Published Back to Strategy Search Strategy Submission Integrating QSEN Competencies into a Capstone Simulation Author: Nancy Lenaghan MSN, APRN, CNE Title: Professor Coauthors: Institution: Brookdale Community College Email: nlenaghan@brookdalecc.edu Competency Categories: Evidence-Based Practice, Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: Evidence Based Practice Demonstrate knowledge of basic scientific methods and processes (K ). Describe reliable sources for locating scientific evidence about Systemic Inflammatory Response Syndrome and sepsis (K ). Explain how the validity and relevance of available evidence influences the interventions (K ). Locate evidence based reports related to clinical practice/topics (S) Value the need for continuous improvement in clinical practice based on new knowledge (A ). Patient Centered Care Integrate multiple dimensions of patient centered care (K ). Value seeing health care through the patient’s eyes (A). Communicate patient values, preferences and needs to other members of the health team (S ). Value the active participation with patients or designated surrogates in planning, implementing and evaluating care (A ). Provide patient centered care with sensitivity and respect for human diversity (S) Assess own level of communication skill in encounters with the patient and family (S ). Safety Examine environmental factors that impact patient safety (K ). Use strategies to reduce reliance on memory (S). Use error reporting systems for reporting errors (S ). Participate in root cause analysis to analyze errors (S ) Implement specific interventions addressed in the National Patient Safety Goals (S ). Communicate observations or concerns related hazards or errors to members of the health care team (S ). Describe factors that create a culture of safety (K ). Demonstrate effective use of standard practices to support patient safety (S ) (recognize and intervene when patient’s status changes). Teamwork and Collaboration Describe the scope of practice and roles of health team members (K ). Function competently within own scope of practice as a member of the health care team (S ). Initiate requests for help when appropriate to the situation(S ). Collaborate and communicate with health team members to ensure continuity of care (S ). Initiate actions to resolve conflict (S ). Quality Improvement Identify gaps between actual and best practices in this simulation (S). Identify tools that can be used to collect data to understand variations in care (K ). Describe approaches for changing processes of care (K). Seek information about Quality Improvement projects in the care setting (S ). Strategy Overview: This teaching strategy is a capstone simulation conducted in the nursing skills laboratory with a small group of senior nursing students in the last course before they enter their preceptor experience. Students complete this simulation when they are studying about urinary tract infections, sepsis and multiple organ dysfunction syndrome. Using a high fidelity mannequin, students progress through the various complexities and unpredictable events that occur when caring for a geriatric patient whose condition changes dramatically. Students are selected randomly to fill the five primary roles in the scenario: Nurse A, Nurse B, an unlicensed assistant, the patient's daughter, and a medical resident. Later in the simulation, students from the radiologic technology and respiratory therapy programs join the scenario to collaborate with nursing students in managing their unstable patient. Three student observers answer key questions designed to encourage clinical reasoning, and they contribute their impressions during the debriefing. The simulated patient is an 85 year old Italian female who is transferred from a long term care facility to an acute care hospital with a urinary tract infection that rapidly progresses to sepsis followed by multiple organ dysfunction. Within two hours of admission, the patient becomes hypotensive, oliguric, tachycardic, and tachypneic. The student identifies signs of Systemic Inflammatory Response Syndrome and calls a Rapid Response. The Sepsis Bundle Protocol is implemented, but the patient continues to progress to septic shock and is transferred to ICU. During the course of the simulation and the debriefing that follows, students apply the knowledge, skills and attitudes for five of the QSEN competencies. Patient Centered Care is emphasized when students consider the patient’s individualized cultural and developmental needs. During the scenario, the student demonstrates therapeutic communication with the patient’s family, considering caregiver role strain and psychosocial concerns. When the patient’s condition worsens, the student informs the ICU nurse about the patient’s wishes related to end of life care. Throughout the simulation, the nurse answers the family member’s questions and elicits input about patient’s care. Teamwork and Collaboration comes alive in this simulation when students from the Respiratory Therapy and Radiologic Technology programs collaborate with nursing students and participate in the plan of care as the patient’s condition deteriorates. The scenario also includes the opportunity to delegate to an unlicensed person and to intervene when the care does not meet appropriate standards. When the medical resident asks the patient’s daughter to leave, the student manages this conflict proactively and advocates for the patient and family. When the patient’s condition becomes unstable, the student communicates critical information to the rapid response team and the ICU nurse, using an organized format Prior the simulation experience, students identify a clinical question about Multiple Organ Dysfunction syndrome and locate Evidence Based Practice to answer their question. They also research an article to explain the rationale for the components of the Sepsis Bundle Protocol and then they compare their findings in an online discussion forum. Faculty can provide the students with specific criteria to evaluate the validity and reliability of the article they choose. During the simulation, when the patient develops an unexpected outcome (pulmonary edema), the nursing must modify the protocol for administering IV fluid . The Safety Competency is threaded throughout the simulation, with incorporation of several of the National Patient Safety Goals, including medication reconciliation, hand off communication, reporting and managing critical lab results and initiation of a rapid response. When discovering an incorrect IV solution, the students must respond by reporting the incident and analyzing potential root causes of the error. Following the simulation, students participate in a small group project either in the classroom or online, to create a simulated Quality Improvement plan to reduce the incidence of nosocomial urinary tract infections. Students discuss the process of collecting data, designing a plan for change and evaluating the outcomes. Submitted Materials: 112.Patient-Information-Sheet.docx - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy 112.PCP-orders.docx - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy 112.QSEN-Competencies-table.docx - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy 112.Simulation-Chronology.docx - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy Additional Materials: Evaluation Description: The following is the result of students' opinion in response to the following question. Please describe how this simulation improved your understanding of: (out of a possible score of 4.0) Patient Centered Care (3.60) Patient Safety (4.0) Quality Improvement (4.0) Teamwork and Collaboration (4.0) Evidence Based Practice ( 4.0 ) (The relatively lower score on Patient Centered Care may be related to students' lack of understanding of the importance of interacting with the family, especially when the patient is confused or unstable.) ____________________________________________________________________________ The following narrative comments were in response to these two questions: Please describe the ways in which this simulation was most beneficial to your learning needs. How do you feel this simulation could be improved? Fine tuned my critical thinking skills. The real time possibilities were crucial and gave me a broader understanding of sepsis and how it can result in multiple organ dysfunction. The simulation was extremely helpful in learning how to communicate and report to other members of the health care team. It also helped with learning about delegation. This scenario was definitely a reinforcement of our learning, and it made you have to really think on your feet because the patient's health situation can deteriorate very quickly. The case study was accurate so we could recognize changes that can develop so quickly. I felt I we could have used more time for this simulation

Published Back to Strategy Search Strategy Submission Writing Assignment Linking QSEN competencies with a Perioperative Clinical Experience Author: Nicole Hall Rn, MSN, MBA, CNE Title: Faculty Coauthors: Institution: Margaret H. Rollins School of Nursing at Beebe Healthcare Email: nhall@beebehealthcare.org Competency Categories: Evidence-Based Practice, Informatics, Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure ADN/Diploma Learner Setting(s): Clinical Setting Strategy Type: Paper Assignments Learning Objectives: 1. Describe the value of seeing healthcare situations “ through patient eyes ” . 2. Discuss principles of effective communication. 3. Describe roles of healthcare team member during the perioperative phases. 4. Identify whether evidence-based practice (EBP) was implemented in actual practice. 5. Discuss the value of their and others ’ contribution to patient care experience in the care setting. 6. Discuss the effect of the hospital ’ s medication administration system ’ s use on safety. 7. Discuss information input into the electronic health record. 8. Develop scholarly writing skills. 9. Seek necessary resources to complete the assignment. Strategy Overview: The purpose of this assignment is for the student to write a professional paper, utilize APA formatting, enhance understanding of hospital systems, and have the opportunity to reflect on a surgical experience from the patient’ s perspective. First year nursing students are assigned a patient in the preoperative period and are expected to follow this patient until they have arrived to the postoperative unit. The following day students provide postoperative care to this same patient. Students are instructed to review the criteria for the paper so they are familiar with what they are observing for. Students then write a professional paper addressing all the required components explicitly laid out in the assignment instructions. Students are encouraged to seek information from staff and clarification from faculty when needed. This assignment addresses each of the six QSEN competencies. The competency of patient centered care is met by students remaining with the patient throughout their surgical experience enabling them to understand the healthcare situation “ through patient eyes” and when they evaluate communication they observe. The competency of teamwork and collaboration is addressed when students describe the roles of healthcare team members. By reviewing an article and identifying whether actual practice matched evidence based practice students meet the competency of evidence-based practice. Quality improvement is met when students d iscuss the value of their and others ’ contribution to patient care experience in the care setting. The competencies of safety and informatics are addressed when students discuss the system used for medication administration. Students must also discuss the use of the electronic health record in the preoperative period. In all this assignment allows students to see the patient’s perspective while also being introduced to the systems perspective of hospital care. Submitted Materials: Additional Materials: Students are provided 5-10 evidence based practice articles that are applicable for a patient undergoing surgery. These articles are reviewed by faculty prior for relevancy, accuracy, and to confirm they are current. The text boxes available would not allow for appropriate formatting. I chose to add the information in a separate document for reviewers to access. It is strategy materials File 1. File 2 is that assignment provided to students. I appreciate your time and consideration. Evaluation Description: This writing assignment is graded using the same rubric student’s use for self evaluation. This rubric has been submitted under additional materials and is available for review. Each of the 14 categories has a maximum point value that is awarded if the student exceeds expectations for addressing the required component. The total number of points a student can earn is 129. The earned points are divided over the total points providing a grade percentage. This is a new writing assignment that has yet to be implemented. In the past a different professional paper was coupled with the student’s perioperative clinical experience. That assignment was lengthier and had criteria that mirrored some care plan components. While student evaluations and comments supported the need to change the assignment the faculty still supported having a professional paper. The need for a written assignment is a necessary activity to aid learners in becoming professional nurses. Their ability to summarize observations and present information in a clear manner is part of their advancement in academia. Instruction on APA format is provided in the previous semester. Students often have significant difficulty applying APA format when writing their papers. While APA is a component of this writing assignment it is less than10% of the overall grade. This provides the students an opportunity to apply principles learned without significant detriment to their overall grade.

Published Back to Strategy Search Strategy Submission Systems Thinking for Quality Improvement: Innovative Teaching Strategy for Advanced Practice Author: Janet M. Phillips PhD, RN, ANEF Title: Clinical Associate Professor Coauthors: Institution: Indiana University Email: janephil@iu.edu Competency Categories: Quality Improvement Learner Level(s): Graduate Students Learner Setting(s): Classroom Strategy Type: Paper Assignments Learning Objectives: Evaluate the leadership role in participation, communication, and accountability for improving health care quality and safety in health systems using systems thinking. Reflect on systems thinking to executive leadership roles in quality improvement in health care. Apply principles of organizational readiness strategies for change Identify the role of just culture in quality improvement. Strategy Overview: Interview with a nurse executive to evaluate and reflect on the role of leadership using systems thinking for safety and quality improvement for advanced practice. Submitted Materials: Fostering-future-leadership-through-ST-1.pdf - https://drive.google.com/open?id=1enhM-2zXe5PepMOfjUediJqVPud9ezS9&usp=drive_copy Stalter_2018-ST-for-HC_Mod.-4-1.pdf - https://drive.google.com/open?id=1mHpG8uAJZNFP1eu6JJeOpqYlp6Xc9nq-&usp=drive_copy 231-revisionsTeaching_Strategy_and_rubric_for_QSEN_Revised_2-4-19-1.docx - https://drive.google.com/open?id=1qG4q0k0QYL7WZdcr-MY7ZlBHtyKJtH70&usp=drive_copy 231-attachmentConcept-analysis-of-ST-2.pdf - https://drive.google.com/open?id=1YozuUnc-KICBngLp8KSbgKojjxQVVoa9&usp=drive_copy Additional Materials: Assignment Guidelines for Systems Thinking for Quality Improvement: Innovative Teaching Strategy for Advanced Practice with grading rubric Phillips, J. M., Stalter, A. M., Dolansky, M. A., & McKee-Lopez. (2016). Fostering future leadership in quality and safety in health care through systems thinking. Journal of Professional Nursing, 32(1) 15-24. doi:10/1016/jprofnuurs.2015.06.003 Stalter, A. M., Phillips, J. M., Ruggiero, J. S., Scardaville, D. L., Merriam, D., Dolansky, M. A., Goldschmidt, K. A., Wiggs, C. M., Winegardner, S. (2016). Concept analysis of systems thinking. Nursing Forum 52(4), 323-330/ doi: 10.1111/nuf.12196 (Nursing Forum’s top 20 most downloaded papers in 2018) Stlater, A. M. & Molta, A. (2018). Using systems thinking to envision quality and safety in healthcare. Nursing Management, 49(2), 32-39. Evaluation Description: Evaluation is completed using the grading rubric (see rubric).

Published Back to Strategy Search Strategy Submission Clinical Performance Evaluation Tools Utilizing the QSEN Competencies Author: Amanda S. Eymard DNS(c), RN Title: Assistant Professor of Nursing Coauthors: Rebecca Lyons, PhD(c), RN, Angele Davis, MSN, RN Institution: Nicholls State University Email: amanda.eymard@nicholls.edu Competency Categories: Evidence-Based Practice, Informatics, Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Continuing Education, Pre-Licensure BSN Learner Setting(s): Clinical Setting Strategy Type: General Strategy Learning Objectives: The Tools are the evaluation strategy. Strategy Overview: Innovative teaching strategies combined with ensuring safe nursing practice is a challenge for faculty across baccalaureate programs. Despite integrating innovative teaching strategies in the classroom, educators continue to struggle with evaluating students’ ability to provide safe, competent patient-centered care in the clinical setting. Gaps in evaluation of clinical practice, the BSN Essentials, and the baccalaureate program’s newly revised conceptual model provided an impetus for rigorous revision of current clinical evaluation tools. Members of the baccalaureate research and evaluation committee developed a set of Clinical Performance Evaluation Tools incorporating the knowledge, skills, and attitudes for each of the Quality and Safety Education in Nursing (QSEN) competencies. Eight course/level specific tools were developed demonstrating progression throughout the program. Remediation strategies for each course were addressed with a separate tool, the Clinical Performance Remediation (CPR) Tool. Walsh (2010) and University of Portland (2011) shared clinical evaluation information and contributed to the development of the tools. Input from faculty representing all levels within the program was also welcomed and considered. In addition to incorporating the QSEN competencies, the faculty felt strongly about including a professionalism section within the tools. This presentation describes the process and outcome for creating an evaluation tool that blended an effective combination of QSEN’s core competencies, the BSN Essentials, and the baccalaureate program’s conceptual model. Spring of 2012, each clinical nursing course across all levels will pilot implementation of the individualized course/level specific evaluation tools. The pilot study will provide student and faculty feedback and serve to improve the evaluation tools prior to creating the finalized versions, which will be implemented in the fall of 2012. Results of the pilot study and all evaluation tools will be presented and shared during this presentation. Nursing programs can enhance evaluation of students’ clinical performance by incorporating the newly developed clinical performance evaluation tools. The tools will then be made available on the QSEN web site for use by other nursing faculty interested in incorporating the QSEN competencies into their clinical evaluation process. Submitted Materials: Clinical-evaluation-tool-guidelines-revised-117.doc - https://drive.google.com/open?id=15bAzZCuKo5bN888gWhU20tqAWzOkyp-0&usp=drive_copy CPR-Tool-for-225.doc - https://drive.google.com/open?id=16I9UMKn59nC0PJ-6n0_896q0eE9gwqe9&usp=drive_copy Level-I-N225-Clinical-Eval-Tool.doc - https://drive.google.com/open?id=17WUSzi6SvNjdgBVJcCp4p4lDMOWzzp4s&usp=drive_copy CPR-Tool-for-420.doc - https://drive.google.com/open?id=16HEVGcZDAaoWraKckCGfXmJkRM-sgVLY&usp=drive_copy Level-III-N420-Clinical-Eval-Tool.doc - https://drive.google.com/open?id=17WUSzi6SvNjdgBVJcCp4p4lDMOWzzp4s&usp=drive_copy Additional Materials: The evaluation tools are progressive throughout the entire curriculum. Remediation tools were developed for each course corresponding with the evaluation tool. The remediation tool is named the Clinical Performance Remediation (CPR) Tool, and are included in the package above. I will be glad to send any additional information upon your request. Evaluation Description: The Tools are the evaluation strategy.

Published Back to Strategy Search Strategy Submission Patient Teaching Related to the Quality and Safety of COVID-19 Vaccines Author: Kathleen Szymanski MSN, RN Title: Coauthors: Institution: Lake Michigan College Email: kszymanski@lakemichigancollege.edu Competency Categories: Evidence-Based Practice, Informatics, Patient-Centered Care Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Clinical Setting, Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: Patient-Centered Care 1. The student will examine ways to eliminate barriers from lack of accurate knowledge to involvement of patients in their own health promotion. 2. The student will demonstrate principles of effective communication with patients and families through the development of a written or oral presentation addressing COVID-19 vaccine safety. Informatics 1. The student will use high-quality electronic sources of healthcare information for patient teaching. 2. The student will provide examples of electronic healthcare sources that promote safe and high-quality patient care. Evidence-Based Practice 1. Differentiate opinions from research and evidence as related to Covid 19 vaccinations. 2. Describe reliable sources for locating evidence reports and clinical practice guidelines for Covid vaccines. Strategy Overview: As pre-licensure students begin to develop in their role as a trusted professional, they will encounter questions from patients that they cannot answer using their textbooks. When they encounter new diseases, medications, vaccinations, and treatments, they need to know where to access accurate, credible, quality information for themselves and their patients. With the plethora of misinformation on the internet, students will encounter patients who are making healthcare decisions based on false information. Students need to be able to understand where to find evidence-based information to include in patient education and how to present accurate information clearly, dispelling myths in a respectful manner, and guide patients towards trusted healthcare information on the internet. (see attached assignment instructions) Submitted Materials: QSEN-290-Evaluation-Rubric.docx - https://drive.google.com/open?id=12yaNmlk4PPLKzTSFhEMc87ywRS_UwX-_&usp=drive_copy QSEN-290.1.docx - https://drive.google.com/open?id=12yaNmlk4PPLKzTSFhEMc87ywRS_UwX-_&usp=drive_copy Additional Materials: See attached: Assignment Evaluation Rubric Evaluation Description: See attached rubric This assignment was given as an online post-conference clinical discussion board. Students all met the objectives and I was impressed that all of the students identified appropriate online sources for their information. The patient teaching was objective and well presented.

Published Back to Strategy Search Strategy Submission Teamwork and Collaboration: Teaching Strategies to Manage Challenging Communications Author: Gerry Altmiller EdD, APRN, ACNS-BC Title: Assistant Professor Coauthors: Institution: La Salle University Email: Altmiller@lasalle.edu Competency Categories: Safety, 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 Strategy Type: Online or Web-based Modules Learning Objectives: Knowledge-Particpants will analyze strategies that infludence the ability to initiate and sustain effective partnerships with members of nursing and interprofessional teams. Knowledge-Participants will describe impact of own communcation style on others. Skills-Participants will communicate with team members, adapting own style of communicating to needs of team and situation. Skills-Participants will initiate actions to resolve conflict. Attitudes-Acknowledge own contributions to effective or ineffective team functioning. Attitudes-Appreciate importance of interprofessional collaboration. Strategy Overview: The purpose of this teaching strategy is to equip nurses to manage conflict and resolve situations where difficult communication creates a challenge to achieving safe and effective outcomes. Educators know that there is increasing potential for their nursing students to encounter difficult situations, difficult colleagues, and negative behaviors in the workplace. Hierarchal relationships and oppressive communication patterns can distract from a patient-centered focus, negatively affect outcomes, and place patients at risk. The Joint Commission has identified communication as the root cause of many sentinel events and now requires accredited agencies to uphold an appropriate code of conduct and to address disruptive behaviors. Educators are in a unique position to influence both a healthy work environment and a culture of safety by teaching their students strategies that de-escalate aggression and promote communication and teamwork. Using this interactive process, students are asked to spend 10 minutes writing about a difficult encounter/situation they were involved in or witnessed, where conflict impacted patient safety. Then the powerpoint presentation is provided where they are taught three communication strategies: (1) Cognitive rehearsal, (2) Reframing communication using safety strategies, and (3) De-escalation techniques for aggressive behaviors. The presentation explains these strategies and how to implement them. Afterward, students are given 10 minutes to rewrite their stories, reframing them using one of the strategies they were taught. Then they are encouraged to share their stories and reframed stories with peers. Through this process, students recognized that they have the ability to develop communication skills that can positively affect outcomes and address safety concerns. As they transition from student to nurse or move between practice areas, during the interview process, students will be asked not only about what actions they would take in particular patient care situations, but also about what measures they would take in difficult interactions with colleagues. Educators need to see the value in helping students develop behaviors that promote effective communication and teamwork. This has been adapted to be an effective teaching tool at the pre-licensure level, at the new-to-practice level, and at the graduate education level. It has been implemented in the classroom and as an on-line activity where the powerpoint presentation was provided as narrated slides and students were asked to post their original story along with their reframed story for their peers to review. Submitted Materials: 124.Difficult-Communications-Presentation-QSEN-website.ppt - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy Additional Materials: Additional Materials Evaluation Description: Students have commented that they have felt badly about how some of the original stories have played out and that learning strategies to approach these types of situation was helpful to them.

Published Back to Strategy Search Strategy Submission Policy Review Author: Angela Bordelon RN, MSN, CNE Title: Assistant Professor of Nursing Coauthors: Martha McMillan, MSN-Ed, RNC-EFM Institution: Louisiana State University of Alexandria Email: angelab@lsua.edu Competency Categories: Evidence-Based Practice, Informatics, 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 select evidence-based articles from peer-reviewed nursing journals. (Informatics, EBP) 2. Examine evidence-based article to determine outcome of research. (EBP, QI) 3. Compare/contrast evidence-based practice with current nursing practice. (EBP, QI, Safety) Strategy Overview: This teaching strategy is designed to teach students how to verify if policies utilized in healthcare facilities are congruent with current evidence-based practice. The policy is selected from a clinical facility. Once approved, students are to examine 3 research-based articles related to the policy to determine if the policy is current with the evidence. The student must then provide no more than a 2-page summary of each article consisting of a 1-2 paragraph summary of the research purpose and conclusion, 1-2 paragraphs summarizing a comparison/contrast of the policy with the research, and a 1-2 paragraph conclusion stating if the policy is in agreement with the current research or not. The project can be submitted electronically or in a 1-inch binder to include: title page, rubric, copy of policy, articles, summaries, and reference page. All written documents must follow APA guidelines. Submitted Materials: TS-270-Attachment-1.Policy-Review-Project-Guidelines.docx - https://drive.google.com/open?id=1BLQXQ4-T_idVmiBHX9VcEpUZQVg1qX1V&usp=drive_copy TS-270-Attachment-2.Policy-Review-Rubric.docx - https://drive.google.com/open?id=1B4CAHOFsX22niSoOa39JYZjpYs-P_N5O&usp=drive_copy Additional Materials: Policy Review Project Guidelines (attached) Policy Review Rubric (attached) Evaluation Description: Evaluation of the learning objectives is accomplished through earning a passing grade on the written project by use of a rubric.

Published Back to Strategy Search Strategy Submission Nurse Leader Interview Assignment Author: Kathleen Peterson PhD, RN, PNP-BC Title: Professor and Chair Coauthors: Institution: The College at Brockport, State University of New York Email: kpeterso@brockport.edu Competency Categories: Evidence-Based Practice, Informatics, Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure BSN Learner Setting(s): Clinical Setting Strategy Type: Paper Assignments Learning Objectives: This assignment utilizes all six of the QSEN competencies: 1. Patient-Centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs. 2. Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care. 3. Evidence Based Practice: Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. Quality Improvement: Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems. 4. Quality Improvement: Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems. 5. Safety: Minimize risk of harm to patients and providers through both system effectiveness and individual performance. 6. Informatics: Use information and technology (IT) to communicate, manage knowledge, mitigate error, and support decision making. Strategy Overview: Student assignment: • The student will interview a nurse leader (nurse manager, nurse leader, nurse administrator) during their capstone/preceptorship experience. • The student will write a synopsis of the answers provided in a paper. • The paper should be a minimum of 4 pages (no more than 5 pages), and be typed using size 12 font and double-spaced. • The student is to observe rules of grammar, spelling, and punctuation and demonstrate a good writing style and flow as established by the APA Style Manual Directions: The student is to interview the nurse leader with the following questions so that the student can describe the processes which occur in the clinical setting related to the QSEN competencies. 1. To what extent do nursing staff of this unit support patient-centered care of individuals and families whose values differ than their own? What are the barriers supporting this fully? How can it be improved? 2. Describe the nursing and inter-professional teams that operate on this unit. 3. Provide an example of a nursing practice that has been changed in the last year based on current best evidence. 4. Provide an example of how an unwanted variation that occurred within the last year on the unit changed practice and improved patient outcomes. 5. How are national safety guidelines implemented on this unit? 6. What are the two main issues with the Electronic Medical Records on this unit? This assignment is within the last Leadership and Management class in a BSN program. The student will interview a nurse leader in the clinical site that they are assignment to for their capstone/preceptorship experience that is scheduled within the same semester. Submitted Materials: Additional Materials: Evaluation Description: Grading Criteria: 1. Complete answers to the above questions (8 points) 2. APA, grammar, and spelling (2 points) This assignment will be completed this semster for the first time.

Published Back to Strategy Search Strategy Submission Website Evaluation Exercise Author: Lisa Day RN PhD Title: Assistant Clinical Professor Coauthors: Elaine L. Smith RN, MSN, MBA, CNAA, QSEN Project Manager, University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, US Institution: UCSF, School of Nursing, Dept. of Physiological Nursing Email: lisa.day@nursing.ucsf.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 Learner Setting(s): Classroom Strategy Type: Independent Study Learning Objectives: Students will: demonstrate skill in locating and accessing electronic information demonstrate skills in evaluating health-related information found on the internet demonstrate skills at teaching patient/family strategies for evaluating web-based information demonstrate attitudes and behaviors that show that they are beginning to internalize responsibility of professional nurse in ensuring patients/clients receive quality information Strategy Overview: Students are assigned to identify learning needs of patients/clients she/he is assigned to that day and to search for web sites that address these needs. Using either of the two resources listed below1,2, and/or other similar resources, the students evaluate the quality of the web sites and complete the Health Information on the Internet: Evaluation Criteria form . In a clinical conference, students discuss their process in finding and evaluating websites and compile a list of high quality websites that can be shared with the nurses on the unit(s). In discussion with the patient/family, students then present the information they have found and describe the evaluation criteria that should be used when searching for health information on the internet. For an alternative classroom-based assignment, faculty can select 5-10 websites at random for students to evaluate. Health Summit Working Group’s policy paper, Criteria for Assessing the Quality of Health Information on the Internet http://hitiweb.mitretek.org/docs/policy.html#top (accessed 3/18/2006) Internet Healthcare Coalition, Tips for Healthy Surfing Online:Finding Quality Health Information on the Internet http://www.ihealthcoalition.org/content/tips.html (accessed 3/18/2006) Submitted Materials: Additional Materials: Evaluation Description: Students are evaluated on how thoroughly they address the criteria for website evaluation. In my experience students are always eager to use the internet as a source of information but less adept at evaluating the content they find there. This assignment shows then that, as healthcare professionals, they can no longer take information at face value but must apply reasonable evaluation criteria. The students are at first frustrated but ultimately find the exercise to be eye-opening and valuable in preparing them to best serve their patients. I am tempted to make students complete a web evaluation tool each time the use a website as a reference for a paper or other assignment!

Published Back to Strategy Search Strategy Submission Student Interdisciplinary Team CQI Field Project Author: Shirley M. Moore RN, PhD, FAAN Title: Associate Dean for Research and Professor of Nursing Coauthors: Institution: School of Nursing, Case Western Reserve University Email: Shirley.moore@case.edu Competency Categories: Quality Improvement, 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): Classroom, Clinical Setting Strategy Type: General Strategy Learning Objectives: Uses data to monitor the outcomes of care processes, and uses improvement methods to design and test changes to continuously improve the quality and safety of health care systems. Functions effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care. Objectives of the field project are: Through a field experience, use the four dimensions of improvement knowledge (knowledge of a system, knowledge of psychology, knowledge of variation, theory of knowledge) to describe a change in patient care. a. Explain the system of care: for instance, the interface between core products, production processes, customers, and improvement. b. Identify specific psychology of work (e.g., organizational design, motivation) and psychology of change factors with potential influence on a health care problem. c. Differentiate the types of variation (common and special) present in a process. d. Examine tools to plot data about processes. e. Describe one Plan-Do-Study-Act cycle. In their work with the interdisciplinary student team and field experience, demonstrate an appreciation for the several health disciplines and a realization that improvement will occur by cooperative problem solving. a. Analyze the contributions of each discipline to the group project. b. Evaluate the success of these efforts. c. Identify ways to improve collaborative efforts. Strategy Overview: The heart of our semester long CQI course is work in an interdisciplinary student team focused around a specific quality improvement field project. This is an organizationally-based performance improvement project. Projects are bid to our course faculty by local health care agencies and we select the ones that best meet our needs for student learning over a semester period. Interdisciplinary student teams (4-5 students) provide consultation/assistance on an improvement initiative in a health care setting in the Cleveland community. The team works in consultation with members of the sponsoring organization and applies the philosophy, methods and tools of improvement. One faculty member serves as a sponsor to canadian kamagra each team. The attached description of the field project experience and assessment form for evaluating the improvement projects have been very successful in experientially teaching CQI over the past 10 years. Submitted Materials: Additional Materials: I can provide more information on the use this field project to teach interdisciplinary experiential CQI. I am best reached at Shirley.moore@case.edu Evaluation Description: As students give their field project reports in class, faculty rate the projects based on the criteria rating sheet. See attached: QSEN field project assessment.doc Also, the team self-analysis is written in a team report of 5 pages or less addressing the criteria listed on page 5 of the directions for the field project (QSEN field improvement project.doc) The self-analysis paper is provided to the faculty at midway and at the end of the field project time, which is usually one semester in length.

Published Back to Strategy Search Strategy Submission Building the Bridge from Evidence-Based Practice to Five Moments of Hand Hygiene Compliance Author: Lisa Foster MSN, APRN, CNP Title: Assistant Professor of Instruction Coauthors: Institution: The University of Akron Email: ljf11@uakron.edu Competency Categories: Evidence-Based Practice, Safety Learner Level(s): Pre-Licensure BSN Learner Setting(s): Clinical Setting Strategy Type: General Strategy Learning Objectives: Evidence-Based Practice Knowledge- Demonstrate knowledge of basic scientific methods and processes Skills- Participate effectively in data collection Attitudes- Recognize the value of theory in practice Safety Knowledge- Discuss the actual impact of patient safety initiatives Skills- Use patient safety resources to focus on safety in care settings Attitudes- Value relationship between safety campaigns and implementation in local practice settings Strategy Overview: The purpose of this teaching strategy is to introduce undergraduate nursing students through guided observation, the rate of evidence-based practice, World Health Organization's (WHO's) "Five Moments of Hand Hygiene" is integrated into clinical practice, which increases safety and minimizes the risk of harm to patients including healthcare-associated infections (HCAIs). This strategy best complements a first clinical rotation at the sophomore level in acute care or nursing home setting. This will be done mid-term of the semester so that nursing students would have already had a lecture on "Asepsis" including "Five Moments of Hand Hygiene" which is reinforced in the learning resources center with black-light technology the first week of the semester. The students will also have enough time to become familiar with their clinical site's routine and procedures. Students will be using direct observation, the "gold standard" for hand hygiene evaluation. To prepare for the clinical, the night before, the students will read an article that describes how a team approach results in improved patient outcomes of infection prevention in acute care and nursing home settings and a black light revelation. In pre-conference, students will be given a pre-evaluation to assess baseline knowledge about evidence-based practice, hand hygiene, and the article. Next, students will be shown the PowerPoint presentation, "Building the Bridge from Evidence-Based Practice to Hand Hygiene Compliance". Using the PowerPoint presentation, the WHO's "Five Moments of Hand Hygiene" will be reiterated and students will be instructed on how to use the WHO's validated observation tool to collect data and measure hand hygiene compliance of the assigned nurse for their assigned nurse preceptor. In post-conference, students will be given a post-evaluation to assess their learning. They will also have an opportunity to participate in the peer-review process and deal with the benefits and challenges of giving and receiving peer feedback using the "Five Facets of Supportive Feedback". A journal will be due that evening in which students can reflect on their learning from other's mistakes or errors and develop a deeper understanding of the 'Five Moments of Hand Hygiene" and OPPORTUNITIES FOR IMPROVEMENT. Submitted Materials: 275.-Building-the-Bridge-From-Evidence-Based-Practice-to-Hand-1.pptx - https://drive.google.com/open?id=1rhRicrADMZx6yTuMDacCDtleTOrsnkBL&usp=drive_copy Hospital-and-skilled-nursing-facility-collaboration-reduces-infections-ANA-Sept-2019-1.pdf - https://drive.google.com/open?id=1jer0WJmWfGH9I4ElSon1J_rD0PaH9Cg-&usp=drive_copy 275-Observation_Form-.docx - https://drive.google.com/open?id=1rqysQD-K831qqusdB7tf2JC7xKgVMNoo&usp=drive_copy 275-Evaluation-Building-the-Bridge-From-EBP-to-Hand-Hygiene-Adherence-1.docx - https://drive.google.com/open?id=1rYwaKWeZypkza9UHGYORlNeu3ZYQi5_M&usp=drive_copy QSEN-TS-275-Feedback-2.docx - https://drive.google.com/open?id=15Y9Do56vkxsnswN-qHEfLpjC2f-_eYUr&usp=drive_copy Additional Materials: Journal article, PowerPoint presentation, Observation Form, Five Facets of Supportive Feedback, and the Evaluation tool. Evaluation Description: Evaluation of the strategy will be through a pre and post evaluation. At the beginning of clinical in pre-conference, students will be asked to complete a short survey about evidence-based practice, "Five Moments of Hand Hygiene", the research article they read, and the purpose of peer evaluation to determine the student's baseline knowledge. At the end of clinical, in post-conference, students will be given the same survey to measure changes in their knowledge. Students will also have a journal due in the evening in which they will reflect upon their observations of hand hygiene. The assignment will be pass/fail.

Published Back to Strategy Search Strategy Submission The Pop-Up Coffee House: Safely Promoting Relaxation and Social Interaction During Psychiatric-Mental Health Clinicals Author: David Foley PhD, MSN, RN-BC, MPA Title: Assistant Professor Coauthors: Institution: Frances Payne Bolton School of Nursing Email: dmf106@case.edu Competency Categories: Evidence-Based Practice, Patient-Centered Care, Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Clinical Setting Strategy Type: General Strategy Learning Objectives: Through participation in this clinical exercise the student will: 1. Identify three safe, evidence-based, alternative interventions to enhance relaxation and social interaction in the psychiatric-mental health clinical setting 2. Explore and affirm safety as a top priority in the psychiatric-mental health inpatient setting in order to minimize risk for patient, student, faculty, or staff injury 3. Review the importance of interdisciplinary collaboration Strategy Overview: Facilitating psycho-social and psycho-educational patient groups is often required by students during their Psychiatric-Mental Health clinicals. Although these groups have typically focused on arts and crafts or simple discussions to promote individual expression, by maintaining a safe and restorative clinical milieu, students can carefully plan and conduct psycho-social and psycho-education patient groups that allow opportunities to teach and role model communication, relaxation, and socialization strategies. One highly successful recent example was the “Pop Up Coffee House,” an idea that seems discordant with the expected sedate milieu of a typical inpatient psychiatric-mental health unit. Nevertheless, as many patients mirror established patterns of socially isolation in their home setting and thus remain seclusive in the inpatient setting, the opportunity to explore social strategies and communication skills in a non-threatening atmosphere can be highly beneficial. Given rapid patient turnover, this group strategy can be employed by students multiple times during the same clinical rotation. Of course, students carefully communicate with each patient’s assigned nursing staff to determine if any elements of the group experience might be contra-indicated. 1. As with any psycho-educational and psycho-social activity, this group has planned goals that correspond to course objectives and is carefully monitored by clinical faculty and facilitated by nursing students. a. Students are required to submit their activity proposal to clinical faculty using a Psycho-Social/Psycho-Educational Group Submission Form no less than two weeks before the activity. b. Faculty reviews the form for safety and appropriateness of teaching/learning strategies, and then returns to students, who then submit their group’s plan to the appropriate ancillary floor staff: Recreation Therapy, Occupational Therapy, Music Therapy, or Art Therapy as applicable. Keeping in mind established safety policy and procedures, students acknowledged the following unit routines must be supported even as the group progresses: c. As with any other unit-sponsored activity, floor staff must have unfettered access to the activity room in order to perform patient safety rounds. Nursing staff often enter to retrieve patients to meet with their Psychiatrist, Social Worker, or visitor. d. Any patient who displays inappropriate language or disruptive behavior is offered appropriate redirection and supervision nursing students, faculty, or unit staff as appropriate. Occasionally a disorganized and thus unintentionally disruptive patient may enter and through successful verbal redirection, is able to remain with the group. This group approach attempts to manipulate as many aspects of the milieu as possible in order to convey a relaxed, non-threatening atmosphere where patients experiencing a variety of psychopathologies will feel comfortable. • Sound: An inexpensive sound machine produces healing sounds such as the rainfall or ocean waves. • Lighting: Small disposable electric tea light candles promote a restorative, relaxed atmosphere. • Smell: Pure lavender oil dispensed on cotton balls and then carefully hidden from view provides an aroma that his highly discordant with typically hospital odors and is thus a pleasant surprise. Upon entry to the activity room, patients find multiple interactive stations, each with a specific purpose. To observe safety as a top priority in the psychiatric-mental health care setting, faculty remained in the room at all times to insure students were provided with careful supervision at each station. To make the experience as normalized as possible and in keeping with current unit practices, decaffeinated coffee is available so that even patients who are acutely ill or reluctant to interact in any of the following activities may still attend and simply enjoy a cup of coffee. • Aroma therapy o Aroma therapy essential oils vials remained in the student’s hand at all times. Patients were offered to try 10 different fragrances and then look through an accompanying booklet that explained their significance and the benefits of having one’s home environment smell as pleasant as possible. • Personal grooming: nail care and make-up o Lipstick, blush, eyeshadow and nail polish were made available. Only neutral colors were offered. o Cross-contamination of make-up did not occur by using disposable cotton swabs. o Gloves were worn by students at all times. o Gloves were changed with appropriate handwashing between each patient. o As expected, female students typically staffed the grooming station, although a male student occasionally offered to paint nails. Students utilized the opportunity to provide guidance on appropriate color choices and application and insured all make-up containers were accounted for at the conclusion of the group. • Hand massages o Students explained the benefits of hand massage to each patient prior to commencing. o Gloves were worn by students at all times o Gloves were changed with appropriate handwashing between patients. o Only unscented, hypo-allergenic lotion is used. o Patients were advised they could discontinue their hand massage if they felt uncomfortable. To the contrary, patients and staff have reported the experience to be very restorative. Although he conversation is typically effortless, to decrease any sense of initial unease, patients may look through a magazine while receiving their hand massage. • Reminiscing/conversation o Patients were engaged in conversation by looking through magazines with students. o In particular, older patients often enjoy looking through magazines with a nostalgia focus and then sharing past experiences with students. o Magazines were also provided to patients who wanted to engage with the group as a peripheral participant. Post Group Follow-Up Immediately following the group, students are asked to document in the electronic medical record using the standard, daily template utilized by other ancillary therapies who conduct groups. The template asks the student to identify the type of activity utilized, the patient’s level of participation, barriers to participation, response, and effectiveness of the strategy. Students occasionally have questions about documentation, providing them with another valuable opportunity to engage in interdisciplinary collaboration. Feedback from floor nursing staff has been overwhelmingly positive. In fact, a number of the floor staff have briefly attended one of the groups, if only to receive some aroma therapy and or sit down with their client in a relaxed, leveled playing field. The group activity is one of the dominant topics in the day’s clinical post-conference. Students have been overwhelmingly favorable in their response, observing that the group achieved its intended goals of promoting social interaction in a relaxed, and often enjoyable manner. To date students have been very supportive of conducting this same group multiple times throughout a semester. Following the clinical day, students are asked to reflect and submit their written reflection to faculty using the Critical Reflection Journal Template. This document asks students to relate their experience with group participation and facilitation to one of the course objectives, classroom content, their daily goal, and future nursing practice. Summary With careful planning and supervision, the “Pop Up Coffee House” activity has been employed as part of the student’s psychiatric-mental health nursing clinical experience for over 10 years. It has been received by seasoned staff with anticipation, demonstrating even seasoned nurses can appreciate the benefits of alternative therapies and promoting effective socialization. References Butje, A., L.M.T., Repede, Elizabeth, MS, APRN-BC,F.N.P., C.M.H., & Shattell, Mona M,PhD., R.N. (2008). Healing scents: An overview of clinical aromatherapy for emotional distress. Journal of Psychosocial Nursing & Mental Health Services, 46(10), 46-52. Delaney, K. R., & Johnson, M. E. (2012). Safety and inpatient psychiatric treatment: Moving the science forward. Journal of the American Psychiatric Nurses Association 18(2), 79-80. doi: 10.1177/1078390312441369 Linz, S. J., & Sturm, B. A. (2013). The phenomenon of social isolation in the severely mentally ill. Perspectives in Psychiatric Care, 49(4), 243-254. doi: 10.111/ppc.12010 Siles-Gonzalez & Solano-Ruiz (2016). Self-assessment, reflection on practice, and critical thinking in nursing students. Nurse Education Today, 45, 132-137. doi.org/10.1016/j.nedt.2016.07.005 Westman, K., & Blaidsell, C. (2016). Many benefits/little risk: The Use of massage in nursing practice. The American Journal of Nursing, 116(1), 34-39. Submitted Materials: Critical-Reflection-Journal-Format.docx - https://drive.google.com/open?id=1d9jXqRpx9UNGHWO28CXftlhAk4W9nNv4&usp=drive_copy PsychoeducationalPsychosocialActivityProposal.docx - https://drive.google.com/open?id=11qnVdBRZYPFFfS4QX-efuVI8fBuW_dPI&usp=drive_copy Pop-Up-Coffee-House-QSEN-Teaching-Strategy-Foley-October-31.docx - https://drive.google.com/open?id=11HpPXsvXNlsNiZrzP-m0aqdsgSsLpWtK&usp=drive_copy Additional Materials: See attached files: 1. Critical Reflection Journal Template 2. Psycho-Social/Psycho-educational Group Submission Form Evaluation Description: 1). Critical Reflection Journal 2). Informal feedback from students, patients and floor staff 3). Demonstration on clinical area