Published Back to Strategy Search Strategy Submission The Faculty Checklist Manifesto: Utilizing a QSEN based orientation checklist for the first day of a clinical rotation Author: Kimberly Silver Dunker DNP, RN Title: Associate Professor of Nursing Coauthors: Karen Manning RN, MSN, CRRN, CHPN; Susan Knowles, DNP, RN, WHNP-BC Institution: Worcester State University Email: kdunker@worcester.edu Competency Categories: Evidence-Based Practice, Informatics, Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Faculty Development Strategies, Graduate Students, Pre-Licensure BSN Learner Setting(s): Clinical Setting, Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: Faculty will be able to: Increase quality and safety during guided clinical experiences using a standardized Quality and Safety Education for Nurses (QSEN) competency-based clinical orientation checklist during the first day of the clinical experience. The student will be able to: Demonstrate the knowledge, skills, and attitudes of safe patient care through the completion of the QSEN checklist assignments. Goal: The goal of this project was to provide clinical adjunct faculty members with a standardized checklist for the clinical orientation. The orientation checklist was developed with support from the QSEN Academic Clinical Practice Task Force committee using the six QSEN competencies. Strategy Overview: Relevance Standardized Checklists for clinical orientation are not found in the nursing journal literature. Therefore, many clinical faculty will develop their own checklist as well as, perform a scavenger hunt for the first clinical day. However, a list of items does not provide the critical thinking aspects necessary for the clinical orientation. A list will only inform the student about items to locate in the clinical agency. Alternatively, the QSEN clinical orientation checklist provides a structured guide for faculty to incorporate the QSEN competencies ,knowledge, skills, and attitudes (KSA)s for their assigned clinical students. The checklist utilizing the QSEN competencies adapted for nurse educators includes: (a) patient-centered care, (b) teamwork and collaboration, (c) evidence-based practice, (d) patient safety, (e) quality improvement, and (f) technology and informatics. Embedded within the checklist are strategies to help guide the clinical faculty in orienting their student group to the clinical environment. Strategy and Implementation Clinical faculty need to provide a quality orientation for students. This adapted orientation checklist was designed for pre-licensure nursing students in all guided clinical rotations including specialty rotations. faculty utilizing this checklist are provided clear objectives for the clinical orientation, which highlights the six QSEN competencies. The new checklist contains an itemized list, a scavenger hunt, and critical thinking strategies to orient students on their first clinical day. Goal: The ultimate goal in using this newly developed standardized orientation checklist is to ensure quality and safety is embedded into the clinical rotation from the first clinical day. Submitted Materials: Clinical-Orientation-CheckList-2.docx - https://drive.google.com/open?id=1vf-PK4-7uHgnrAXxwP-u2gy8vW8LJoC1&usp=drive_copy QSEN-Teaching-Strategy_Checklist-2-1.docx - https://drive.google.com/open?id=15vVscBA2B_jDGDhV60XDUoPnaNug91L9&usp=drive_copy Additional Materials: Clinical Orientation Checklist Found at: https://onlinetraining.umassmed.edu/checklist/ Evaluation Description: Evaluation Faculty were given the checklist before taking their students to the clinical site.. After using the checklist on the first day, faculty reported that utilizing the checklist allowed students to have a systematic orientation as well as, an introduction to the QSEN competencies. Faculty were queried about their experience using the QSEN adapted checklist during their orientation on the first clinical day. All faculty were asked these specific questions: Clinical Faculty Questions Did the checklist help organize your orientation day? Did you add additional items to the checklist? Were you able to integrate QSEN KAS into orientation? Which KAS activities did you utilize? Rationale for using the particular strategy? Student feedback: What was their take away learning from completing the activities? Lastly, the clinical instructor used the QSEN activities and post conference ideas throughout the remainder of the clinical rotation to enhance post conference discussions. Implication for Nursing Practice This newly developed orientation checklist resource is available on the Academic Clinical Practice Task Force website, which allows both academic and clinical partners an opportunity to implement this standardizing orientation strategy into any clinical rotation. In the future, implementation of this orientation checklist strategy into all clinical rotations can provide greater quality and safety for students while attending a clinical experience.

Published Back to Strategy Search Strategy Submission Incorporating Quality and Safety Case Studies, problem-based learning assignments and reflective practice exercises into Geriatric Practicum Setting Author: Jill Gaffney Valde PhD, RN Title: Associate Professor Coauthors: Institution: University of Iowa; College of Nursing Email: jill-valde@uiowa.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: Case Studies Learning Objectives: 1.Communicate patient values, preferences and expressed needs to other members of health care team. (PCC ) 2. Recognize contributions of other individuals and groups in helping patient/family achieve health goals. (T&C) 3. Locate evidence reports related to clinical practice topics and guidelines. (EBP) 4. Identify gaps between local and best practice. (QI) 5. Communicate observations or concerns related to hazards and errors to patients, families and the health care team. (Safety) 6. Use high quality electronic sources of healthcare information. (Informatics) Strategy Overview: The purpose of this teaching strategy is to incorporate the six QSEN competencies into a series of geriatric practicum seminars. Using a variety of interactive teaching techniques, including the unfolding case study and problem-based learning, students increase their awareness and assessment of quality and safety issues specific to older adults. Seminar A: Students listen to the unfolding case study of an elderly man named Sherman “Red” Yoder, who is an 80 year old widower with multiple health care needs. The case study is available free at the National League of Nursing (NLN) website http://www.nln.org/facultyprograms/facultyresources/ACES/unfolding_cases.htm . Students divide into pairs and identify and prioritize care needs of the client focusing on individual preferences and values revealed in the tape. They are also asked to discuss what other members of the health care team would be appropriate to collaborate with based on the team member’s role and education, and what referrals they would make. (PCC and T&C) Seminar B: Students interview a client the week before and bring a comprehensive medication list (both prescribed and over the counter) of their client to this week’s seminar. Students then draw from a list of pre-selected websites by the instructor and look up medication information and interactions. The students critique the credibility of the sites selected using the critique developed by the University of Minnesota. http://hsl.lib.umn.edu/biomed/help/evaluating-web-resources (Informatics) Seminar C: Students research and present articles on evidence based practice for one of the 3 D's- (Delirium, Dementia or Depression) comparing their literature findings to the current practice and policies in their assigned facility. Students are then expected to share their findings with their assigned preceptors. (EBP) Seminar D: Students are asked to select an assigned client and to go into the client’s room and time and conduct the “One Minute Safety Checklist” developed by K. Amer and found under Submitted Materials . Students need to quickly assess six categories of safety risks, (e.g. weight and age, assessment of airway) and based on the findings develop a prioritization of concerns and a plan of care (POC). The student is expected to involve the client, family and preceptor in the discussion of possible risks and interventions. (Safety and PCC) Seminar E: Students do a quality assessment of a long term care facility where they have a client and develop plans for improvement based on identified needs and opportunities using the “Observable Indicators of Nursing Home Care Quality Instrument" found under Submitted Materials . Students are instructed to spend 30 minutes walking around the long term care facility and making observations, focusing on what they see, hear and smell. Following the observation walk, students answer the 30 questions and compute a score. The results of their findings are shared with the preceptor and or administrator. In seminar students share findings, looking for common themes and identifying opportunities for quality improvement. (QI) Submitted Materials: Additional Materials: • Evaluating Web Resources (http://hsl.lib.umn.edu/biomed/help/evaluating-web-resources) University of Minnesota. Accessed August 16, 2012. • National League for Nurses. (www.nln.org). http://www.nln.org/facultyprograms/facultyresources/ACES/unfolding_cases.htm. Accessed August 16, 2012. • Rantz, M., Zwygart-Stauffacher, M., Mehr, D., Petroski, G., Owen, S., & Madsen, R. (2006). Field testing, refinement and psychometric evaluation of a new measure of nursing home care quality. Journal of Nursing Measurement, 14(2), 129-148(20).* PMCID: PMC3254215 Evaluation Description: The clinical practicum seminar activities have not yet been formally evaluated. The plan is to revise the existing clinical evaluation tool to include successful demonstration of the six identified learning objectives. I welcome further implementation and evaluation of these activities and would be interested in receiving feedback.

Published Back to Strategy Search Strategy Submission Circle of Objects Activity: Reflecting on Cultural Heritage Author: Stacy Lutter D. Ed, RN Title: Assistant Professor, The Stabler Department of Nursing Coauthors: Institution: York College of Pennsylvania Email: slutter@ycp.edu Competency Categories: Patient-Centered Care Learner Level(s): Graduate Students Learner Setting(s): Classroom Strategy Type: General Strategy Learning Objectives: Patient-Centered Care Skill: Incorporate reflective practices into own repertoire Patient-Centered Care Attitudes: Honor learning opportunities with patients who represent all aspects of human diversity Seek to understand one’s personally held attitudes about working with patients from different ethnic, cultural and social backgrounds Strategy Overview: The Circle of Objects is a teaching strategy that can be used as a way to acknowledge cultural differences and facilitate reflection of one’s own heritage, which is an essential component of establishing patient-centered relationships in nursing practice. This exercise was originally developed by the Fetzer Institute in San Francisco and is discussed in Brookfield and Preskill (2005). For this activity, students are asked to bring an object to class that reflects their cultural heritage. Students are sometimes initially concerned with this request because they do not believe they have a unique history or traditions. While it is tempting to give examples of objects students could bring, it is best to let the prompt open to interpretation and allow students to reflect on an aspect of their cultural heritage they are willing to share. During class: • Because this is a vulnerable activity, the course instructor should begin the sharing process. • Each student is given 2-3 minutes to share their cultural artifact. • Students must stand to present their artifact and there should be no interruptions during this process. • There should be no specified order in presenting and each student should speak when they feel ready to share. • Silence should be maintained between students. • After each student presents his/her object, it should be placed on a centralized table. • Time for discussion and interaction with the objects should be allowed after everyone has had an opportunity to participate. • The instructor should express gratitude for the participation in this process and state the importance of reflecting on our own identity and attitudes in order to provide high-quality patient centered care. Ideally, the activity should take place towards the end of class, because it can be overwhelming and deeply personal. The course instructor does need to be prepared for the potential for students to become emotional in respect to their own background or the cultural heritage of others. Submitted Materials: Additional Materials: Evaluation Description: This activity honors the backgrounds of different ethnicities and social classes. It brings awareness to the notion that we are more than our outward appearance, which is a critical step in developing the attitude required to provide high level patient-centered care. Self-reflection is an important step towards developing competence in patient-centered care. During this activity, students have brought in favorite family recipes or foods, traditional cultural garments, religious objects, immigration paperwork, and symbols of favorite family activities or traditions. After this experience, students who perceived their family life as “normal” are often surprised to find that they do have unique traditions. Additionally, using this activity in an introductory graduate course can provide an opportunity for students to know each other better and connect on a deeper level. Students have reported this is as a valuable learning activity on course evaluations. I would not recommend soliciting feedback immediately, because many students will continue to reflect on the experience. Soliciting a written reflection after a period of time may enhance the reflective process. The reflection should focus on how this activity facilitated their thinking about: 1.one’s personally held attitudes about working with patients from different ethnic, cultural, and social backgrounds 2.patients who represent all aspects of human diversity 3.strategies they could infuse into their own practice to promote patient-centered care While this activity could be adapted for use in the on-line environment using video or photography, the opportunity to kinesthetically connect to the cultural heritage of others is a powerful learning tool. Brookfield, S., & Preskill, S. (2005). Discussion as a way of teaching: Tools and techniques for democratic classrooms (2nd Ed.). San Francisco, CA: Jossey-Bass.

Published Back to Strategy Search Strategy Submission Error Near Miss Event On-Line Discussion Author: Diane Rudolphi RN, MS Title: Senior Medical Surgical Clinical Faculty Coauthors: Institution: University of Delaware Email: drudolph@udel.edu Competency Categories: Evidence-Based Practice, Quality Improvement, Safety Learner Level(s): Pre-Licensure BSN Learner Setting(s): Clinical Setting Strategy Type: Online or Web-based Modules Learning Objectives: The Students will: 1) analyze an error or near miss event that occurred in the clinical area utilizing clinical practice guidelines, best practice and evidence based practice to describe and support your position regarding this event. 2) respond to peer submissions regarding their clinical incident while providing evidence/research to support your submission response. Strategy Overview: Students complete this assignment using the discussion board found on their course site. This on-line format provides an excellent platform for students to interact, share and discuss clinical experiences. This particular assignment provides honesty, transparency and a just culture to error and near miss events (as well as reporting of these events). This is a critical step in preparing students for practice as new graduates. This assignment requires students to complete their initial discussion (part #1) using critical thinking and research to support their submission. They must then engage and reflect on their peer’s experiences in order to complete their response (part #2) of the assignment. In all submissions, students are expected to utilize clinical practice guidelines, institution policies and research to support their position. This assignment has been used in all clinical specialty areas within the senior preceptorship practicum. During these clinical experiences it is often difficult to schedule group discussion conference times due to challenging student schedules. Submitted Materials: 249.1-Assignment-Discussion-Rubric-Finaldocx.docx - https://drive.google.com/open?id=1qOPxA5kVhgMowHY4jxcMdDFsVybp-ucc&usp=drive_copy 249.Error-Near-Miss-Event-DiscussionFinal.docx - https://drive.google.com/open?id=1qxsw7zzFYLiC10oCEUaV3Rv7d1hwTE6O&usp=drive_copy Additional Materials: Attached Assignment Instructions Attached Grading Rubric Evaluation Description: The discussion Rubric provides students with clear guidelines of the grading process. The additional section is provided for faculty comments. Students enjoy the discussion board and appreciate learning more about their peer’s experiences. They appreciate the on-line format which allows them to make the best use of their time. Faculty have found the student assignments to be more meaningful, thoughtful with more of an EBP approach and higher levels of critical thinking as compared to traditional student group discussions.

Published Back to Strategy Search Strategy Submission Webquest on Patient Safety & Quality Author: Christina N. George RN, MS, CNE Title: Assitant Professor of Nursing Coauthors: Institution: Tulsa Community College Email: cgeorge@tulsacc.edu Competency Categories: Informatics, Quality Improvement, Safety Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Classroom Strategy Type: Online or Web-based Modules Learning Objectives: These objectives have been identified and linked to these specific KSA and are encompassed in the stated student objectives. SAFETY Knowledge - The learner will utilize the WebQuest activity to build knowledge and discuss with peers the potential and actual impact of national patient safety resources, initiatives and regulations. Skills - The learner will utilize the WebQuest activity to apply national patient safety resources for own professional development and to focus attention on safety in care settings. Attitudes -The learner will gain an understanding of the value of the relationship between national campaigns and implementation in local practices and practice settings. QUALITY Knowledge – The learner will be introduced via the WebQuest activity to the basic terminology related to quality improvement while directly exploring the initiatives to improve healthcare. Knowledge – The learner after completing the WebQuest activity will discuss with peers about the quality improvement projects that are seen in the practice setting. Skills – The learner after completing the WebQuest activity will identify and discuss with peers gaps between local and best practice standards. Attitude – The learner after completing the WebQuest activity will appreciate and discuss why continuous quality improvement is an essential part of the daily work of all healthcare professionals. Strategy Overview: The webquest is formatted to strategically introduce basic concepts of Safety and Quality as well as expose the learner to the preferred best practices of these concepts. In this assignment the learner will find a wealth of information and shared knowledge from the healthcare community and this activity may be the first exposure to new organizations, groups, initiatives, goals, plans, ideas, and to the leaders and drivers of the healthcare reform movement. The student reviews the narrated powerpoint and then begins the webquest either in a classroom setting or as an independent learning opportunity. Submitted Materials: 126.Doc-4-Webquest-Activity.docx - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy 126.Note-to-the-Educator.docx - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy 126.Pt-safety-and-quality-IP-spr-11.pptx - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy 126.student-learning-objectives-and-activity-overview.docx - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy Additional Materials: I have included the overview and the short narrated powerpoint that the students read prior to beginning the webquest activity. If you have any questions please contact: Christina George Rn, MS, CNE cgeorge@tulsacc.edu Evaluation Description: We utilized this activity in a blended Issues & Perspectives on Nursing course. There were a total of 4 activities and discussions that were worth 10 points, the students were to post 1 original post and then reply to 1 of their peers with a relefctive and thoughtful reply. This activty has been used for 3 semesters and the feedback from the students confirms the use of the activity. Many of them do not realize the resourse that are available to them via the web. This is a demonstration and a confirmation to them that there are high quality on-line resources that enhance, improve, and guide their future nursing practice.

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.