Published Back to Strategy Search Strategy Submission Quality and Safety Education for Nurses: An Introduction to the Competencies and the Knowledge, Skills and Attitudes Author: Gerry Altmiller EdD, MSN, RN Title: Assistant Professor Coauthors: Institution: La Salle University Email: Altmiller@lasalle.edu Competency Categories: Evidence-Based Practice, Informatics, Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN, Staff Development Learner Setting(s): Classroom Strategy Type: General Strategy Learning Objectives: Learner with be able to identify the IOM/QSEN competencies and resources that support development of those competencies. Strategy Overview: This powerpoint presentation is a brief overview for individuals that are unfamiliar with the IOM/QSEN competencies and wish to introduce ideas that promote development of the knowledge, skills, and attitudes that support the competencies. It includes direct links to helpful resources such as the First Touch web site, to Infection Control Bundles at The Joint Commission website, and to the TeamSTEPPS video collection at the Agency for Healthcare Research and Quality web site. Submitted Materials: Additional Materials: Evaluation Description: Faculty have found this presentation helpful as they learn about the IOM/QSEN competencies and as they share information with their students. Each semester the presentation is updated to include more information and resources. This powerpoint presentation is introduced in the Fundamentals of Nursing course but is also available to each course in our curriculum as faculty have found that there are variations in each course of how the information and the web link resources can be utilized.

Published Back to Strategy Search Strategy Submission Respectful Conversations for Difficult Situations Author: Beth Bolick DNP, PPCNP-BC, CPNP-AC Title: Professor and Director Acute Care Pediatric Nurse Practitioner Program Coauthors: Cole Edmonson, RN, DNP, FACHE, NEA-BC •Rita Adeniran, RN, DrNP, CMAC, NEA-BC, FAAN • Ric Cuming, RN, MSN, EdD, NEA-BC, CNOR • Bernadette Khan, RN, MSN, NEA-BC • Linda B. Lawson, RN, DNP, NEA-BC • Debra Wilson, RN, MSN, MSA, ACNS-BC, NEA-BC Institution: Rush University College of Nursing Email: Beth_N_Bolick@rush.edu Competency Categories: Teamwork and Collaboration Learner Level(s): Continuing Education, Graduate Students, New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN, Staff Development Learner Setting(s): Classroom, Skills or Simulation Laboratories Strategy Type: Online or Web-based Modules Learning Objectives: This FREE tool is designed to help those of us who work in healthcare to learn to respectfully manage conversations regarding incivility or bullying in our workplaces. It is specifically intended for use with students during their preparation for careers in healthcare and for employers to use with new hires during their onboarding experience. However, it can also be used by anyone or any profession working to build a respectful workplace. Define incivility and bullying Describe common situations of incivility and bullying Describe the impact of incivility and bullying on human capital and patient outcomes Develop a list of terms that are deleterious to collaboration, can invoke a negative emotional response in the listener, and are disrespectful Reflect on personal contribution to an incivil workplace Describe the approach to respectful conversations for difficult situations Model the respectful conversations approach to managing difficult situations Apply the respectful conversations approach to managing difficult situations in a safe training setting Strategy Overview: Tool Overview: Video 1: Overview of Incivility and Bullying in Healthcare https://www.youtube.com/watch?v=4DOQ593cHfE Incivil and Bullying Behaviors Exercise Language of Collaboration Exercise Self-Reflection Exercise Video 2: Approach to Respectful Conversations https://www.youtube.com/watch?v=WbP3O_UC1LE Group Discussion Videos 3: Practice Vignettes https://www.youtube.com/watch?v=t8XddfSddzU Role-play Exercises Set-Up: This tool is designed to be used as time permits and can be divided into 2, 2.5, and 4 hour segments. If used as a whole it is completed in one 8 .5 hour day. If used in a combination of online learning and onsite simulation, then the first two segments can be completed online with a facilitated discussion and the final segment can be facilitated during an onsite session. A room will be needed with projection capabilities for the videos and tables and chairs for large group and small group work. Flip charts, electronic writing board, or other writing system is recommended for group discussion and group work reports. Download pertinent self-assessments from the Truth Bucket for the Self-Reflection Exercise. http://stopbullyingtoolkit.org/truth-2/ Download, print, and laminate if desired, the Respectful Conversations pocket card and the Mnemonic BE AWARE and Care from the Courage Bucket. http://stopbullyingtoolkit.org/courage-2/ Segment III Simulation Exercises: Consider using standardized participants if available and tablets or other recording devices for video playback. Dashboard: Consider measuring the level of incivility and bullying in your organization through a dashboard prior to initiating training. A sample dashboard is available in the Truth Bucket and can be modified as needed. Submitted Materials: Additional Materials: Website: Civility Tool-kit: Resources to Empower Healthcare Leaders to Identify, Intervene, and Prevent Workplace Bullying www.stopbullyingtoolkit.org YouTube videos for Respectful Conversations training: https://www.youtube.com/channel/UCfambua1b0CnkdxMXtX36kA Evaluation Description: Self-assessments Ongoing Dashboard Role-playing exercises User survey

Published Back to Strategy Search Strategy Submission Enhancing Medication Safety in Clinical: A Video for Students and Nursing Faculty Author: Kimberly Silver Dunker DNP, RN Title: Assistant Professor of Nursing Coauthors: Institution: UMASS Graduate School of Nursing Worcester Email: kimberly.silver@umassmed.edu Competency Categories: Patient-Centered Care, Safety Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Clinical Setting, Skills or Simulation Laboratories Strategy Type: Modules Learning Objectives: After viewing this medication safety video vignette the students and faculty will be able to minimize risk of harm to patients and providers through both system effectiveness and individual performance. Describe how to safely administer medications in a clinical setting to understand causes of error and allocation of responsibility and accountability improve the quality and safety of nursing care. Participate appropriately in a medication administration role-play in the lab prior to attending clinical. Identify their role in communicating essential information to patients about their medications during the administration process. Demonstrate comprehensive understanding of the multiple dimensions of patient centered care utilizing the five rights to medication administration pass. Strategy Overview: Video Link: Click Here This vignette was designed for both faculty and students to learn how to administer medications safely in clinical settings. The vignette demonstrates to nursing faculty how to manage more than one student in clinical and how to manage a medication administration pass for a student while in clinical. This vignette also is designed to explicate teaching strategies for student and faculty when the student isn’t quite prepared or ready to administer medications. This vignette also reviews how to question a student prior to approaching the patient at the bedside and then demonstrates how to empower the students while working with their patients at the bedside. The student demonstrates how to administer the medications safely and ensures the five rights during the process. Strategy Activity: Prior to engaging in clinical experiences, the students and or clinical faculty will view the vignette in the nursing lab. Then the students will discuss the aspects of safe medication administration and the five rights of medication administration. The students will be given a MAR (Medication Administration Record) to look up medications (see example). While in the nursing skills lab, the students will prepare the medications and administer medications to their patients. They will utilize drug guide resources and other e-tools to gather important information about their patients. They will also discuss the right situation for these medications, medication reconciliation, and patient data to connect essential patient information. This activity will help the students to learn how to safely administer medications to their patients prior to going live in the clinical setting. Patient Centered Care Students will gather information of the medications they are to prepare for their patients in clinical. (Knowledge) Students will value their knowledge and how dissemination of essential information about their patients’ current medications create a more patient-centered environment. (Knowledge, Attitudes) Safety Students will utilize drug guides and other e-tools, learn how gather essential information about their medications and be confident when communicating with their clinical instructors about their patients and their medications. (Knowledge, Attitudes) Students will demonstrate the five rights of medication administration while administering medications in clinical. (Skill) Students will value own role in providing safe medication administration while in clinical. (Attitude) Submitted Materials: Additional Materials: http://onlinetraining.umassmed.edu/medicationadministration/ https://youtu.be/MUn4Ec2X93g Evaluation Description: This activity was used in the lab as a strategy to teach novice nursing students how to safely administer medications while in clinical. Concurrently, the novice adjunct clinical faculty were also taught how to safely perform a medication administration pass while in clinical for the first time. The faculty were taught how students should be questioned on medications prior to administering them to their patients at the bedside. Ultimately by viewing the video vignette, both the faculty and student were on the same page on the ultimate expectations for medication administration while in clinical. This activity helped to create an empowering environment for medication administration. Anecdotal information: This assignment was utilized with pre-licensure nursing students. These students were in a skills course and had not yet gone to their first clinical. Medication administration is part of the safety competency. The students were to view this video vignette to teach them how to administer medications safely in clinical and learn about patient needs during medication administration. Secondly, both faculty and students who participated in this activity were clear of the objectives for medication administration and ensure safety, and focus on patient centered care while in clinical. Feedback from both the clinical faculty and the students was positive. Faculty reported greater critical thinking skills in clinical as evidence by two medication transcription errors were identified during a medication administration pass while at clinical. This generated a great discussion around safety and medications. This exercise has bridged the clinical practice environment with theory. As a result, clinical nursing faculty have reported feeling they were competent in giving medications with students prior to going to clinical. This increased knowledge empowered both the faculty and students during this important nursing responsibility in clinical settings. Ultimately no medication errors occur with the clinical faculty during the semester after implementation of this activity, thus increasing safety in clinical practice.

Published Back to Strategy Search Strategy Submission A Mock Hospital: Collaborating to Improve Quality and Safety Author: Ann M. Stalter RN, PhD, M. Ed Title: Associate Professor Coauthors: Institution: Wright State University College of Nursing and Health Email: ann.stalter@wright.edu Competency Categories: Teamwork and Collaboration Learner Level(s): New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN Learner Setting(s): Classroom Strategy Type: General Strategy Learning Objectives: Upon completion of the Ten Week Mock Hospital experience, learners will: 1)Take professional ownership for their Mock Hospital by naming it and their units, assuring organizational mission, philosophy and strategic plans are in place, preserving its reputation, maintaining evidence-based quality, and mitigating errors for the safety of its patients and employees (skill). 2)Collaborate in teams to solve patient, family, and agency issues to achieve quality and safety (QSEN, Defining competency). 3)Communicate with team members regarding the clinical problems (case studies) (QSEN, Teamwork & Collaboration, skill). 4)Involve the patent and family as partners in examining assurance and improvement of assuring safe, quality care (QSEN, Patient-Centered Care, knowledge). 5)Employ evidence based practice from reliable sources in solutions that integrate best practice into the work environment (QSEN, EBP, knowledge and skill). 6)Appreciate how technology supports clinical decision-making, error prevention and care coordination to enhance patient outcomes (QSEN, Safety, attitude). 7)Value own role in error prevention (QSEN, Safety, attitude). 8)Acknowledge own potential in contributing to effective team functioning (QSEN, Teamwork & Collaboration, attitude). 9)Appreciate the importance of teamwork and collaboration (QSEN, Teamwork & Collaboration, attitude). 10)Contribute to resolution of conflict (QSEN, Teamwork & Collaboration, attitude). 11)Value the influence of system solutions in achieving effective team functioning (QSEN, Teamwork & Collaboration, attitude). 12)Reflect on assignments to transfer key learning points into clinical practice (skill). 13)Employ systems thinking to reduce personal effort and reliance on authority, while increasing critical reasoning and system interdependencies (skill). 14)Employ conflict resolution skills to improve group functioning and to advance safe nursing practice. 15)Participate in debriefing exercises in order to analyze and synthesize key learning (skill). 16)Employ reflection as a means of transferring knowledge, skills and attitudes to clinical practice (skill). 17)Participate in a root cause analysis of a sentinel event (QSEN, Quality Improvement, skill). 18)Participate in a Mock Debriefing Panel 19)Serve on a Mock Hospital Board 20)Review a budget Strategy Overview: This innovative teaching strategy could be used in online, hybrid or face-to-face environments. It suggested that it be used using hybrid format in a Leadership/Management, BSN senior-level course. This strategy is designed to accommodate 24-60 students. It has several working parts: The Mock Hospital Board, the Mock Unit Meetings and the Debriefing Panel. The students are assigned to work in six groups with up to 10 students per group. The greater the number of students, the more complex and challenging it is to manage. This teaching strategy employs four theory-based educational approaches (Appendix A). This teaching strategy is designed for 90 minute in-class sessions across 10 weeks. There are pre-class and after-class assignments integrated into the teaching strategy. Suggested Time Frame for each week Prep work (before class) 1 hour* (includes voiced over Powerpoint, readings, videos & website perusal) IRAT (in-class) 20 minutes TRAT (in-class) 10 minutes Mock Board (in-class) 15 minutes Unit Meeting (in-class) 30 minutes Debrief (in-class) 15 minutes Journal (After class reflection) 30 mniutes Each week the Mock Hospital Board, Mock Units and Debriefing Panels meet. Ideally, each group member should rotate across The Mock Hospital Board, the Mock Unit Meetings and the Debriefing Panel over the course of the academic session. Larger groups may have a difficult time with rotating. Within the Unit, each group member rotates the following roles each week: Patient/Family member, Secretary, Nurse Manager, Objective Observer, and Staff Nurse. Each student must assume each role at least once during the academic session, but may assume it more than once throughout the academic session. Other roles that may be assigned are: Clinical expert, Patient advocate, Quality improvement nurse. Additional roles could include other members of the health care team (physical therapy, social work, clergy, etc.), administrators (Chief Nursing Officer, Chief Executive Officer), or other roles (mentor, clinical nurse educator, preceptor, nurse practitioner, nurse researcher, infection control nurse, wound specialist, etc.). A sample of the following job descriptions are provided: Staff Nurse, Secretary, Nurse Manager & Objective Observer. Additional sample job descriptions are available (free domain) for use and adaptation on Monstor.com (See link on attached document) (Appendix B) To assure rotations across groups, have the Nurse Manager for the week participate on the Mock Board and have the Objective Observer serve on the Debriefing Panel. Members of the Mock Board are as follows: Chair, Vice Chair, Secretary, Treasurer, and up to six Ex-officio members. The members participate by script. Suggested Topical Outline for Module/Topic by Week is as follows Week Module Topic 1 1 Forming Teams to Design the Mock Hospital Organizational Structures 2 2 Leading and Managing Teams to Follow Quality and Safety Initiatives 3 3 Storming for Success: Conflict Resolution 4 4 Collaborating to Improve Patient/population Outcomes 5 5 Norming: Civility as a Value 6 6 Using Evidence to Promote a Culture of Health 7 7 Performing: The Aim for Excellence 8 8 Systems Thinking to Lead Quality and Safety in Complex Organizations 9 9 Transforming: The Value of Change 10 10 Adjourning: Organizational Restructuring Suggested Concepts by Module, Suggested Group Assignments by Module and Suggested Debriefing Questions are provided (Appendix C). Suggested Tools for Module 1 include: A Sample Module Template, Mock Board Script, Case Study, Class Assignment (Charter), IRAT and TRAT quizzes, a Rubric, and Faculty Preparation Tips for Module 1 (Appendix D). Submitted Materials: A-Mock-Hospital-ra1-1.docx - https://drive.google.com/open?id=1tj62UhY2E4FN8yGZar9IOG8H0DZ-S6Nw&usp=drive_copy Curriculum-Alignment-2.docx - https://drive.google.com/open?id=1xRZbG7TEUssCoqesTohJYIv5wRtAIz0V&usp=drive_copy Integration-of-Four-Theory-based-educational-approaches-_.docx - https://drive.google.com/open?id=1zFRR40k_i5vJFGJHdv3NsXPXg0TxIwEp&usp=drive_copy Post-Survey-for-Mock-Hospital-Teaching-Strategy-Arev-1.docx - https://drive.google.com/open?id=118YwJA2F30SCoMeCVPV337gLm1LwRcJP&usp=drive_copy Pre-Survey-for-Mock-Hospital-Teaching-Strategy-Arev.docx - https://drive.google.com/open?id=1NTc5ffRWDfPerpzLdMxW1c1Fi5NqsBEA&usp=drive_copy Preand-Post-Survey-for-Mock-Hospital-Teaching-Strategy-09042018-2-1-1.docx - https://drive.google.com/open?id=11U2I0Ub2RMs62_0dnX-u3RFx-pxuOq3A&usp=drive_copy Suggested-Job-Descriptions-2.docx - https://drive.google.com/open?id=19Tpt3P201_tNJapggxewbtlpn77YjfNT&usp=drive_copy Suggested-Tools-for-Module-1-2.docx - https://drive.google.com/open?id=19D3Y5kIYcGQ0KUgakJxsILybFzu5Fl6x&usp=drive_copy Additional Materials: Based on the QSEN peer review comments, modules 2-10 will be provided if they are wanted and in formats requested. If they are requested, the number of files to attach to the QSEN site will increase 9-fold. Otherwise, interested parties should contact me for the materials at ann.stalter@wright.edu Appendix A: Integration of Four Theory-based Educational Approaches Appendix B: Suggested Job Descriptions Appendix C: Curriculum Alignment: Content and Evaluation Appendix D: Suggested Tools for Module 1 Evaluation Description: The innovative teaching strategy is evaluated through pre and post surveys assessment. Confidence in mastery of each objective is measured using a 5 point Likert agreement scale. T-tests can be used to quantify learning outcomes. The surveys are provided in Appendix C. Students who enjoy team based learning enjoy this teaching strategy; those who prefer passive learning are more resistant. Overall, student feedback is positive.

Published Back to Strategy Search Strategy Submission Using QSEN competencies to foster Professional Development among Baccalaureate Nursing Students Author: Nadine M. Marchi, Co-Author;Colleen Sweeney Title: Assistant Professor of Nursing Coauthors: Institution: Notre Dame College Email: nmarchi@ndc.edu Competency Categories: Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure BSN, RN to BSN Learner Setting(s): Classroom Strategy Type: General Strategy Learning Objectives: Patient safety 1. Knowledge-Discuss potential and actual impact of national patient safety resources, initiatives and regulations. 2. Skills- Use national patient safety resources for own professional development and to focus attention on safety in care settings. 3. Attitudes-Value relationship between national safety campaigns and implementation in local practices and practice settings. Evidence-based Practice 1. Knowledge-Delineate the reliable sources for locating evidence reports and clinical practice guidelines. 2. Skills-Evaluate research and evidence reports related to patient safety. 3. Attitudes- Explain the importance of regularly reading relevant professional journals. Teamwork 1. Attitude- Acknowledge own potential to contribute to effective team functioning. 2. Skills-Demonstrate awareness of own strengths and limitations as a team member. 3. Knowledge- Describe own strengths, limitations, and values in functioning as a member of a team. Strategy Overview: Senior students at Notre Dame College organize a patient safety conference as part of a Health Policy course to fulfill the requirements for the degree of Bachelor of Science in Nursing. Using the QSEN competencies related to safety, evidence-based practice and teamwork, students plan the conference in the beginning of the senior year. Although senior nursing students are responsible for the planning and implementation of the conference, junior and sophomore students also have an active role. Each class is given an assignment for the patient safety conference corresponding to respective curricular level objectives. For example, sophomore-level student poster presentations focus on the factors creating a culture of safety and assessment criteria for safe patient handling. Junior-level student poster presentations integrate evidence-based practice to identify clinical questions. Senior-level poster presentations address policy issues concerning quality of care and safe healthcare delivery. A few examples of student work include: Effective Communication among Caregivers, Reducing Harm from Anticoagulants and Joint Commission National Patient Safety Goals. Senior nursing students are divided into four teams: publicity, evaluation, set-up and registration. The senior student teams are responsible for organizing all areas of the conference such as-arranging a venue, locating a speaker, ordering refreshments and working as a team to implement all logistics related to the conference. Senior students are also required to work as a team with the junior and sophomore nursing students so patient safety is integrated among all three levels of the curriculum. Also, nursing students from nursing schools in the region are invited to attend and present posters. The patient safety conference enables nursing students throughout the northeast Ohio region to focus on patient safety by participating in an active student-centered learning event. In addition, a patient safety speaker presents students with new information related to patient safety. Conference participants evaluate the conference by completing evaluation forms at the end of the conference. Submitted Materials: Additional Materials: Evaluation Description: Conference attendees evaluate the conference in three areas: conference logistics, posters and speaker. In November 2012, attendees rated the conference as excellent (50% of the attendees) and very good (40% of the attendees). Regarding the posters, the attendees rated posters as excellent (60%) and very good (39%). The speaker was rated as 64% excellent and 26% very good. Some of the comments written on the evaluation forms were: "Presentation was informative and very interesting" "Will definitely be extremely mindful and conscious of patient safety and infection control" "Speaker put things in perspective with scenarios, facts and evidence" "Chairs to close to posters" "Keep spreading word to surrounding schools" "Reduce time to 2 hours not 2.5"

Published Back to Strategy Search Strategy Submission Linking EBP with a Nursing Procedure Author: Kelly Beischel PhD, RN, NCSN, CNE; Deborah Davis BSN, MSN, MEd Title: Assistant Professor; Faculty Coauthors: Institution: Xavier University Email: beischelk@xavier.edu Competency Categories: Evidence-Based Practice, Informatics, Teamwork and Collaboration Learner Level(s): Pre-Licensure BSN Learner Setting(s): Classroom Strategy Type: Paper Assignments Learning Objectives: Locate evidence reports related to clinical practice topics and guidelines. Explain the role of evidence in determining best clinical practices. Compare and contrast evidence-based practice (EBP) with actual practice. Value the concept of EBP as integral to determining best clinical practice. Develop scholarly writing skills. Seek necessary resources to complete the assignment. Strategy Overview: We developed a scholarly paper assignment using Chris Tesch's teaching strategy "Linking EBP with a Nursing Procedure" as the framework.” We assign junior students to choose a nursing intervention they have performed or have seen performed on their clinical unit. They are required to locate and make a copy of the policies, procedures or standards available in their clinical setting related to the intervention they observed. Using the information search strategies they have previously learned, as well as, available resources, they locate the best-published evidence related to the intervention they observed. Students then write a scholarly paper that thoroughly describes the policy and procedure, synthesizes the best evidence, compares and contrasts the written policy with the best evidence, and discusses their reflection concerning what they found, their ease or difficulty in locating evidence and anticipated challenges implementing the best evidence. We are sure to include detailed instructions required to complete the paper as well as helpful hints for scholarly writing and APA formatting. We require that students submit a self-evaluation of their paper using the instructor's rubric. Requiring the self-evaluation assures us they are familiar with the criteria with which they will be evaluated. Informatics is emphasized with this assignment. First, computer and information literacy skills are both necessary to complete the assignment. In addition, students are encouraged to use high quality information sources. Examples of these sources are provided in the description of Submitted Materials: Additional Materials: Evaluation Description: Papers are graded using the rubric created for this assignment. Students can earn up to 4 points in each of the 15 categories resulting in 60 possible total points. The percentage grade for the paper is then calculated by adding up the number ofpoints the student earned in each category and dividing this number by the 60 total possible points. Grading these papers can be a wearisome and time intensive challenge, but one we think is important in facilitating student learning. It is apparent that students have had limited exposure to writing scholarly papers using an APA format in their previous courses. We are hopeful this assignment aids in developing scholarly writing skills that students will in turn use when they are in practice, reviewing and developing policies and procedures. Students admit they learn much from completing this assignment. They find the APA format challenging, but learn the importance of using the APA book to follow directions. Students comment on their surprise with the difficulty they had in locating current best evidence and nursing research. Students state they thought nurses had more evidence for the interventions they performed. Some admit to experiencing difficulty using the nursing search engines and knowing which key terms to use to yield useful articles. They learn being creative and persistent are key when searching the literature. Students report they appreciate going through the process of locating policies, procedures and standards in the clinical setting and think this will be helpful later in practice. We discuss their findings during a conference provided in the assignment description. When students who used the suggested resources (the librarian, faculty, and the writing center tutors) voice how helpful the resources were in completing the project, fellow students who failed to take advantage of those resources hear about the benefits of teamwork and collaboration. Students also report that nurses do not always follow policies and this assignment gives them the opportunity to reflect on how that might influence patient outcomes.

Published Back to Strategy Search Strategy Submission Mass Casualty Triage Bear Learning Activity Author: Marylou Robinson PhD, RN, FNP Title: Assistant Professor Coauthors: Institution: University of Colorado Denver College of Nursing Email: Marylou.Robinson@ucdenver.edu Competency Categories: Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: Communicate observations or concerns related to hazards and errors to patients, families and the health care team. Function competently within own scope of practice as a member of the health care team. Value the perspectives and expertise of all health team members. Communicate with team members adapting own style of communicating to needs of the team and situation. Value teamwork and the relationship upon which it is based. Strategy Overview: This is a low fidelity simulation exercise that can be used to enhance content on mass casualties. This activity was originally noted as a simulation activity for the Kirkland Fire Department in Washington. Some nursing curricula cover this content in advanced Med/Surg, alongside emergency room content. Other programs place this content in a public health course. The necessary content to properly contextualize this activity focuses on the mass casualty ideas of: scene safety, incident command structure, triage choke points and allocation of resources (e.g. staff, supplies and transportation). The value of this learning activity is that it augments a theoretical, academic discussion with a hands-on, low fidelity simulation learning activity. The necessary materials for this activity are a variety of stuffed animals that represent participants of a mass casualty. Although the activity is called “Triage Bears,” any kind of stuffed animal can be effective, and can convey the diversity of victims that might be the result of a mass casualty. Faculty have found it effective to include such diverse stuffed animals as teddy bears, stuffed snakes, gorillas, cats, dogs and tarantulas. Faculty aim to acquire one stuffed animal for every two students. Each of these stuffed animals represents a specific patient in a mass casualty situation. Faculty have found that worn and used stuffed animals work especially well. You can modify the appearance of the stuffed animal to match the nature of the injury (e.g. lipstick works very well as moulage blood on teddy bears, you can have a rip on the right arm to suggest a right arm fracture, etc…). Victims can also be grouped together as is appropriate (e.g. you can identify a family unit of a mother bear with two bear children, or bear siblings). It is helpful in this exercise to have a wide representation of ages and injuries. Including medical emergencies such as cardiac concerns and disabled individuals (e.g. a victim who is blind, or paraplegic, or a child with Down’s syndrome) adds to the complexity. Each stuffed animal has a tag that includes the following information: age, vital signs, and a brief description of the injury. Students are divided into teams of two students. Each team assesses every stuffed animal. The students use the Lou Romig Start/Jump Start Algorithim (pdf file is attached) to determine whether the patient’s condition needs minor attention (green), delayed attention (yellow), immediate attention (red) or whether the patient is deceased or beyond reasonable resuscitation (black). Consistent with this well recognized algorithm, the students have 15 seconds to determine the color assignment of each stuffed animal. The goal of this activity is to have the students be working very quickly, but be systematic and focused in their determination of triage priorities. Each team must keep track of how many victims end up in each color category per standard triage protocols. The team then provides an inclusive report to the site commander about the number of patients at the scene, the number in each category and the location of the victims that need priority attention. The scenario can be extended to include transport of bears to collection points, re-prioritizing those in each category, providing recommendations about how to organize care in a limited supply setting, and preparation for transport. After the class has finished this work in teams of two, there can be a group debriefing. Some questions and pointers for discussion might include: How did you find making decisions alongside another nursing clinician? How did it feel to be making determinations about care in such a compressed timeframe? What was most difficult about the limited timeframe? What information did you wish had been provided to you that was not on the victim’s tag? What are your insights into each of the triage categories (green, yellow, red, black) that you gained from this experience? How would your assessment have been different if there were other team members working on the victims alongside you, such as respiratory therapists, physicians or EMTs? How would your care have differed if there were families hovering over your victims as you were trying to make these quick clinical decisions? What was most difficult about the inclusive report that you provided to the site commander? What did you learn about your communication style/effectiveness from working alongside another nurse, and reporting off to the site commander? Reflections on cultural bias can include impact of “saving” spiders and snakes, but not puppy dogs. Submitted Materials: Additional Materials: Evaluation Description: It can be helpful to have students provide feedback to the student with whom they were teamed up. This feedback can be given in written form, or verbally, and can be provided to the course instructor. Some questions that students might want to consider in providing feedback to their team member: Name your team member’s strengths in working effectively in a stressful, time limited situation. Name two improvements your team member could make to work more effectively in a stressful, time limited situation What are your overall observations about your team member’s communication practices?

Published Back to Strategy Search Strategy Submission Case Study: Focus on Teamwork/Collaboration, Quality Improvement, and Safety in Caring for a Newly-Diagnosed Schizophrenic Patient Author: David Foley PhD, MSN, RN-BC, CNE, MPA Title: Research Associate Coauthors: Institution: Case Western Reserve University Email: dmf106@case.edu Competency Categories: Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Advanced Practice Providers, Continuing Education, Faculty Development Strategies, Graduate Students, Interprofessional, New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN, Staff Development Learner Setting(s): Classroom, Clinical Setting Strategy Type: Case Studies Learning Objectives: Global QSEN Competency Objective (GQCO): The purpose of analyzing this case study is to provide nurse educators (clinical/classroom faculty, practice-based nurse educators, and staff development personnel) with an immersive situation to promote critical/analytical thinking regarding the QSEN competencies of Teamwork/Collaboration, Quality Improvement, and Safety. The questions that follow the case study should thus be used to provide learners with opportunities to demonstrate a practical understanding of these QSEN competencies. Unit Learning Objectives: As an immersive exercise, this scenario thus promotes affective development by placing leaders within a low-incidence/high-risk clinical scenario involving a serious breach of safety during the initial assessment of a young male patient experiencing his noted episode of psychosis and subsequent transfer from the primary care to the Emergency Room settings. Three key QSEN Competencies (Teamwork and Collaboration, Quality Improvement, and Safety) provide the framework for the development of analytical skills through reflective thought and ensuing discussion: 1. Through analysis, reflective thought, and discussion the learner will affirm the importance of safety for patients and caregivers in the acute phase of mental illness. 2. Through analysis, reflective thought, and discussion the learner will identify opportunities to enhance effective teamwork/collaboration during a low-incidence/high-risk psychiatric patient care scenario. 3. Through analysis, reflective thought, and discussion the learner will identify rapid-cycle quality improvement as a top priority following low-incidence/high-risk situations involving acutely ill psychiatric patients. Strategy Overview: The QSEN competencies provide an ideal framework to promote opportunities for analysis, reflective thought, and discussion. In the case of this scenario, the lead characters in a primary are setting perceive their performance as competent as they provide appropriate care to a newly-arrived psychotic patient. Despite finding themselves in a low-incidence/high-risk scenario, they engaged in Teamwork/Collaboration to promote safety throughout the initial assessment and subsequent transfer to the Emergency Room. After the transfer, however, it appears that the narrative of safety may have been a fallacy, as a serious breach in safety is observed and the need for rapid-cycle quality improvement. In short, while many nurses are highly clinically competent, opportunities for analytical/critical thinking skills may be evident. This scenario thus focuses on promoting critical thinking and reflective thought to prevent such a highly dangerous scenario from reoccurring. As for tips for educators, the mechanics of this unit thus provide opportunities to review the scenario within the framework of three key QSEN competencies (Teamwork/collaboration, quality improvement, and safety in that: o Questions for group discussion are strategically inserted at the end of the case study and are intended to be discussed—with corresponding instructor/peer feedback—in a synchronous manner. o Whether in the classroom or clinical setting, learners should be granted no prior access to the scenario but given approximately one-half hour to read it independently, with peer interaction followed by instructor-facilitated discussion immediately following. o Following robust discussion, a written Reflective Journal assignment follows the exercise’s conclusion and should be prepared and submitted to the instructor prior to the next classroom/clinical, or staff development session. The Reflective Journal is completed asynchronously and thus gives students a more discrete format to present the thoughts they might not have felt comfortable sharing in a public forum. Submitted Materials: QSEN-301.-Student-Reflective-Journal-Format-SNITCH-SNITCH-WITCH.docx - https://drive.google.com/open?id=1o5VQ_u6URy1w-xWiSRfzwbDyQduUoRxR&usp=drive_copy QSEN-301.Case-Study.docx - https://drive.google.com/open?id=12uOVyG1Fgxu7dD72Zfm5eg1pTgxrncZJ&usp=drive_copy QSEN-301.Psychotic-Disorders-Overviewpp.pptx - https://drive.google.com/open?id=1o5VQ_u6URy1w-xWiSRfzwbDyQduUoRxR&usp=drive_copy QSEN-301.Faculty-Communication-Teaching-Strategies.docx - https://drive.google.com/open?id=136SFqp8IYJUZkQrV7nFxdCW_KZJ44Vda&usp=drive_copy Additional Materials: 1). “Snitch, Snitch, Witch” Case study 2). Critical Reflection Journal Template 3). Faculty Tips Sheet: Therapeutic Communication 4). Psychotic Disorders: A Brief Overview Evaluation Description: Post-Scenario Evaluative Questions All involved ER staff are interviewed the next week as part of a Root Cause Analysis (RCA) performed by Quality Management. Please project into this situation and imagine you are one of the ER nurses being interviewed. How would you respond to the following questions? • How often do you receive patients from an individual provider’s office? Is this a relatively novel occurrence? • Given the patient arrived undressed and wearing a gown, would you assume he had already been ‘wanded’ and his belongings searched/inventoried? (Obj. 1) • Given the opportunity to review the entire scenario, is there a breakdown of teamwork/collaboration that ultimately impacted patient safety? (Obj. 1 and 2) • What recommendations would you have for quality improvement to prevent this scenario from happening in the future? (Obj. 3) Summary Evaluation Description 1. Written instructor feedback as to evidence of analytical/critical thinking in Reflective Journal questions, each of which is tied to a learning objective/QSEN competency. 2. Student to peer and instructor to peer verbal feedback regarding evidence of affective development as tied to learning objectives/QSEN competencies in classroom sessions, clinical pre- or post-conference discussion, staff development, or any other group as facilitated by a nurse educator.

Published Back to Strategy Search Strategy Submission Cory Doolittle: Impaired Nurse Simulation Author: Maria del Carmen Molle MSN, RN-BC Title: Assistant Professor-Nursing Coauthors: Professor Heather Heithoff, MN, RN Institution: Raritan Valley Community College Email: maria.molle@raritanval.edu Competency Categories: Evidence-Based Practice, Patient-Centered Care, Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN Learner Setting(s): Classroom, Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: The nursing student will: - demonstrate sensitive patient-centered care to an impaired nurse. - apply the clinical judgment model to implement appropriate nursing interventions to a substance-impaired nurse (patient safety, patient-centered care) - apply evidence-based practice in the assessment of the substance impaired nurse (evidenced-based practice). - demonstrate professional behaviors while prioritizing and managing nursing care to a substance-impaired nurse while collaborating with multiple nursing specialist(s) (Patient-centered care, teamwork, and collaboration, safety). - demonstrates standardized nursing practice and use of technology that supports patient safety and quality patient-centered care (Evidenced-based practice, teamwork & collaboration, safety). - demonstrate effective communication with team members to assist the patient achieve health care goals (Teamwork & collaboration). Strategy Overview: The Cory Doolittle: Impaired Nurse Simulation, provides nursing faculty and students the opportunity to participate in a clinical judgment activity in order to provide the appropriate care for an impaired patient while collaborating with interprofessional team members. The Impaired Nurse Simulation can be used for graduating ADN or BSN nursing students. The students are expected to apply all levels of clinical judgment model but more specifically all the steps in level 3 when providing care to a substance-impaired nurse. This activity has been designed to facilitate the clinical judgment process when assessing patients with substance abuse disease processes and providing the appropriate required patient-centered care. Submitted Materials: 279.2SimulationImpaired-Nurse-DebriefingTools.docx - https://drive.google.com/open?id=1s03f8rZG1lQAX9K7ikiAGaZUhrnEPd1C&usp=drive_copy 279.1Simulation-Scenario-CoryDoolittleImpaired-Nurse.docx - https://drive.google.com/open?id=1s9UY-TRu-6YBSfweSuoSHQE_UeDS9PDr&usp=drive_copy Additional Materials: Cory Doolittle: Impaired Nurse Simulation and Debriefing Tools. References: Adams, M., Holland, N. and Urban C. (2017). PHARMACOLOGY FOR NURSES-A PATHOPHYSIOLOGIC APPROACH. Pearson. Barlett, D. (2019). Drug Diversion Training. nurseCe4Less.com Chmil, J.V. (2016). Prebriefing in Simulation-Based Learning Experiences. Nurse Educator- Teaching Strategies. Vol.41, 64-65. http://dx.doi:10.1097/NNE.0000000000000217 Cutara, K.P (2015). Prebriefing in Nursing Simulation: A Concept Analysis. Clinical Simulation in Nursing. (2015). 11, 335-340. http://doi.org./10.1016.ecns.2015.05.001. Dusaj, T.K. (2014). Five Fast Fixes: Debriefing. INASCL. http://doi.org/10.1016/j.ecns.2014.06.002 Gardner, R. (2013). Introduction to Debriefing. SciVerse Science Direct. 37(2013) 166-174. http://dx.doi.org/10.1053/jsemperi2013.02.008 Halter, M.J. (2018). Varcarolis’ FOUNDATIONS of PSYCHIATRIC-MENTAL HEALTH NURSING: A Clinical Approach. Elsevier. Lestander, O., Lehto, N. and Engstrom, A. (2016). Nursing students’ perceptions of learning after high fidelity simulation: Effects of a Three-step Post-simulation Reflection Model. Nurse Education Today. 40(2016) 219-234. http://dx.doi.org/10.1016/jnednedt201603011. NCSBN (2014). NCSBN Guidelines for Alternative Programs and Discipline Monitoring Programs. Substance Use Disorder Guidelines. https://www.ncsbn.org/Mgr_SUDiN_Brochure_2014.pdf https://www.ncsbn.org/SUDN_11.pdf NCSBN (2020). NCSBN Clinical Judgement Model. https://www.ncsbn.org/search.htm?q=clinical+judgement+model. NCSBN (2020): NCSBN State Boards of Nursing. https://www.ncsbn.org/search.htm?q=state+board+of+nursing New Jersey Board of Nursing Laws (2020). https://www.ncsbn.org/SUDN_11.pdf Plus/Delta Template Example: https://miro.com/templates/plus-delta/ RAMP of N.J. (2019). RAMP, Recovery and Monitoring Program. RAMP@njsna.org , peerassistance@njsna.org , www.njsna.org . Evaluation Description: Pre-briefing Time: 1 hour All students will engage in an open discussion regarding medication diversion specifically by the nurse in varied healthcare settings and current national substance abuse situations with participation in a pre- and post-test. The students are randomly assigned nursing roles: Cory: impaired nurse, Avery: Cory’s partner, Surgical Nurse, ED nurse preceptor, ED nurse preceptee, Psychiatric Advanced Practice Nurse and 4 nursing student observers for a total of 10 potential student participants. Expected Simulation Run Time: 20 minutes Debriefing Time: 40 minutes

Published Back to Strategy Search Strategy Submission Teaching Pre-licensure Nursing Students to Communicate in SBAR in the Clinical Setting Author: Kimberly Silver Dunker DNP, RN Title: Assistant Professor of Nursing Coauthors: Institution: University of Massachusetts Graduate School of Nursing, Worcester Email: kimberly.silver@umassmed.edu Competency Categories: Patient-Centered Care, Safety, Teamwork and Collaboration Learner Level(s): Faculty Development Strategies, Graduate Students, Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Clinical Setting, Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: After viewing this SBAR communication video vignette, the students will be able to: Learn how SBAR communication can be used as a simulation activity in a clinical setting to improve the quality and safety of nursing care. Analyze a patient situation then disseminate important information to physicians, mid-level providers (nurse practitioners and physician assistants) and nurses using SBAR communication. Strategy Overview: Online Video Vignette http://onlinetraining.umassmed.edu/sbarcommunication/ This vignette was designed for both faculty and students to learn how to communicate using SBAR. The vignette demonstrates to nursing faculty how to manage more than one student in clinical and how to direct each student to gather and then disseminate information in a clear, concise manner utilizing the SBAR format. The vignette demonstrates to nursing students how they can gather information in clinical and put patient information together to develop a clear and concise communication strategy to speak with other health care team members. Strategy Activity: After the students and or faculty have viewed the vignette while in clinical the student needs to practice this skill. At some point in the clinical day, the student will actually call the clinical faculty on the telephone. The faculty will role play a health care provider either a nurse practitioner or physician. The student will communicate in SBAR essential information to their faculty member/healthcare provider. The faculty/physician will give the student an order or intervention for the student to transcribe. At the conclusion of this role-play the faculty member and student will debrief and review the verbal encounter and transcription order. This activity will help the student to learn how to communicate in SBAR and take a verbal physicians order. Patient Centered Care Students will identify patient concerns and abnormal findings and communicate in SBAR their assessment. (Knowledge, Attitudes) Safety Students will discover how gather essential information and be confident when communicating their findings to the physicians, nurse practitioners, nurses, and physicians assistants. (Knowledge, Attitudes) Teamwork/Communication Students will gather subjective and objective patient data, and will communicate using SBAR a concern or abnormal finding to the physicians, nurse practitioners, nurses, and physicians assistants. (Knowledge, Skills, Attitudes) Submitted Materials: SBAR-Rubric-1-1.pdf - https://drive.google.com/open?id=1X1TJtwLBHQW0fuDJ5FxebxOf6Du7zttm&usp=drive_copy Additional Materials: http://onlinetraining.umassmed.edu/sbarcommunication2/ Evaluation Description: This activity was used in clinical as a strategy to teach SBAR and communication with physicians, nurse practitioners, nurses, and physicians assistants. The students did not receive a grade however they demonstrated competency in this technique as evidence by: Assessment of essential patient subjective and objective data to communicate. Report priority data to the physicians, nurse practitioners, nurses, and physicians assistants using clear and concise method. Model the use of SBAR on the clinical setting to demonstrate to other providers improved quality of care and safety of care Perform the learning objectives by successfully role-playing with their faculty member, and telephone calling the faculty member who was role-playing the physician or mid level provider. Attached is a grading rubric example that could be used by the clinical faculty member to help evaluate how the student performed during this task. The rubric gives a score to allow the faculty to review how the student performed communicating in SBAR. Anecdotal information: This assignment was implemented among pre-licensure nursing students in an accelerated Master’s degree program. This graduate entry pathway prepares second-degree individuals as nurse practitioners. These students are finishing the clinical requirements for RN pre-licensure. The students are in the first year of a three year graduate program for a degree as an advanced practice nurse practitioner. During this activity they were completing the requirements for their pre-licensure RN certification. This teaching strategy integrated cognitive and psychomotor competencies from three pre-licensure nursing courses; (1) medical-surgical nursing theory (2) medical-surgical nursing clinical, and (3) nursing concepts course. The integration of this strategy enhanced students’ ability to gain knowledge about SBAR communicate and to practice it while in clinical. The assignment could be utilized in a variety of settings including: adult medical surgical, maternal child, pediatrics, mental health, and leadership courses. Feedback from this assignment has been positive. Students were able to identify essential information while in clinical to communicate to physicians, nurse practitioners, nurses, and physicians assistants. Thus connecting the clinical environment and course or theory component. It has helped the students see the correlation between theory and clinical, and increased their awareness of how to enhance communication, build teamwork, and facilitate a more patient centered environment. This exercise has bridged the clinical practice environment with theory. As a result, clinical nursing faculty have reported becoming aware of QSEN and SBAR communicate and incorporating the technique into the clinical practice environment.

Published Back to Strategy Search Strategy Submission Literature Review Author: Martha McMillan MSN-Ed, RNC-EFM Title: Assitant Professor Coauthors: Angela Bordelon, RN, MSN, CNE Institution: Louisiana State University of Alexandria Email: mmcmillan@lsua.edu Competency Categories: Evidence-Based Practice, Informatics, Patient-Centered Care, Quality Improvement, Safety Learner Level(s): New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN, Staff Development Learner Setting(s): Classroom, Clinical Setting, Skills or Simulation Laboratories Strategy Type: Paper Assignments Learning Objectives: 1.Demonstrate effective use of technology to conduct a literature review of a nursing topic of choice to obtain evidence based articles from reliable peer review nursing journals. (EBP, Informatics) 2.Summarize evidence based practice presented in the peer review nursing journal. (EBP) 3.Apply evidence based practice to nursing practice today. (EBP, Safety, Patient Centered Care, Practice) 4.Formulate a problem statement or question related to how the evidence can help improve nursing practice. (EBP, Quality Improvement) Strategy Overview: This teaching strategy is designed to teach students how to develop research skills through the development of a problem statement and formal review of literature related to the problem statement. Areas selected may pertain to nursing, a clinical nursing issue, or healthcare issue related to nursing. The area of interest, clinical issue, or research problem may focus on content related to didactic/clinical component of the course or current trends in nursing or health care. The topic/problem statement requires approval before the review is started. Once approved, students are to examine six research based nursing articles that relate to the chosen topic. The student must then provide no more than a one page summary on each article consisting of: 1-2 paragraphs summarizing the purpose for the research, how the research was conducted (research methods), and research conclusions; and, 1-2 paragraphs describing relevance to the problem statement and how the findings impact nursing practice. Summaries are to be written according to APA guidelines. The project can be submitted electronically or in a 2 inch binder and includes: rubric, title page, articles, article summaries, and reference page. All written documents must follow APA guidelines. After submission and grading of the project, students are to make corrections as needed and create a professional poster, that depicts summarized research, to present at an interdisciplinary campus event or at local health care related events. Submitted Materials: QSEN265.2-Lit-review-and-poster-presentation-guidelines-3.docx - https://drive.google.com/open?id=127qwflL2sDUHdOCvCvMRTzQQasjqI3pi&usp=drive_copy QSEN-265.3-Literature-Review-Poster-Rubric3.docx - https://drive.google.com/open?id=1263iA3ODvcR-Y40ozJ1bY3mojIKIV_Kf&usp=drive_copy QSEN-265.4-Literature-Review-Rubric.docx - https://drive.google.com/open?id=12tnlHpHGo94EnzrP6YewBr9sd-B1hQLG&usp=drive_copy Additional Materials: Attached is the literature review and poster presentation guidelines and rubrics. Evaluation Description: Evaluation of the learning objectives is completed through earning a passing grade on both the written assignment and the poster presentation by the use of a rubric for each. Additional points deducted for late submission in the first 24 hours. After 24 hours, the student earns a zero on the assignment. Through this project, students are able to identify QSEN competencies while identifying how patient care can be improved utilizing current evidence based practice protocols.

Published Back to Strategy Search Strategy Submission Medication Education Collaboration Learning Activity Author: Gail Armstrong ND, RN Title: Assistant Professor Coauthors: Institution: University of Colorado Denver College of Nursing Email: gail.armstrong@ucdenver.edu Competency Categories: Teamwork and Collaboration Learner Level(s): Graduate Students, New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN Learner Setting(s): Clinical Setting Strategy Type: Case Studies Learning Objectives: Describe own strengths, limitations, and values in functioning as member of a team. Act with integrity, consistency and respect for differing views. Appreciate importance of intra- and inter-professional collaboration. Describe scopes of practice and roles of health care team members. Function completely within own scope of practice as a member of the health care team. Value the perspectives and expertise of all health team members. Describe strategies for identifying and managing overlaps in team member roles and accountabilities. Respect the centrality of the patient/family as core members of any health care team. Respect the unique attributes that members bring to a team, including variations in professional orientations and accountabilities. Analyze differences in communication style preferences among patients and families, nurses and other members of the health care team. Communicate with team members adapting own style of communication to needs of the team and situation. Value teamwork and the relationships upon which it is based. Describe examples of the impact of team functioning on safety and quality of care. Demonstrate commitment to team goals. Strategy Overview: This learning activity is best suited for students who are in the senior level of a pre-licensure program, or are newly practicing graduates. The activity can also be easily adjusted for a graduate level student to complete more independently. This activity fits particularly well in a Public Health course or in Mental Health course. The students need to be operationally familiar with medication reconciliation and have utilized this process independently before this learning activity. A commonly overlapping area of practice for pharmacists and nurses is the realm of medication education. Pharmacy curricula spend more time on specific facets of medication education, and there is much for nurses to learn from the pharmacy literature. This learning activity invites nurses or nursing students to engage in a focused interprofessional collaboration with a pharmacist or a pharmacy student in the area of medication administration. Prior to clinical, I ask the students to read part of a chapter from Building a Successful Collaborative Pharmacy Practice: Guidelines and Tools. I ask the students to read pages 103 -122 from Chapter Two, which focuses on Services Covered by Pharmaceutical Collaborative Care. The entire citation is below: Bennett, M. & Wedret, J.E. (2004). Building a successful collaborative pharmacy practice: guidelines and tools. Washington DC: American Pharmacists Association. The first twenty pages of this chapter provide very specific strategies for what pharmacists label, “patient counseling,” and nursing calls “medication education.” There are 30 strategies offered to the reader, with substantive details provided for each strategy. The chapter also breaks these strategies down to three prime questions (What did the doctor tell you the medicine was for? How did the doctor tell you to take the medicine? and What did the doctor tell you to expect?) Additionally there are suggested approaches for working with special populations (geriatric, pediatric, cross cultural and physically impaired). The second part of the reading focuses on “Compliance Counseling.” There is background data about the costs of noncompliance, the clinical implications of noncompliance and analysis of some operative factors in the phenomenon of noncompliance. The reader is guided in how to assess nonadherence as well as strategies for developing patient-focused interventions for this problem. The clinician is provided specific strategies for enhancing adherence to pharmacotherapy, and modifications are proposed for special populations. Examples of interventions are provided for common chronic diseases (e.g. hypertension, and Type 2 diabetes). Prior to the clinical assignment below, I review with students the main points of the reading. Some discussion questions that I ask in class (or online) are: What did you learn from this reading? Which content of the assigned reading felt specific for the scope of practice of pharmacists? Identify 3 of the 30 Medication Education strategies that are most helpful to your nursing practice. How will you alter your nursing practice, based on these strategies? Is there a different philosophical stance in how the patient is viewed that emerges from this reading, because of the assumed reading audience? Are there different approaches to patient education that you noted from this reading, specific to the scope of pharmacists? Identify 5 areas of overlap from the reading in terms of how pharmacists and nurses provide medication education. And then I give the students the following assignment for their clinical rotation. Choose a patient or family whose medication regimen is complex. Most important in identifying the best patient for this activity is to find a patient whose medication list is complex and who seeks ongoing advice from a pharmacist. Write up each section of the activity into a cumulative paper. The first task is to complete a thorough medication reconciliation review with this patient/family. Be sure that the medication list with which you end up is inclusive, up to date and includes the necessary details for each medication (name of medication, indication for the medication, dosage, route, frequency, and any special instructions [e.g. take with food, take on an empty stomach]). Begin your paper with this medication list and then summarize the ease or difficulty in completing this correct medication list. Identify contributing factors to the patient’s clarity or lack of clarity about his/her medications. Assess your patient’s overall familiarity with his/her medications and his/her level of engagement in his/her own health processes. Identify contributing factors to these phenomena. Once you have a thorough medication list, assess the highest priority for this patient for medication education. Write out a plan for educating this patient over several visits and check that plan out with the patient. Include at least 5 strategies identified in the Bennett reading for this patient. Does the plan meet the patient’s self-identified needs around medication education? Are there issues for this patient around adherence to his/her medication regimen? Include some of the reading’s strategies around enhancing adherence. Revise your plan for medication education as recommended by the patient. You will submit both of these plans – be sure to clearly identify each version. Call the patient’s consulting pharmacist. Consult with the pharmacist about his/her perception of this patient’s needs for medication education. Ask for this health care team member’s strategies in working with this patient. What does the pharmacist assess as the patient’s highest priority in medication education? Revise your plan for medication education as recommended by the pharmacist. You will submit this third version – clearly identify each version. The last part of the write up is to reflect back on your original assessment, and consider the alterations you made along with the way with increased input and increased understanding. Did your priorities shift? What was the most influential factor in altering your original plan? How did your understanding of this patient shift with input from the patient and from the pharmacist? Reflect on what you learned from this collaborative exercise. Submitted Materials: Additional Materials: Evaluation Description: Total possible points:100 Inclusive, thorough list of medications with analysis: 20 points Assessment of patient’s familiarity with medication regimen: 20 points Alteration of med education plan based on pt’s self-identified needs: 20 points Collaboration with pharmacist: 20 points Overall reflection on the exercise: 20 points