Simulation Skills Demonstration and Documentation Refinement

Objective. The student will perform a minimum of four prioritized nursing skills drawn directly from the care plan on a simulation mannequin within a timed session, document each skill using SBAR communication format, and receive a satisfactory evaluation on all critical-safety steps.

This lab brings together every skill, concept, and clinical judgment you have developed throughout your practical nursing program. You will perform four prioritized nursing skills on a high-fidelity simulation mannequin, document your findings using SBAR communication format, and compile all materials into the care plan binder that supports your oral defense. Performance in this session is evaluated against a standardized skills-performance checklist aligned to LPN scope of practice.

Why Simulation Matters

Simulation provides a controlled environment where mistakes become learning opportunities rather than patient-safety events. Research consistently shows that deliberate practice in simulation improves clinical competence and reduces errors at the bedside. Treat the mannequin as a real patient: introduce yourself, perform hand hygiene, confirm patient identification, and explain every procedure before you begin. Faculty observe not only your technical technique but also your professional behavior and your ability to recognize and respond to findings.

The Four Required Skills

Your four skills are drawn directly from your individualized care plan scenario. Common skill sets for this session include:

Wound assessment and dressing change — Inspect wound margins, measure wound dimensions, describe drainage character, apply appropriate dressing using sterile or clean technique as indicated, and document findings.
Blood glucose monitoring and insulin administration technique — Perform fingerstick glucose testing using the glucometer, interpret the result against the prescribed parameters, prepare and demonstrate subcutaneous insulin injection technique (including site selection and rotation), and verbalize verification steps before administration.
Cardiac and respiratory auscultation with findings documentation — Auscultate heart sounds at the four standard landmarks and lung fields bilaterally; document rate, rhythm, and any abnormal sounds; correlate findings with the patient's condition.
Patient repositioning with fall-prevention protocol — Reposition the patient to a therapeutically appropriate position using correct body mechanics, apply all elements of the fall-prevention bundle (bed in lowest position, call light in reach, side rails per policy, non-skid footwear), and verbalize the rationale.

You may be assigned a different combination based on your care plan scenario. Review your care plan the night before so you can prioritize skills in order of clinical urgency.

Critical-Safety Steps: No Exceptions

Four behaviors are mandatory-pass items on every skill. A single failure on any of these steps requires remediation before your binder can be submitted:

1. Hand hygiene — Perform correct hand hygiene before and after patient contact and before and after any glove change.

2. Patient identification — Use at least two patient identifiers (name and date of birth, or name and medical record number) before any assessment or procedure.

3. Allergy verification before medication administration — Check the patient's allergy status and verbalize it aloud before preparing any medication, including insulin.

4. Correct technique on invasive steps — Maintain sterile or clean technique as required; handle sharps safely; dispose of materials per standard precautions.

These steps are not merely procedural courtesies — they are evidence-based safeguards against wrong-patient events, healthcare-associated infections, and medication errors. The NCLEX-PN consistently tests your understanding that safety always takes priority.

SBAR Communication

Immediately after each skill, you will give a verbal SBAR handoff to the faculty member acting as the receiving nurse. SBAR is a structured communication tool that reduces miscommunication during care transitions.

S — Situation: What is happening right now? State the patient's name, your role, and the immediate concern. Example: "I am reporting on Mr. Jones, who has a stage II pressure injury to the sacrum. I just completed a dressing change."
B — Background: Relevant clinical history. Include diagnosis, pertinent medications, allergies, and how long the condition has been present.
A — Assessment: Your clinical interpretation of the findings. Example: "The wound measures 2 cm × 3 cm with scant serous drainage; wound margins are pink without signs of infection."
R — Recommendation: What you believe needs to happen next. Example: "I recommend continuing the current dressing protocol and reassessing in 24 hours; notify the supervising RN if drainage increases or odor develops."

Keep each verbal SBAR concise — aim for approximately 60–90 seconds. Faculty will give you real-time feedback; use that feedback immediately when you write your formal documentation.

Documentation Refinement and the Care Plan Binder

After all four skills are complete, review your audio or video recording (if available) and the faculty checklist. Identify any gaps: missing assessment data, incomplete SBAR elements, or steps out of sequence. Revise your written SBAR notes and integrate them with your full care plan, assessment data, nursing diagnoses, interventions, and evaluation statements. The finished care plan binder must tell a coherent, accurate story of your patient's care from initial assessment through your skills demonstration. This binder is the primary deliverable for your capstone and the reference document you will defend orally.

Preparing for the Session

Review your care plan and identify which findings from your assessment drive each skill.
Practice each skill in the open lab at least once before the formal session.
Memorize the SBAR framework so you can use it fluently under observation.
Bring all required personal protective equipment and verify that lab supplies are available before the session begins.
If you fail a critical-safety step, remain calm. Accept the faculty feedback, complete remediation, and repeat the skill with full focus.

Your performance in this lab is a direct preview of the professional behavior and technical competence expected of you as a licensed practical nurse.

Key terms10

SBARA structured communication framework — Situation, Background, Assessment, Recommendation — used to convey essential patient information clearly and concisely during care transitions or handoffs.

Critical-safety stepA mandatory checklist item whose omission or incorrect performance poses direct risk of patient harm; in this program, failure of any critical-safety step requires remediation before the skill is considered complete.

Standard precautionsA baseline set of infection-prevention practices applied to the care of all patients, including hand hygiene, appropriate personal protective equipment, safe sharps handling, and proper waste disposal.

Patient identificationThe process of confirming a patient's identity using at least two identifiers (such as full name and date of birth) before performing any assessment, procedure, or medication administration.

High-fidelity simulation mannequinAn advanced patient simulator that can replicate physiologic responses such as breath sounds, heart sounds, and palpable pulses, allowing learners to practice clinical skills in a realistic but safe environment.

Standardized skills-performance checklistA faculty-developed evaluation tool listing each required step of a nursing skill; used to ensure consistent, objective assessment of student performance against LPN scope-of-practice standards.

Scope of practiceThe range of assessments, interventions, and responsibilities that a licensed practical nurse is legally and professionally authorized to perform, as defined by state nurse practice acts and employer policy.

Care plan binderThe compiled project deliverable containing all assessment data, nursing diagnoses, planned interventions, evaluation notes, SBAR documentation, and skills-performance records that the student submits and defends orally.

Allergy verificationThe mandatory step of checking and verbally confirming a patient's known allergies before preparing or administering any medication, in order to prevent adverse drug reactions.

RemediationA structured opportunity for a student to receive additional instruction and repeat a failed skill or competency until a satisfactory level of performance is demonstrated.

In class: Each student performs their four required skills (selected from the scenario-relevant skill set, such as wound assessment and dressing change, blood glucose monitoring and insulin administration technique, cardiac and respiratory auscultation with findings documentation, and patient repositioning with fall-prevention protocol) on the simulation mannequin under direct faculty observation using a standardized skills-performance checklist. · Immediately after each skill, the student dictates a verbal SBAR handoff report to a faculty member acting as the receiving nurse, identifying the situation, background, assessment, and recommendation relevant to that skill finding; faculty provide real-time corrective feedback. · Students review their recorded SBAR notes and the faculty checklist, identify any documentation gaps, revise their written documentation, and compile all assessment, care plan, and skills-documentation materials into a unified care plan binder that will be submitted as the project deliverable and referenced during the oral defense.
Materials: High-fidelity simulation mannequin, skills lab supplies (dressing supplies, glucometer, stethoscope, sphygmomanometer, personal protective equipment per standard precautions), SBAR documentation form, standardized skills-performance checklist (faculty-developed, aligned to LPN scope of practice), care plan binder template, audio/video recording capability for self-review (optional per program policy)
Check: The standardized skills checklist is used by faculty; all critical-safety steps (hand hygiene, patient identification, allergy verification before medication administration, correct technique on invasive steps) are mandatory-pass items with no allowance for error; the overall skills session requires satisfactory on all critical steps and 80% on non-critical steps; students with any critical-step failure repeat that skill with remediation before submitting the final binder.

Practice check8

Answer each question, then check it. Nothing is recorded; this is your own practice.