Renee Latoures
NURS 733
Instructor: T. Doan
Teaching-Educational Project Plan
Purpose
The Purpose of this teaching-educational project is to provide the graduate nursing class
the information necessary to understand how to utilize the Broselow Pediatric Emergency Tape
and system when responding to a pediatric emergency.
Goal:
The class will return demonstrate accurate use of the Broselow Tape and system through
case simulation scenarios.
Objective:
Following a 10 minute presentation and 10 minute interactive simulation, the class will
be able to use accurately return demonstrate correct use of the Broselow Tape.
Sub-Objective:
The class will be able to use the accompany resource binder to answer basic resuscitation
questions accordingly with use of the tape.
Outline of Related Content:
1. What is the Broselow-Luten System?
2. When/where is it used?
3. What is the Broselow Pediatric Emergency Tape?
4. Efficacy of Broselow Pediatric Emergency Tape/system
5. How to use the Broselow Pediatric Emergency Tape
a. Why is it color coded?
6. What accompanies the Broselow Pediatric Emergency Tape
a. Color coded supplies and medicines
7. Simulation/practice
a. Simulation questions
Learning Theories Used:
Cognitive theory of multimedia learning encompasses several principles of learning
including multimedia. It is based on based on three main assumptions: there are separate
channels (auditory, visual, tactile) for processing information; there is limited channel capacity;
and that learning is an active process of filtering, selecting, organizing, and integrating
information. By presenting both auditory and visual information I am increasing understanding
and retention. Following auditory and visual presentation with tactile practice further reinforces
the information being learned.
I also focused on adult learning theory, which encompasses the basic concepts of
behavioral change and experience. Adult learning theory also takes into account the adult’s
experiences, which may be applicable to what is being taught. This was appropriate because the
class is full of nurses and they have applicable experiences to what I am teaching (they have
worked with children, many have emergency medicine experience, all are public health nurses
and could be asked to respond using this system in an emergency). Furthermore simulation is
often used in nursing education and it is rooted in adult learning theory.
Three learning theories, cognitive, social, and constructivist, explain how learners gain
knowledge with simulation experiences. All of these were used to identify how people learn and
why I chose to use simulation as part of my presentation. I decided to provide background
information and then have the class practice with the actual Broselow tape because actual
simulation with the real tools facilitates better learning and stronger retention.
The instructional methods used:
1. Setting: classroom, I chose this approach because most hospitals and continuing
education teach nurses in groups not individually and I wanted this to be reflective of our
future careers.
2. Lecture via powerpoint
3. Hands on simulation using the tools and case scenarios
4. Discussion
Rationale of content selection:
While presenting to my N801 group I realized that neither the instructor nor the 3 other
students in the group were even aware of a system that is considered the pediatric standard of
care in all emergency settings. This surprised me and I asked a few other students in my classes
if they knew of the standard of care. They also did not know. Therefore, based on my informal
needs assessment I identified a need and realized that no one in my class understood the pediatric
standard of emergency care. And while only one of our students is a CNS with a pediatric focus,
it is still valuable for everyone to understand this specific system as we are all eligible to be
public health nurses and may treat patients in future settings or in crisis. Therefore, I decided to
give my presentation on this system.
Rationale of teaching format:
The seminar is full of registered nurses. If they were employed in an emergency room
and received training on this system they would not just be lectured to they would be asked to
practice/simulate the clinical situation. I intend to follow this same format. Furthermore, actually
practicing with the tools and case scenarios helps the information be more applicable to them and
solidifies their theoretical understanding of a new concept into a skill they can perform.
Rationale of approaches:
I could just lecture about it, but if it were a new system and the hospital were presenting
it to the nurses they would do a brief presentation and then a skills
review/assessment/demonstration they would not lecture so I decided to present it as a skills lab
lecture/demonstration/practice since that is real world applicable.
Time Allotment:
7 minutes for lecture/powerpoint presentation
10 minutes for hands on simulation/practice
2 minutes for questions/wrap up
Instructional Resources:
1. Powerpoint Presentation (11 slides)
a. Rationale and literature support
2. Broselow Pediatric Emergency Tape and Resuscitation Drug Manual
a. I decided to have the class practice with the actual Broselow tape because actual
simulation with the real tools facilitates better learning and stronger retention
(site)
3. Pediatric mannequins
a. I needed these to perform the simulations on.
Method used to evaluate learning:
Evaluation method: I will use return demonstrate of the utilization of the skills taught to assess if
the class learned the intended skills.
Rationale: The goal of this presentation is not just to present information about the Broselow
tape and system it is to teach the class how to utilize it if they need to. I cannot evaluate if they
know how to utilize the system if they don’t show me that they can. Obviously, they will be
more efficient with the system with more practice but each student was able to follow the case
scenario and questions proving they could implement the system and utilize the tools presented.
References
DeBoer, S., Seaver, M., & Broselow, J. (2005). Color Coding to Reduce Errors. American
Journal Of Nursing, 105(8), 68-71.
Bourdeau, S., Copeland, J., & Milne, W. (2011). Accuracy of the Broselow tape in estimating
the weight of First Nations Children. Canadian Journal Of Rural Medicine, 16(4), 121125.
Color-coded pediatric emergency cart. (2006). Nursing, 3612.
DeBoer, S., Seaver, M., & Broselow, J. (2005). Color Coding to Reduce Errors. American
Journal Of Nursing, 105(8), 68-71.
Lafleur, K. J. (2008). Promoting safe pediatric resuscitation. Nursing, 38(3), 61-62.
Martin, S. (2012). Does instructional format really matter? Cognitive load theory,
multimedia and teaching. Educational Research & Evaluation, 18(2), 125-152.
doi:10.1080/13803611.2012.659899
Rutherford-Hemming, T. (2012). Simulation Methodology in Nursing Education anc Adult
Learning Theory. Adult Learning, 23(3), 129-137. doi:10.1177/1045159512452848
C or r ect U se of th e
B r osel ow ™ P ed i atr i c
E m er g en cy T ap e
The Broselow-Luten System
Color Coding Kids
ì
Objectives
u At the end of the presenta on you
u will understand what The Broselow-Luten System is and be
able to describe what the associated resources
u Know how to use the Broselow Pediatric Emergency Tape
u Know how to use the Pediatric Resuscita on drug manual
u Be able to describe the purpose of the color coding
u Will be able to answer basic resuscita on ques ons using the
tape and binder
In a pediatric Emergency
What is Broselow Tape?
u The Broselow Pediatric
Emergency Tape provides
a tool for determining the
correct dosage of
medica ons and
equipment sizes
(endotracheal tubes,
suc on catheters, etc.) for
children, based on their
length.
Effic cy of the Broselow Tape
u Analysis shows that mean
medica on dosing error
severity when subjects used
the B-LPS was 33.88% lower
then when B-LPS was not
available.
u The tape is recommended
for use on any child under
the age of 12 years old.
u For any child that is longer
than the tape, the
prac oner should use adult
dosages and equipment.
How to use Broselow Tape
1.
Place the red end at the top of
the pa ent's head. Measure
when pa ent flat, never si ng.
2.
Rest one hand at the top of the
tape and slide your other hand
down the tape to the heel of
the pa ent. Be sure to maintain
the posi on of the hand at the
top of the head.
3.
Measure the pa ent's color
zone at the heels NOT the toes.
Stop at the heel.
Why is it color coded?
u By using a color-coded
system tool, the providers
are able to concentrate on
more important factors of
care during the emergency,
such as securing the airway,
maintaining circula on,
making a diagnosis and
securing appropriate
transport.
Equipment and medications are organized and
stored by color to facilitate access in an
emergency
The Broselow-Luten System, Examples:
Resources
ì
1. Rowe C, Koren T, Koren G. Errors by pediatric residents in calcula ng drug doses. Archives of Disease in Childhood. 1998 Jul;79(1):56-58.
ì
2. Lesar TS. Errors in the use of medica on dosage equa ons. Arch Pediatr Adolesc Med. 1998;152:340-344.
ì
3. Koren G, Barzilay Z, Greenwald M. Tenfold errors in administra on of drug doses: A neglected iatrogenic disease in pediatrics.
Pediatrics. 1986 Jun;77(6):848-849.
ì
4. Perlstein PH, Callison C, White M, et al. Errors in drug computa ons during newborn intensive care. American Journal of Diseases of
Children. 1979 Apr;133(4):376-379.
ì
5. Kausahal R, Bates DW, Landrigan C. Medica ons errors and adverse drug event in pediatric inpa ents. JAMA. 2001;285:2114-2120.
ì
6. Po s MS, Phelan KW. Deficiencies on calcula on and applied mathema cs skills in pediatrics among primary care interns. Arch Pediatr
Adolesc Med. 1996;150:748-752.
ì
7. Harris M, Pa erson J, Morse J. Doctors, nurses, and parents are equally poor at es ma ng pediatric weights. Pediatric Emergency Care.
1999 Feb;15(1):17-18.
ì
8. Lubitz DS, Seidel JS, Chamcides L, et al. A rapid method for es ma ng weight and resuscita on drug dosages from length in the pediatric
age group. Annals of Emerg Med 1988 Jun;17(6):576-581.
ì
9. Hamil PW, Drizl TA et al. Physical Growth: Na onal Center for Health Sta s cs percen les. Am J Clinical Archives 1979;32:607-629.
ì
10. Luten RC, Wears RL, Broselow J et al. Length-based endotracheal tube and emergency equipment in pediatrics. Ann Emerg Med. 1992
Aug;21(8):900-904.
ì
11. Luten RC, Wears RL, Broselow J et al. Length-based endotracheal tube and emergency equipment in pediatrics. Ann Emerg Med. 1992
Aug;21(8):900-904.
ì
12. Luten, RC, Wears RL, et al. A Color-Coded Pediatric Therapeu c and Pa ent Safety System: The Broselow-Luten System. Submi ed to
Pediatrics, June 2001.
ì
13. Shah A, Frush KS, Luox. Reduc on in error everity associated with use of a pediatric medica on dosing system: A crossover trail.
Submi ed to JAMA, June 20, 2001.