Date of Graduation

Spring 5-7-2013

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions

First Advisor

Dr. Jo Loomis

Second Advisor

Dr. Amy Nichols

Third Advisor

Dr. Linda Walsh


Prompted by evidence that clinical simulations improve patient safety, team simulations are emerging in hospital settings. Accrediting organizations such as the U.S. Joint Commission on Accreditation of Healthcare Organizations and the American College of Obstetricians and Gynecologists (Joint Commission, 2004, American College of Obstetricians and Gynecologists, 2002) have recommend simulation of obstetrical emergencies, including shoulder dystocia for hospital teams. National patient safety mandates for simulation training of critical events have not been available to small, rural hospitals because of lack of talent and equipment, creating a gap in resources. Other than demonstrations by manikin companies, this author has currently been unable to sufficiently document the existence of active, non-academic resources for in-situ simulations available to small, rural hospitals in California.

The California Simulation Alliance (CSA) is uniquely positioned as a state consortium for healthcare simulation to solve the deficiencies of talent and equipment by bringing the benefits of in-situ simulations to rural and urban community hospitals. The CSA Onsite Sims project described in this proposal initiates the move to in-situ scenarios from simulation center scenarios by expanding the CSA nurse-based scenarios into interprofessional, in-situ team simulations while maintaining the validity, repeatability, and integrity of the CSA scenarios. The CSA Onsite Sims scenarios promote the identification of desired behaviors, communication, and patterns that improve outcomes satisfying the medico-legal need for documented patient safety practices.