Sixty Minutes That Fit a Shift: Designing a Blended Continuing Education Program on Failing High-Flow Nasal Oxygen Therapy
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Master of Science in Nursing Program, Aspen University
N584: Curriculum Development, Implementation and Evaluation
Instructor Name
Month Day, Year
Sixty Minutes That Fit a Shift: Designing a Blended Continuing Education Program on Failing High-Flow Nasal Oxygen Therapy
The previous modules identified the gap in recognizing failing high-flow nasal oxygen therapy on two medical-surgical units at a composite hospital and translated it into a performance outcome and eight objectives. This paper designs the program: its structure, content, teaching methods, timing, faculty and materials. The design is shaped by three findings from the needs assessment: the gap concerns judgment rather than equipment, nurses prefer short sessions on the unit, and staffing allows only two nurses at a time to step away.
Program Structure
The program is a 60-minute blended activity in three parts. The first is a 15-minute online module, completed on a unit computer or at home, covering the physiology of high-flow therapy, the combined oxygenation and respiratory rate index and the unit's escalation criteria, with embedded calculation practice. The second is a 30-minute in situ simulation on the unit, run for pairs of nurses during a planned lull in the shift. The third is a 15-minute structured debrief immediately after the simulation. Nurses must complete the online module before the simulation so that simulation time is spent applying knowledge rather than acquiring it.
Content
Content follows the objectives, with the greatest time given to recognition and escalation. The online module explains that high-flow oxygen delivers heated, humidified gas at high flow rates, reducing dead space and providing a modest positive airway pressure, which improves oxygenation and can reduce breathing effort (Ashraf-Kashani & Kumar, 2017). It then explains why saturation can remain near target as a patient tires and teaches the combined index, which divides the ratio of oxygen saturation to inspired oxygen by the respiratory rate. Nurses practice calculating the index from three sets of values and interpreting a trend over twelve hours. The module ends with the unit's escalation criteria and a structured format for calling the provider.
The simulation uses an unfolding case: a 71-year-old woman with pneumonia on high-flow oxygen at 40 liters per minute and 50% oxygen. In the first phase, her values are stable. Ten minutes later, her respiratory rate has risen from 24 to 32, she is using accessory muscles and is speaking in short phrases, while saturation remains at 92% and the monitor shows no alarm. Nurses must notice the change, calculate the index, recognize that escalation criteria are met, call the provider using the structured format and document their findings. A third phase, in which the provider asks what they recommend, tests whether they can articulate the concern.
Why In Situ Simulation
In situ simulation, run in the actual clinical environment rather than a simulation center, fits the program's constraints and aims. Nurses practice with the equipment, monitors, documentation system and call procedures they will use in practice, and the simulation can reveal latent problems, such as a missing escalation criteria card or a monitor that does not display respiratory rate. A review of in situ simulation in health care education found it useful across specialties for improving skills and team functioning, with designs ranging widely in fidelity, duration and topic, and concluded that no single design was most efficient; what mattered most was choosing a design that fits the setting's resources, educational needs and clinical demands (Martin et al., 2020). A short, low-equipment scenario that pairs of nurses can complete during a shift fits this unit's demands.
The design also includes safeguards. Simulations are canceled without penalty if the unit becomes busy, simulation equipment is clearly labeled to prevent confusion with real supplies, and a respiratory therapist co-facilitates so that clinical questions can be answered accurately.
Debriefing
The debrief uses a structured sequence: nurses describe their reactions, analyze what they noticed and when, compare their actions with the escalation criteria and identify one change they will make in practice. The facilitator focuses particularly on the moment when the nurses noticed the rising respiratory rate, or did not, and on what prompted them to calculate the index. Because the program is planned backward from a performance outcome, the debrief ends by asking each nurse to state the specific practice change they will make, which links the learning activity to the outcome it is meant to produce (Moore et al., 2009). Each nurse leaves with a pocket card summarizing the index calculation, thresholds and escalation steps.
Faculty, Materials and Contact Hours
Faculty include a nursing professional development specialist, who designs the program and facilitates debriefing, and two respiratory therapists and two experienced charge nurses trained as co-facilitators, so that simulations can run on day and night shifts. Materials include the online module in the hospital's learning platform, a low-fidelity simulator or a task trainer with a programmable monitor display, a simulated chart in the electronic record's training environment, pocket cards and the escalation criteria posted at each high-flow bedside. The activity is planned to meet continuing education standards, with learner engagement throughout and a 60-minute contact hour, and conflicts of interest of planners and faculty will be disclosed, including any relationship with manufacturers of high-flow devices.
Accessibility is part of the design. The online module includes captions and a transcript, works on a phone as well as a desktop computer and can be paused and resumed, which matters for nurses completing it during breaks. The simulation script avoids jargon that is unfamiliar to newer nurses, and co-facilitators are prepared to slow the scenario for nurses who have never cared for a high-flow patient, since the goal is learning rather than testing. Nurses who have recently experienced a patient's deterioration are offered the option to observe rather than lead the scenario.
Conclusion
The design responds directly to the needs assessment: a short online module for knowledge, an in situ simulation built around the trap of stable saturation and rising work of breathing, and a structured debrief that links the experience to practice. By fitting into a single hour on the unit, repeated across shifts with trained co-facilitators, the program can reach all 88 nurses without removing them from patient care for a full day. The next module plans how it will be implemented.
References
Ashraf-Kashani, N., & Kumar, R. (2017). High-flow nasal oxygen therapy. BJA Education, 17(2), 63-67. https://doi.org/10.1093/bjaed/mkw041
Martin, A., Cross, S., & Attoe, C. (2020). The use of in situ simulation in healthcare education: Current perspectives. Advances in Medical Education and Practice, 11, 893-903. https://doi.org/10.2147/AMEP.S188258
Moore, D. E., Green, J. S., & Gallis, H. A. (2009). Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities. Journal of Continuing Education in the Health Professions, 29(1), 1-15. https://doi.org/10.1002/chp.20001
How this N 584 Module 5 example is structured
Aspen does not publish N584 module prompts, so check your classroom for the exact instructions. This example states the design constraints, sets out the program's three-part structure, describes content and the unfolding case, justifies in situ simulation with evidence, explains debriefing and lists faculty, materials and continuing education requirements.
N584 Module 5 questions, answered
What does N584 Module 5 usually ask for?
After outcomes and objectives, N584 typically asks for the design of the continuing education program: content, methods, time, faculty and materials. Check your classroom for the required elements.
What is in situ simulation?
Simulation run in the actual clinical environment, using the unit's equipment and systems, rather than in a simulation center. It can fit into shifts and reveal practical problems in the real setting.
Why combine an online module with simulation?
The online module delivers knowledge efficiently before the session, so the limited simulation time can be spent applying it to a realistic patient and discussing decisions.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Aspen University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.