Triage and flow are the beating heart of every emergency department, making sure patients are prioritized appropriately and treated seamlessly. Because triage and flow skills are so crucial, nurses need to educate each other. Too often, lessons can be dry and uninspiring, which is why a pair of Wisconsin nurses have livened up the learning using interactive games.
Melissa Ratzmer shared how an interactive game visually mimics the triage flow experience at an ED.
Dawn Zakzesky, DNP, RN, CNS-BC, CEN, a clinical nurse specialist at Froedtert Health in Brookfield, Wisconsin, was the “mastermind” behind the games, according to Melissa Ratzmer, RN, BSN, CEN, NPD-BC, Froedtert Health’s ED clinical educator, who is carrying on Zakzesky’s legacy by sharing the innovative teaching method with fellow ED staff. Ratzmer’s presentation “Game on: A Hands-On Learning Approach to Teaching ED Triage and Flow” had attendees abuzz yesterday.
Ratzmer presented a game that visually mimics the triage flow experience at an ED. Anchored by a game board resembling a typical ED, with exam rooms and two trauma rooms located around the perimeter of the board, a nursing station in the middle, a bench to denote the waiting room, and a slate of nurses and techs of varying abilities and years of experience in the wings. A deck of cards features various patient scenarios. Every time they choose a card, participants must make quick decisions about what ESI level to assign the patient, where to place them and which nurse should take the case.
The first patient of the presentation was a 32-year-old female who was three weeks postpartum, hypertensive and with a headache. What was her acuity and who should attend to her? Another patient was a 92-year-old woman who had fallen from a stepladder and hit her head. She was on blood thinners. A different card yielded a middle-aged man with a cough and body aches but normal vital signs. “I do encourage you all to just shout out answers,” Ratzmer said to the room as it buzzed with nurses conferring with each other and venturing guesses.
The excitement and engagement of an interactive game hopefully will coax more educators to include them in their curricula. “Traditional education can be pretty passive,” Ratzmer said, allowing that memorization has its place. “Game-based learning is fun, it’s active, it’s team based — you can do a lot of decision-making on the fly.”
The triage flow game can unfold in many different ways, with cards pulled at random or in a more orderly fashion. During the session, Ratzmer even added to the fun by including on one of the patient cards a nurse who came down with a fever and was vomiting on her shift, forcing her colleagues to make quick staffing decisions.
Not only do games such as triage flow board games and a Jeopardy knockoff that Ratzmer favors keep things lively during learning, they’re also cheap teaching tools. “You can do it yourself for 20 bucks,” she said, citing the costs of cards and laminating.
Asked if she ever got pushback from staff when revealing her game-based teaching methods, Ratzmer said that when Zakzesky first presented the concept she heard complaints from more seasoned staffers, although they grudgingly participated. Now with people newer to the roles, “they’re very accepting of it,” she said. “They’re a little hesitant at first but I think but by the end they’re all loving it.”