pain and severe shortness of breath. Pain is worse on inspiration and in her substernal chest.

Post-op Hip Arthroplasty (University of Saskatchewan)

This is an unfolding scenario that incorporates two different student groups participating in a 20 minute segment of the case, each segment is followed by a debrief. The purpose of this scenario is to bring together learning from various courses in 2nd year Nursing and have the students apply this learning to a simulated patient. This scenario focuses on communication, collaboration, and head to toe assessment of a post-operative patient, medication administration (pain management & antibiotic administration), environmental safety, and IV therapy. The client is a 78 year old female who has been admitted to the orthopedic unit following a total left hip arthroplasty. She is POD #1.

Post-op surgical site infection (Laurentian University)

A 7-year-old male patient previously healthy, 2 days post-op (# L femur-ORIF) with increased c/o pain and the presence of localized swelling to the left leg. In this scenario, learners are to assess and recognize signs and symptoms related to surgical site infection and pain management following an open reduction internal fixation (ORIF) procedure 2 days ago. In addition, the learner needs to be able to intervene effectively; which should include: pain assessment, vs assessment, infection control, wound care, PCA pump management, and appropriate communication skills for the pediatric patient and their families/caregivers.

Post-partum assessment (Red River College)

This simulation focuses on the postpartum woman following a spontaneous vaginal delivery. The patient exhibits risk factors for postpartum hemorrhage the learner will need to identify and respond to in order to prevent deterioration. The simulation progresses and the patient will improve with intervention.

Post-Partum blood clot/PPH and infant temperature instability (Trinity Western University)

To provide students with the opportunity to develop critical assessment and family-centred relational practice skills through the assessment and management of care and teaching for a postpartum family, in the context of a postpartum client who reports passing a clot and an infant with an unstable temperature.

Respiratory Deterioration of the Asthmatic Child (Trinity Western University)

Ellie, a 5 year-old female, is admitted to the inpatient unit with diagnoses of pneumonia and asthma exacerbation. Her condition deteriorates despite appropriate interventions based on a standardized asthma protocol in a progression from respiratory distress to failure.

Resuscitation of a Newborn with Subdural Hemorrhage and Seizures (Markham Stouffville Hospital)

A 39 + 5-week newborn male was delivered 24 hours ago with the assistance of forceps due to a prolonged second stage of labour, chorioamnionitis, maternal exhaustion and intermittent fetal decelerations. Required brief PPV after delivery but recovered quickly and was monitored in NICU for 8 hours. Apgars 5 and 8. Transferred to 4WF but has been irritable and feeding poorly and now returned to NICU for further assessment/evaluation. Begins seizing in NICU requiring anti-seizure medications. Becomes unstable, will need to be intubated. The team will prepare RSI medications.

Rural Care for the Patient with Chest Pain (Nova Scotia Health Authority)

In this scenario, learners will need to manage rural realities in addition to the clinical scenario. The patient frequently presents with chest pain, the physician is not on the premises, and the patient can not go to a higher level of care in a timely manner.

Severe Asthma Exacerbation (Laurentian University)

In this scenario, learners are to assess and recognize signs and symptoms related to a severe asthma attack. In addition, the learner needs to be able to intervene effectively and in a timely fashion; which should include: assessment, vital signs, oxygen therapy, medication administration communication skills for pediatric patient and their families/caregivers and identification of triggers.

Shoulder dystocia vaginal delivery – healthy neonate (Nipissing University)

Noelle is a 24 year old gravida 3 para 1 who enters the birthing unit at 41 weeks gestation who experienced a previous vaginal delivery of a macrosomic infant after a 16-hour labor period. She was diagnosed with gestational diabetes in both pregnancies and that she has been taking her own capillary blood glucose (CBG) levels 3 times a day.

Suicide risk assessment (University of Western Ontario)

The client is a 19 year-old university student who presents to the Student Health Services Clinic accompanied by his roommate. His friend is concerned about the client’s extreme fatigue and withdrawal from his usual social activities. The nurse determines a suicide risk assessment should be performed. Results of the assessment are to be reported to the health care team.

Tracheostomy care – (Mcmaster University)

10-year-old male, admitted to the pediatric floor with a diagnosis of pneumonia. He has a past history of Type 1 diabetes that is well controlled. Overnight, the patient develops fever, nausea, and vomiting. His blood sugar at home was 22 mmol/L. In this scenario, learners are to assess and recognize diabetic ketoacidosis and intervene effectively to include: physical assessment, O2 administration, glucometer testing, mixing and administration of an IV insulin infusion.

Unstable patient with fluid volume deficit (University of Saskatchewan)

A 40-year-old woman came to the emergency department early this morning after experiencing multiple episodes of vomiting and diarrhea over the last five days. She recently returned from a trip to Mexico and since her arrival home, she has been unable to keep any fluid down and has had frequent watery stools. She has no relevant medical history. The patient was admitted to the medicine unit and just arrived to her room.

Well Child Visit with Vaccine Hesitancy (Nova Scotia Health Authority)

Chrissy, a healthy infant, has come to the Public Health office for her well child exam and scheduled 12-month Immunizations. She has had the recommended immunizations at 2, 4 and 6 months without any complications. She is accompanied by her mom Chera who is reluctant to have Chrissy receive the MMRV vaccine scheduled for today. Chera is unsure if she is going to have Chrissy vaccinated and expresses this concern to the nurse.

Working as a street nurse (Durham/UOIT)

A street nurse works full-time in a downtown urban setting. Her position encompasses developing supportive relationships and identifying social, mental and physical health needs with clients and linking clients with community resources. A client living on the street requests socks and money from the nurse. As the client is changing her socks, the nurse observes an open wound on the heel of her right foot.  The nurse recognizes signs of substance use and the client reports recently being sexually assaulted by her boyfriend. The nurse establishes a connection with the client and collaboratively discusses a plan of care that results in the client consenting to accept care and go to the emergency department/urgent care/walk in clinic with the nurse.

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Campus Shuttle Bus Routing - National Institutes of Health (NIH) Utilizing Simulation to Evaluate Shuttle Bus Performance Under Passenger Counts Impacted by Covid-19 - National Institutes of Health (NIH) The National Institutes of...

Campus Bus Routing – A Streamlined Approach

Campus Shuttle Bus Routing - National Institutes of Health (NIH) Shuttle Bus Routing using Simio Simulation Software for National Institutes of Health (NIH) The National Institutes of Health (NIH) is the steward of...

How Simulation Modeling Works | Mining Industry (Case Study)

The Business Case Simulation - Twin Metals Minnesota Twin Metals simulation case study is a mining project based out of St. Paul, Minnesota, focused on the construction and operation of an underground copper,...

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Stockpile Facility Analysis Using Dynamic Simulation Twin Metals Minnesota (TMM) partnered with MOSIMTEC simulation to answer vital questions about its Coarse Ore Stockpile (COS) and validate a major project. This specific simulation was...

Alphabot: A Case Study In Use Of Simulation For Product Feasibility Analysis

  If spending your precious free time in a grocery store is not your idea of fun, Walmart (WMT) may have the solution for you.  Walmart, the world’s largest seller of groceries, has…

Chemical Manufacturing Supply Chain Simulation

Chemical Supply Chain Simulation Chemical Manufacturing - Integrated Global Supply Chain Model A chemical manufacturer was constructing one of the largest petro-chemical facilities of its kind, designed and built in a single phase....

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F-35 Joint Strike Fighter Airplane Simulation Modeling

The challenge faced by Lockheed Martin Aeronautics was ramping up production from 1 aircraft per month to 1 per day.  The response time and accuracy of decision support techniques is insufficient to evaluate...

Chemical Manufacturer Simulation

A chemical manufacturer was constructing one of the largest petro-chemicals complexes in the world.  The production facility had limited space for on-site storage and produced goods that would be shipped via two ports...

A Steel Corporation Simulation

The company produces build-to-specification rolled-steel products. The most important metrics for the organization is quality & on-time delivery. Challenge: The challenge was that current tools do not capture key scheduling considerations, for instance:....

Medical Device Manufacturer Simulation

A medical device manufacturer needed to understand the throughput impacts of a proposed instrument change.  The company also needed to understand if and how scheduling algorithms should change given the proposed physical change...

Intermodal Terminal Simulation

Validated and optimized the layout and operations of a planned Intermodal Container Facility. Goal was to evaluate the facility design for future growth scenarios and optimize key infrastructure decisions, along with analyzing system...

Common Materials Warehouse Simulation

Customer is designing a common materials supermarket to support replenishment of parts to assembly lines manufacturing 3 series of vehicles (50+ models).  Use simulation technology to test different replenishment methods for each of the...

Rail Network Simulation

Simulated a complex rail network to understand issues and identify bottlenecks in the system upon introduction of new terminal. The system included 90+ trains operated by Tier 1 railroads, with varying schedules, priorities...

Supply Chain Modeling

Evaluate the supply chain to test performance under a range of different situations, events, and constraints.  Also focus on key areas including cost, capacity, equipment, inventory, transit time, and other areas, along with...

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Re-engineered an existing client simulation focused on automated prescription order fulfillment. The client required support in developing an advanced tracking and sortation system for collecting items in an order before shipping. Enhanced a...

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Assisted client in evaluating plans for new underground mine. Focus was on reviewing the capacity constraints and infrastructure of the material handling system to ensure that the system was robust enough to meet...

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Provide a visualization tool to serve as a communication medium of planned mining operations and supply chain. Subsequently apply this mining simulator tool to help with engineering design and process improvement. Utilized advanced...

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Nursing Simulation Library

The Nursing Simulation Scenario Library is a resource for nursing educators in all settings and made possible by the generosity of the Healthcare Initiative Foundation. The library is being expanded through the support of the Nurse Support Program (NSPII) funded by the Maryland Health Services Cost Review Commission (HSCRC). Please read the Terms & Conditions of use. We welcome your feedback on the library and encourage you to utilize and share this resource with other nurse educators.

Each library listing contains video (used either independently or with accompanying document(s) to enhance education using simulation in any setting) and accompanying documents (used as guides for educators to recreate content in areas relevant to practice).

Adult Telehealth | Assessment | Briefing | Code Blue | Cultural Sim | Debriefing | Eating Disorders | End of Life | Implicit Bias in Healthcare | Managing Incivility | Medical Error | Opioid Withdrawal | Pediatric Telehealth | Postpartum Hemorrhage | Sepsis | Stress and Crisis | Transgender Care

Discipline: Nursing Student Level: Multi-level pre-licensure Expected Simulation Run Time: 11 minutes Guided Reflection Time: 22 minutes

Discipline: Nursing Student Level: Beginning/Intermediate Expected Simulation Run Time: 15 minutes Guided Reflection Time: 30 minutes

Description: Students respond to a code blue situation from a lecture. The simulation guide has two options for ending. The patient can be discovered to have a DNR order, or the patient is successfully resuscitated (as in the video). Depending on which one is used, the appropriate order sheet would be included in the scenario set up. The roles and function description is an additional document that can be used for student prep. Discipline: Nursing Student Level: Intermediate/Advanced Expected Simulation Run Time: 20 minutes Guided Reflection Time: 30 minutes

Discipline:  Nursing  Student Level:   All Levels  Expected Simulation Run Time:   20 minutes  Guided Reflection Time:  40 minutes

Duration: TBD

Discipline:  Nursing  Student Level:   Intermediate/Advanced  Expected Simulation Run Time:  10 minutes  Guided Reflection Time:  20 minutes

Discipline:  Nursing  Student Level:   Intermediate/Advanced  Expected Simulation Run Time:   15-20 minutes  Guided Reflection Time:  40 minutes

Discipline: Nursing Student Level: Any Expected Simulation Run Time: 20 minutes Guided Reflection Time: 40 minutes

Discipline:  Nursing  Student Level:   Advanced  Expected Simulation Run Time:   10 minutes  Guided Reflection Time:  30-45 minutes

Discipline:  Nursing 

Discipline:  Nursing  Student Level:  Multi-Level Clinical Immersion Expected Simulation Run Time:  20 minutes  Guided Reflection Time: 40 minutes

Discipline:  Nursing  Student Level:     Expected Simulation Run Time:   Guided Reflection Time:

Discipline:  Nursing  Student Level:  Advanced  Expected Simulation Run Time:     Guided Reflection Time: 

Discipline:  Nursing  Student Level:  Advanced  Expected Simulation Run Time:  15 minutes  Guided Reflection Time:  30-45 minutes

Expected Simulation Run Time:  TBD

PLEASE READ THESE TERMS AND CONDITIONS OF USE CAREFULLY BEFORE USING the Montgomery College Nursing Simulation Scenario Library.

By using the Montgomery College Nursing Simulation Scenario Library (and related content including documents and videos), you signify your assent to these Terms and Conditions. If you do not agree to all of these Terms and Conditions of use, do not use the Montgomery College Nursing Simulation Scenario Library.

Montgomery College may revise and update these Terms and Conditions at any time. Your continued usage of this library and viewing or use of its content will mean you accept those changes.

The nurse simulation scenarios, documents, and videos contained in the Montgomery College Nursing Simulation Scenario Library (the “Content”) are reviewed and updated periodically for accuracy and current best practices.  Nevertheless, these scenarios, documents, and videos, including but not limited to text, graphics, images, and other material are for informational and teaching purposes only; this Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something contained in this Content.

If you think you may have a medical emergency, call your doctor or 911 immediately. This Content does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned. Reliance on any Content contained in this Library is solely at your own risk.

The Content may contain health related materials that are sexually explicit. If you find these materials offensive, you may not want to view or use the Montgomery College Nursing Simulation Scenario Library. The Content is provided on an "as is" basis.  Montgomery College, Montgomery College Foundation, Inc. and a sponsoring organization, Healthcare Initiative Foundation (together, all referred to as “Content Providers”), TO THE FULLEST EXTENT PERMITTED BY LAW, DISCLAIM ALL WARRANTIES, EITHER EXPRESS OR IMPLIED, STATUTORY OR OTHERWISE, INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY, NON-INFRINGEMENT OF THIRD PARTIES' RIGHTS, AND FITNESS FOR PARTICULAR PURPOSE. Without limiting the foregoing, the Content Providers make no representations or warranties about the following:

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Walmart’s Alphabot: Designing Material Handling System with Simulation

Walmart, the world’s largest retailer by revenue, was looking for an automation technology that would help complete orders faster and at a lower cost in the company’s fast-growing online grocery business. They wanted to evaluate Alert Innovation’s Goods-to-Person (GTP) concept, Alphabot (an AGV or robot-based system), which could automate the grocery pickup process by using autonomous mobile carts capable of operating in all three dimensions within a multilevel storage structure.

Optimizing E-Commerce Warehouse Operations

The global e-commerce sector has seen 320% growth in five years, and demand is increasing following the COVID-19 pandemic. To reduce costs and remain competitive, DHL Supply Chain ran a warehouse operations optimization project. The project involved developing a smart and robust warehouse simulation tool for testing wave picking strategies.

Optimizing Warehouse Operations for Pharmaceutical Distribution Company

Cardinal Health, a billion-dollar pharmaceutical distribution and logistics firm, manages multiple products from brand name pharmaceuticals and generic drugs to over the counter drugs, health & beauty items and their own private label. They face a multitude of typical distribution warehouse challenges that are further complicated by the nature of pharmaceutical products. Brian Heath, Director of Advanced Analytics at Cardinal Health, and an experienced user of AnyLogic software, employed agent based modeling to solve various business problems, saving Cardinal Health over $3 Million annually.

Warehouse Simulation for Choosing Optimal Picking Algorithm

Kuehne+Nagel, a leading global provider of logistics solutions, was involved in planning a new warehouse for one of their clients. The warehouse would process 13K order lines or 750 picking cartons per day. The project included the development of the best algorithm for multi-order picking. It was planned that the orders in the warehouse would be served by workers with trolleys (or fangos). Workers with trolleys would pick the goods and put them in cartons by order.

Warehouse Cluster Pick Optimization

How DHL optimized warehouse order picking and improved efficiency. Analysis using simulation-based modeling increased picking speed and reducing order completion times. The tool integrates with warehouse management systems.

Developing a Forecasting Simulation Model for Efficient Warehouse Operations

A warehouse in Thailand was encountering difficulties because of a number of complicated processes involved in their logistics and storage systems. In order to overcome these and achieve more efficient warehouse operations, EPIC InnoLabs was contracted to develop a forecasting simulation model. This model would be used to predict system behavior based on a number of inputs as well as retrieve the expected values of selected KPIs.

Large-Scale Logistics Network Planning and Optimization

For a delivery network processing 15 billion parcels annually, simulation modeling provided significant saving across key metrics in a package easily accessible to all stakeholders. Find out how in this case study and presentation from Pitney Bowes.

Creating a Workforce Optimization Model for a Micro-Fulfillment Center

Micro-fulfillment centers are small, sometimes highly automated facilities that can fulfill online orders for delivery as well as click-and-collect in-store pickups. They use a combination of automated picking technology and manual picking. Dematic wanted to create a workforce optimization model that they would be able to present to retailers. It would help them understand the staffing required to operate their micro-fulfillment centers and how different scenarios could impact their ability to fulfill orders.

Evaluating Introduction of Warehouse Automation Systems

Symbotic is a warehouse automation solutions provider. Its systems are based on mobile robots that can travel freely throughout a dense storage structure, accessing products in all locations and handling them at a very high throughput rate. The company needed a tool to help their customers learn the impact of warehouse reorganization and compare capital investments against expected operational savings before the actual introduction of automation systems.

Cold Store Warehouse Operations Optimization

Phoenix Analytics is a Turkish consulting company and provider of simulation solutions for various industries. They were involved in developing a warehouse optimization project for one of the biggest ice-cream and frozen desserts manufacturers in Europe and Asia.

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• Corpus ID: 113420259

Casting Simulation - Best Practices

• Published 2010
• Engineering, Materials Science

Figures from this paper

32 Citations

Selection and utilization of casting simulation systems, a comparative study of simulation software for modelling metal casting processes, design of the casting technology using foundry simulation codes – development condition, virtual casting: state of the art in metal casting simulation tools, the conditions for application of foundry simulation codes to predict casting quality, simulation tools in enhancing metal casting productivity and quality: a review.

• Highly Influenced

Review Paper on Simulation Based Casting

Yield improvement of castings using computer aided simulation – a case study, optimization of casting process parameters through simulation, analysis of casting defects using casting simulation technique and using design of experiment: a review, one reference, casting simulation and optimisation: benefits, bottlenecks, and best practices, related papers.

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