High-fidelity simulation and emergency preparedness.

Ongoing threats of bioterrorism and the consequences of natural disasters require nurses entering the workforce to be competent in emergency preparedness. Nurses need to collaborate with multidisciplinary teams and use their critical thinking skills to provide safe nursing care during potentially chaotic public health emergencies. Using Institute of Medicine recommendations and Quality and Safety Education for Nurses competencies, the authors describe a public health emergency simulation exercise with undergraduate senior nursing students enrolled in a public health clinical course. Students applied chronic disease, mental health, and pharmacology knowledge acquired in previous nursing courses to an unfolding infectious disease outbreak while practicing their assessment, treatment, delegation, organizational, and leadership skills. The students' quantitative evaluation of the experience indicated that 90.36% thought the purpose of the experience was clear, 91.5% thought the importance of delivering safe care during a public health emergency was stressed, and 79.5% thought the presimulation briefing and postsimulation debriefing helped them understand and participate in the drill. Qualitatively, the students' reflections of the exercise indicated that although they initially felt overwhelmed and anxious, they realized the importance of participating in emergency preparedness and recognized their ability to apply nursing skills learned in previous courses.