Published Back to Strategy Search Strategy Submission Implementation of a Math Simulation in First Semester Nursing Students in PreLicensure Programs Author: Maria Calhoun RN, MSN, CPNP Title: Coauthors: Shunda Wilburn, RN, MSN, DNP Institution: Troy University- Montgomery Campus Email: mkk702@jagmail.southalabama.edu Competency Categories: Quality Improvement, Safety Learner Level(s): Pre-Licensure ADN/Diploma Learner Setting(s): Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: Upon completion of the math simulation, students will: 1. Utilize math formulations learned throughout the semester to perform mathematical calculations. 2. Explain the process of mathematical calculations throughout the simulation experience. 3. Apply mathematical concepts to understand their role in quality improvement for patient safety. 4. Students will demonstrate how to accurately perform mathematical calculations by achieving a 90% or higher score. Strategy Overview: Strategy Overview The math simulation experience is designed to meet the needs of first-semester undergraduate nursing students in a Pre-Licensure Program. The simulation is a quality improvement project within the educational setting to prepare students for future nursing semesters. The simulation is designed to improve student retention of mathematical skills which leads to safer clinical practices through accurate calculations. This simulation includes opportunities for students to practice mathematical skills learned throughout the semester (preparing oral and parenteral medications, programming IV pumps, etc.) and apply them to real-life scenarios. This application helps to better prepare students to practice safely in future clinical settings. Further, implementation of this simulation is to provide a learning experience that is non-stressful and fun. Not only will students identify areas of weakness in his or her mathematical calculation abilities, but also reduce medication errors. A nursing student that can adequately calculate medication doses will not only provide safe patient care but also decrease medication errors in the clinical setting. Strategy/Simulation Activity Students will be given the opportunity to participate in a math simulation before the dosages and solution final exam. The math simulation will have five stations (IV, oral tablets, oral liquid, household/metric conversions, & parenteral injections) with five students starting at each station (total of 25 students). Each student will be assigned a color-coded folder labeled A through E (example: Folder A is red). The students will keep the same assigned letter and color throughout the entire simulation (folders will remain at each station). Each folder will contain dosage calculation problems and student answer sheets. Students will be given 10 minutes to complete the problems and simulation. Once the student reaches the simulation aspect, the answer sheet will be given to the instructor to evaluate completion of math problems. The instructor will evaluate the simulation after grading the student’s answer sheets. Graded sheets will be collected at the end of the simulation experience. After students have completed all five stations, an evaluation form will be given to each student regarding the math simulation experience. Remediation will be offered to students who make less than 90%. Submitted Materials: Math-Simulation-Questions-Folder-A.pdf - https://drive.google.com/open?id=1jqz6LaxeHdxtcbpDXR8FYoR-ubHeMtXU&usp=drive_copy Math-Simulation-Student-Answer-Sheet-Folder-A.pdf - https://drive.google.com/open?id=1jp0ClFSMAKaz6NqGZHq79ha7exaJ1aJe&usp=drive_copy Math-Simulation-Folder-A-Instructor-Answer-Key.pdf - https://drive.google.com/open?id=1jLXgHtqKZUVaqlA5mXM87ZM20nL13O8A&usp=drive_copy Math-Simulation-Student-Evaluation.pdf - https://drive.google.com/open?id=1k4SdyRUI3GA-syY09JX4O7xinZg9-yBD&usp=drive_copy Additional Materials: Strategy Materials Attach: evaluation tools, grading rubric, Problem examples (Group A) Evaluation Description: The evaluation of the math simulation will include successful completion of math problems and simulation (to be graded by an instructor). Instructors will be given a grading rubric to assist with evaluating mathematical calculations. The goal will be that students who complete all parts of the calculations and simulations will achieve a score of 90% or higher. At the end of the simulation, students will have an opportunity to evaluate the simulation experience and provide his or her recommendations for improvement.

Published Back to Strategy Search Strategy Submission Obstetrical Simulation: Unfolding Case Study on Postpartum Hemorrhage Author: Mary Lou Gies Ed.D, RN Title: Assistant Professor Coauthors: Institution: La Salle University Email: gies@lasalle.edu Competency Categories: Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure BSN Learner Setting(s): Classroom, Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: At the end of this simulation of an unfolding case study, the learner will be able to: Recognize the importance of family-centered and patient-centered care; Summarize the knowledge, skills, and attitude necessary for a nurse in a critical care situation; Demonstrate professional behaviors during the simulation; Perform a focused and overall assessment of a postpartum mother; Use SBAR (Situation, Background, Assessment, Recommendation) reporting during patient transfer from a labor and delivery unit to a postpartum unit; Implement The Joint Commission safety standards in the care of a postpartum mother, including correct identification of infant and mother; Demonstrate standard infectious disease precautions when performing nursing care; Provide safe nursing care to the newly delivered postpartum mother; Analyze a critical care clinical situation and respond appropriately within a safe learning lab. This teaching strategy evaluates the following KSAs: Knowledge: Incorporates family-centered care for the newly delivered postpartum mother by communicating with the patient and family about the critical situation, including patient needs in plan of care. Skills: Encourages open, effective communication, when possible, between multi-disciplinary team and family. Attitude: Provides emotional support to patient and family and encourage support for one another. Core-Competency: This teaching strategy evaluates the following KSAs: Knowledge: Demonstrates nurse’s role in providing safe and effective patient care according to The Joint Commission standards of nursing care of a critically ill patient. Skills: Implements safe patient care when identifying patient, administering medication, transferring patient, and intervening with a critically ill patient. Attitude: Promotes patient care in a safe and effective manner. Strategy Overview: This simulation can take place in a Learning Resource Center or classroom setting at mid-semester or during the final weeks of a Nursing Care of Women and the Childbearing Family course. The goal of the simulation is to teach neophyte students about applying the QSEN KSA competencies to the care of a critically ill postpartum mother, by presenting them with an unexpected clinical situation. The earning objectives, equipment, and case study of a new mother with a postpartum complication are given. Students demonstrate skills on a manikin as the case study progresses. Questions about the situation are posed during the debriefing, to encourage critical thinking and patient-centered care. Submitted Materials: Additional Materials: Evaluation Description: The simulation was evaluated based on debriefing feedback after the simulation and NCLEX style questions. The debriefing questions and NCLEX are incorporated in the document submitted. The faculty and student feedback had positive learning outcomes, as reflected in debriefing and correct responses to NCLEX questions. Students and faculty were in favor of having more simulations in the learning lab.

Published Back to Strategy Search Strategy Submission Introduction to Quality and Safety in Nursing Author: Candace C. Cherrington PhD, RN Title: Associate Professor Coauthors: Institution: Wright State-Miami Valley College of Nursing & Health Email: candace.cherrington@wright.edu Competency Categories: Quality Improvement, Safety Learner Level(s): New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN, Staff Development Learner Setting(s): Classroom Strategy Type: Online or Web-based Modules Learning Objectives: Identify the indicators of quality of nursing care in the acute setting. Discuss the importance of national patient safety goals. Describe 4 communication tools for ensuring patient safety. Strategy Overview: Powerpoint lecture presention intended for an introductory nursing course. Submitted Materials: 99.intro_quality_and_safety_presentation.ppt - https://drive.google.com/open?id=1YFTvxXzLZd9eH0F9LB_lEiFdFbDR1zmY&usp=drive_copy 99.quality_and_safety_quiz_questions.doc - https://drive.google.com/open?id=1YFTvxXzLZd9eH0F9LB_lEiFdFbDR1zmY&usp=drive_copy Additional Materials: Evaluation Description: Student knowledge was evaluated on a quiz and the final exam using multiple choice and short anwser question.

Published Back to Strategy Search Strategy Submission Simulation Author: Tara Heagele MSN Ed., RN, PCCN Title: Educator Coauthors: Elizabeth Mizerek, MSN, RN, CEN, FN-CSA, EMT-B Institution: Robert Wood Johnson University Hospital Hamilton Email: theagele@rwjuhh.edu Competency Categories: Evidence-Based Practice, Informatics, Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Continuing Education, 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: General Strategy Learning Objectives: At the completion of this simulation clinical, students will: - Describe the nurse’s role, how the nurse can protect the safety of himself/herself and the patients, and the role of the healthcare facility during a disaster. - Successfully triage victims of a mass casualty event as evidenced by correct triage tag designations. - Successfully perform a rapid trauma assessment on two victims, as evidenced by observing the students follow the Trauma Nurse Core Curriculum ABCDEFGHI method of rapid trauma assessment. - Apply, administer and perform all necessary nursing interventions to the simulation manikins with traumatic injuries. - 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. - Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care. - Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. - 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. - Use information and technology to communicate, manage knowledge, mitigate error, and support decision making. Strategy Overview: Educator will assign 2-4 students to triage 15 patients. Discuss each patient scenario with the class and decide if each patient was triaged appropriately. Transition the clinical group to the Emergency Department. The student nurses will assume the care of Patient 9 and Patient 11. Submitted Materials: Additional Materials: Evaluation Description: This simulation clinical was used five times between February 2012 and September 2012 with last semester nursing students in an ADN program. Pre and post conference discussion questions (provided in the materials) resulted in a lengthy discussion about the nurse's role in a mass casualty incident during each simulation clinical day. Motivation to participate in disaster drills and emergency preparedness was a recurrent theme during the discussion.

Published Back to Strategy Search Strategy Submission National Patient Safety Goals in Acute Care Author: Louise A. Fura MSN, CRNP Title: Assistant Professor of Nursing Coauthors: Cynthia Rothenberger, MSN, RN, ACNS, BC Institution: Alvernia University Email: louise.fura@alvernia.edu Competency Categories: Safety Learner Level(s): Pre-Licensure BSN Learner Setting(s): Clinical Setting Strategy Type: General Strategy Learning Objectives: - Explore impact of national patient safety standards on an acute care unit. - Utilize national patient safety standards to evaluate patient safety in acute care. - Value application of national patient safety standards in an acute care environment. Strategy Overview: This learning activity has been used early in the semester of the first acute care clinical experience. • Distribute and review current National Patient Safety Goal (NPSG) Worksheet with clinical instructors during orientation of the first clinical course. • Encourage clinical instructors to review the NPSG Clinical Worksheet with students during orientation to the acute care facility and during pre-conference on the designated clinical day. • Direct students to monitor and evaluate safety practices in the clinical setting. • Instruct students to document observations and recommendations on NPSG Clinical Worksheet and direct activity questions and safety concerns to the clinical instructor. • Instruct each student to develop a plan of care during the clinical day based on analysis of observations. • Discuss observations, recommendations, and plan of care with clinical group during post-conference. Submitted Materials: Additional Materials: Evaluation Description: The critical thinking activity engaged students in application of patient safety principles in the acute care clinical setting. Students completed a brief evaluation of the learning activity (included on the attached document). Informal student feedback indicated the learning activity was helpful in applying patient safety standards and care plan development using the nursing process. Faculty implementing the strategy supported the use of the learning activity to facilitate application of patient safety concepts, care plan development, and critical thinking in the clinical setting. The worksheet can be updated easily to reflect changes in the NPSG. In addition, the learning activity can be modified for usage in a variety of practice settings.

Published Back to Strategy Search Strategy Submission Critiquing Nursing Research Articles: Safety Research Author: Zane Robinson Wolf PhD, RN, FAAN Title: Dean and Professor Coauthors: Diane M. Breckenridge, PhD, RN Institution: La Salle University Email: wolf@lasalle.edu Competency Categories: Evidence-Based Practice, Informatics, Safety Learner Level(s): Pre-Licensure BSN, RN to BSN Learner Setting(s): Classroom Strategy Type: General Strategy Learning Objectives: Critique selected nursing research studies. o Prior to taking the critique test, complete in-class critiques of three published nursing research studies using guidelines. o Complete a graded test, a critique of one published research study using guidelines. Apply qualitative or quantitative critique guidelines to research study addressing patient safety. Compare study to published research after consulting several databases, including Cochran, CINAHL, and Medline. Describe two strengths of the study. Describe two weaknesses of the study. Discuss application of study results to a clinical setting. Strategy Overview: In this research assignment, students prepare to take a critique test scheduled during the latter part of an undergraduate nursing research course. Earlier in the course schedule, students complete in-class critiques of three research studies, including qualitative and quantitative examples. Students will receive the article before the test, so that they are able to prepare for the test and complete the learning objectives. They bring the article and their notes to the test. The articles represent current research on patient safety topics that faculty select such as: • Chiang, H-Y., & Pepper, G. A. (2006). Barriers to nurses’ reporting of medication administration errors in Taiwan, Journal of Nursing Scholarship, 38(4), 393-399. (A sample test has been constructed based on this study). • Ebright, P. R., Urden, L., Patterson, E., & Chalko, B. (2004). Themes surrounding novice nurse near-miss and adverse-event situations. JONA, 34, 531-538. • Eisenhauer, L. A., Hurley, A. C., & Dolan, N. (2007). Nurses’ reported thinking during medication administration. Journal of Nursing Scholarship, 39(1), 82-87. • Wolf, Z. R., Hicks, R., & Serembus, J. F. (2006). Characteristics of medication errors made by students during the administration phase: A descriptive study. Journal of Professional Nursing, 22(1), 39-51. • Dennison, R. B. (2007). A medication safety education program to reduce the risk of harm caused by medication errors. Journal of Continuing education in Nursing, 38(4), 176-184. • Meurier, C. E., Vincent, C. A., & Parmar, D. G. (1997). Learning from errors in nursing practice. Journal of Advanced Nursing, 26, 111-119. Faculty distribute the study to be critiqued and the content domains of the test map at least two weeks before the scheduled critique exam. See the two test maps, one for a qualitative safety research study, one a quantitative research study. Also, note an example of a test on one study identified in the studies cited for critique. Guidelines for critiquing a study are also listed. Submitted Materials: 74.CritiquingNursingResearchArticles.doc - https://drive.google.com/open?id=1YFTvxXzLZd9eH0F9LB_lEiFdFbDR1zmY&usp=drive_copy Additional Materials: Evaluation Description: Two test maps and one critique exam are included in the file.

Published Back to Strategy Search Strategy Submission Quality and Safety Monitor Assignment Author: Laurie J. Palmer RN, MS, AOCN Title: Professor Coauthors: Judy Wilson, RN, MS Institution: Monroe Community College Email: lpalmer@monroecc.edu Competency Categories: Patient-Centered Care, Quality Improvement, Safety Learner Level(s): Pre-Licensure ADN/Diploma Learner Setting(s): Clinical Setting Strategy Type: Case Studies Learning Objectives: Analyze the care environment and informatics and collaborate with team members to identify hazards which effect the provision of safe high-quality patient-centered care. Communicate observations and concerns related to hazards and errors to the health care team. Value one’s own role in preventing error. Strategy Overview: Each week one student is assigned to the role of Quality and Safety Monitor in the clinical setting. Using a structured checklist, the student nurse analyzes potential and actual risks which effect the provision of safe high-quality patient-centered care. During post conference the student provides a summary of findings and actions taken to improve safety. Submitted Materials: 128.Quality-and-Safety-Monitor.docx - https://drive.google.com/open?id=1DbkqXTT6SpPFZ5zNX90tkcwb5BzegaD6&usp=drive_copy Additional Materials: Evaluation Description: In the post-conference setting, the clinical instructor facilitates discussion of the quality and safety concerns noted by the student in the role of Quality and Safety Monitor. The clinical instructor highlights how linear thinking by the nurse negatively impacts the delivery of safe high-quality patients-centered care, how systems and individuals unconsciously adapt to unsafe practices, and how team work, collaboration, and a “just culture” facilitates a patient-centered focus and prevents a focus of blame on the performer. After post-conference, the clinical instructor reviews the Quality and Safety Monitor Assignment Worksheet submitted by the student. Based upon the student’s performance in the role of Quality and Safety Monitor, the instructor provides evaluative feedback on the student’s Clinical Performance Appraisal, for standards which relate to the assignment’s learning objectives. (This assignment was piloted by our first year second semester medical surgical course during Spring 2011. Four of eight clinical groups participated and reported overwhelming positive feedback from faculty and students. The tool utilized in this assignment was revised based upon written feedback of students and verbal feedback of faculty. Feedback of both students and faculty affirmed that students were able to meet the learning objectives of the assignment and that the assignment provided a learning experience that enhanced patient care outcomes.)

Published Back to Strategy Search Strategy Submission Draw your Day Room Author: Lindy Mitchell MSN Title: BSN Faculty Coauthors: Institution: Arizona College of Nursing Email: lmitchell@arizonacollege.edu Competency Categories: Teamwork and Collaboration Learner Level(s): Pre-Licensure BSN Learner Setting(s): Classroom, Skills or Simulation Laboratories Strategy Type: Case Studies Learning Objectives: 1. Safety: Demonstrate effective use of strategies to reduce the risk of harm to self or others. 1) Patient-Centered Care: Assess the presence and extent of pain and suffering. Recognize the role of the nurse in relief of all types and sources of pain and suffering. Value the patient’s expertise with health and symptoms. 2) Teamwork and Collaboration: Demonstrate awareness of own strengths and limitations as a team member. Strategy Overview: The strategy for this activity is to give the students a chance to assume the role of a nurse in a safe and non-punitive environment. The students are given instruction and supervision throughout the activity. The students are told to draw 5 cards. They look at the key and determine what the diagnosis and gender of their client are. Then they organize activities that they would complete and how they would monitor and ensure a safe milieu, such as staffing needs, assessment tools, and therapies. The students are expected to discharge and admit new clients to their units at regular intervals. To discharge the students must have the client’s discharge needs listed, such as case management and medication compliance and housing needs. They must also be able to verbalize how they know that a client is ready for a safe discharge from the inpatient environment. When a new client is admitted, they then draw from the top of the deck and re-evaluate their day room and the needs for safe and effective nursing care of the client. The students are periodically evaluated and expected to give an SBAR report on their clients throughout the activity. This allows them to complete aspects of client care that they are not afforded in clinical. The students are also given admission and discharge requirements. By admitting and discharging the students are gaining in knowing what they would do and need to have ready for a safe admission of a client, such as who can share a room, which assessment data will be needed to safely incorporate this client into the unit. By discharging clients the student is able to test their knowledge of available resources, and therapies that the client will have access too. The students address what does a client that is ready for discharge look like? How does this client obtain services within the community? The students are told to draw 5 cards. They look at the key and determine what the diagnosis and gender of their client are. Then they organize activities that they would complete and how they would monitor and ensure a safe milieu, such as staffing needs, assessment tools. and therapies. The students are expected to discharge and admit new clients to their units at regular intervals. To discharge the students must have the client’s discharge needs listed, such as case management and medication compliance and housing needs. They must also be able to verbalize how they know that a client is ready for a safe discharge from the inpatient environment. When a new client is admitted, they then draw from the top of the deck and re-evaluate their day room and the needs for safe and effective nursing care of the client. The students are periodically evaluated and expected to give an SBAR report on their clients throughout the activity. Submitted Materials: 261.1Draw-your-Day-Room-QSEN-Strategy.docx - https://drive.google.com/open?id=1qjAS1gJ0I3MjhNmdWc8XQ5MbgXlQ0hvI&usp=drive_copy Additional Materials: Video: https://youtu.be/WIqiRldbyV0 Evaluation Description: Their peers and their instructor evaluate the students during the activity. The students are given feedback upon the safe discharge. If the student or group does not have the information needed or they are lacking details they are prompted and given time to re-evaluate. This technique is used throughout the semester and gives instant feedback to the faculty about what knowledge the students are lacking. It also opens up dialogue about safe care for the clients that they will care for with mental health.

Published Back to Strategy Search Strategy Submission A Virtual Encounter with Mental Illness Author: Angela D. Jones DNP, RN Title: Assistant Professor Coauthors: Institution: Stephen F. Austin State University Email: jonesas7@sfasu.edu Competency Categories: Patient-Centered Care, Teamwork and Collaboration Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Classroom, Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: 1) Patient-Centered Care: a. Skills- i. Assess the presence and extent of pain and suffering. b. Attitudes - i. Value seeing health care situations through the patients’ eyes. ii. Recognize the role of the nurse in relief of all types and sources of pain and suffering. iii. Value the patient’s expertise with health and symptoms. 2) Teamwork and Collaboration: a. Attitudes– i. Respect the centrality of the patient/family as core members of any health care team. Strategy Overview: A Virtual Encounter with Mental Illness reflective assignment offers prelicensure students the opportunity to have a psychiatric clinical experience by imagining their responses to patient encounters as they hear real patients’ stories of their struggles with diverse mental illness thru video recordings. This reflective assignment can be used as a classroom or a clinical assignment. It can be an individual or group assignment depending on the needs of the learner(s). Incorporating the reflective assignment in the mental health/illness course encourages students to focus on patient-centered care in assessing the presence and extent of pain and suffering in their patient(s) while valuing the seeing the health care experience through the patients’ eyes. This assignment also aids in the student’s recognition of the role of the nurse in relief of pain and suffering, encouraging the student to value the patient’s expertise with their health and associated symptoms. Students are encouraged to respect the centrality of the patient/family as a key member of the health care team to promote teamwork and collaboration. This reflective assignment encourages the prelicensure student to develop a patient-centered focus when caring for those with mental illness as they are able to hear the stories of real individuals and their health care experiences in dealing with mental illness. Additionally. this promotes teamwork and collaboration as the student is encouraged to maintain focus on the patient being a key member of the health care team. Directions for use: The A Virtual Encounter with Mental Illness reflective assignment is typically assigned for individual clinical credit. The assignment is made at beginning of the mental health/illness course with a specified due date. Students are instructed to follow the directions as written which includes viewing all of the assigned TED Talks for “The Struggle of Mental Health” and one additional video “Amy’s Mental Health Recovery Story.” As the student watches each of the videos, they are to take brief notes on key points or their major “take-aways.” They are asked to consider their role as a nurse, supporting their point with credible evidence. Additionally, they are to self-identify their most significant barrier in relating to or dealing with patients with mental illness. There are instructions for the written report that follows APA format. Rather than a written report, this could be adapted to a small group discussion. Submitted Materials: 271.-A-Virtual-Encounter-with-Mental-Illness-Assignment-TED-Talk-rev.-1.docx - https://drive.google.com/open?id=1rlrBJiGK1QN3M7NSiT8L4SzgHuKGlinb&usp=drive_copy 271.Virtual-Encounter-with-Mental-Illness-Reflective-Assignment-Grading-Rubric.docx - https://drive.google.com/open?id=1rhRicrADMZx6yTuMDacCDtleTOrsnkBL&usp=drive_copy Additional Materials: Evaluation Description: Students often express anxiety or fear of psychiatric clinical experiences. Focusing on real people with real illnesses aids in removing the stigma of mental illness, even in a virtual setting. Evaluation of student performance on the reflective assignment offers insight as to the student’s ability to understand the key points of mental illness while evaluating their insight as to their role as the nurse. This method of formative evaluation will allow the instructor the opportunity to correct any misconceptions and/or encourage additional opportunities for professional growth focusing on the needs of the patient in all aspects of care.

Published Back to Strategy Search Strategy Submission Information Literacy in Nursing Author: Paula Jarzemsky MS, RN Title: Clinical Professor Coauthors: Cassie Voge, MSN, RN Tim Piatt, Information Processing Consultant Institution: University of Wisconsin-Madison Email: pajarzem@wisc.edu Competency Categories: Evidence-Based Practice, Informatics Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN Learner Setting(s): Clinical Setting Strategy Type: Online or Web-based Modules Learning Objectives: Appreciate the importance of regularly reading relevant professional journals Value the concept of EBP as integral to determining best clinical practice Describe reliable sources for locating evidence reports and clinical practice guidelines Read original research and evidence reports related to area of practice Use high quality electronic sources of healthcare information Strategy Overview: When surveyed about how they sought information needed for clinical practice, our students indicated a preference for using internet sources (such as Google) over bibliographic databases such as CINAHL or PubMed. In contrast, our library instruction emphasized how to search the latter sources. Based on this data, we developed an online tutorial that incorporated a wider variety of information sources. In addition to traditional bibliographic databases, the new online tutorial explained how to search for clinically relevant information using reference textbooks and personal digital assistants (PDAs), along with health portals such as Medline Plus and decision support tools such as UptoDate. Tips for assessing the credibility of information from popular open sources such as Google and Wikipedia were also included. This activity was intended to help students locate and evaluate information, in preparation for clinical. Independent study of an online tutorial was assigned by first-semester clinical instructors, each working with a group of 8 students. After completing the tutorial, each student searched one of the sources mentioned above, using a term that was relevant to his/her particular clinical setting (provided by instructor), and then described their search results using parameters defined in the tutorial (see Word attachment). Submitted Materials: 91.Assignment_Ideas_for_Information_Literacy_Tutorial.2.doc - https://drive.google.com/open?id=1YFTvxXzLZd9eH0F9LB_lEiFdFbDR1zmY&usp=drive_copy Additional Materials: http://academic.son.wisc.edu/courses/n219/info_lit/info_lit.htm Note: you may use this link to view the online tutorial Evaluation Description: Informal student/faculty feedback on the tutorial and assignment has been positive. Students seem to be citing from a wider variety of sources. Plans are in place to survey students about their information-seeking patterns at the end of this semester. Note: you may use this link to view the online tutorial http://academic.son.wisc.edu/courses/n219/info_lit/info_lit.htm

Published Back to Strategy Search Strategy Submission “Building a Quality House” Using an Interdependent QSEN Competency Model Author: Ann Hook RN, MSN Title: Nursing Lecturer Coauthors: Pam Dunagan, RN, PhD Institution: Berry College Email: ahook@berry.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): Classroom, Clinical Setting, Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: Following implementation of the teaching strategy, students will be able to: 1. Identify clinical issues/situations surrounding each individual QSEN competency within the clinical practice setting. 2. Demonstrate knowledge of the interdependency of competencies as revealed in the Interdependent QSEN Competency Model. 3. Value the interdependency of the QSEN competencies and how each competency influences the other competencies in the pursuit of safe, quality outcomes. 4. Apply the Interdependent QSEN Competency Model to clinical problem solving when striving for safe, quality outcomes. Strategy Overview: Integrating the Quality and Safety for Education of Nursing (QSEN) competencies as individual concepts or “silos” of knowledge into existing nursing curricula limits the student’s ability to apply the concepts in clinical decision making. Nursing academia is obligated to instill knowledge, skills, and attitudes in clinical decision making that promote a culture of safety and quality outcomes (IOM, 2003; QSEN, 2012). The Institute of Medicine (2003) suggested an interdependent relationship between competencies for the clinical education of healthcare professionals. It is believed that the competencies are not relevant to the students unless they see a use for them in clinical decision-making. Illustrating the interdependency of the competencies through practical clinical application encourages the need for and use of all the competencies throughout the decision-making process. Using the theories of Problem-based Learning (Savery & Duffy, 1995) and Mezirow’s (1995) Transformative Learning Theory, an Interdependent QSEN Competency Model was developed (Hook & Dunagan, 2013). The “Quality House” model illustrates Safety and Quality Improvement as overarching or “roof” competencies supported by the “pillars”: Patient-centered Care, Teamwork and Collaboration, Evidence-based Practice, and Informatics. The nurse at the bedside acts as the “foundation” and “general contractor” of the house. Each component of the house is interdependent and structurally sound only when all parts are equally valued and maintained. A holistic and interdependent view of the competencies is promoted with continual and early application of the model to theory, clinical problem solving, and simulated laboratory experiences. One way to apply the interdependent QSEN competency model is using the following strategy in the clinical setting or simulation laboratory. An innovative teaching strategy which integrates interdependent QSEN competencies has been developed to prepare nursing students to actively participate as collaborative partners in a transforming health care system. After learning about the Interdependent QSEN Competency Model in the classroom, faculty will implement a teaching strategy in the clinical setting which applies real life healthcare problems to the model. In addition to their patient care assignments, each student will be assigned one of the six QSEN competencies. Students will be instructed to identify issues/situations illustrating use or lack of use of a specific competency in the clinical setting for the day. In post conference, faculty will ask students to share their findings with the group. Faculty will guide discussion with the students to aid them in identifying how an issue with one competency is affected by other competencies. For example, one student may be asked to identify issues/situations surrounding Team-Work and Collaboration. Faculty will assist the student in identifying how an issue with Team-Work and Collaboration may compromise Safety and Quality Improvement; as well as how Informatics and Patient-Centered Care could be a part of the solution. Changing healthcare systems demand that nurses participate in collaborative partnerships to promote safe, quality care. Within these collaborative partnerships, bedside nurses must be comfortable advocating for a culture of safety and quality (Rutherford, Lee, & Greiner, 2004; Rutherford, Phillips, Coughlan, Lee, Moen, Peck, & Taylor, 2008). To support competencies of safety and quality improvement, students should continually assess for factors that increase patient risk and be willing and able to assume a nursing identity that demonstrates efforts to promote quality outcomes (IOM, 2011). A culture of safety and quality is dependent on the nurse’s ability to apply knowledge, skills, and attitudes associated with each competency both separately and interdependently to clinical problem solving. Submitted Materials: Additional Materials: Evaluation Description: The student’s ability to identify a clinical issue/situation surrounding a competency indicates knowledge about the individual competency and its value to clinical practice. Evaluation of the student’s ability to meet each individual competency is also accomplished through the clinical evaluation tools (QSEN, 2013). Following this teaching strategy, learning related to the competency’s interdependency will be assessed in post conference by the faculty. Learning is realized when the nursing student is able to identify interdependent relationships among the competencies when problem solving in the clinical setting. No current researched evaluation method exists to assess students for knowledge about the interdependency of the competencies in the clinical setting. Prior to the development of the model, clinical instructors have determined a lack of student insight into clinical reasoning using QSEN competencies in an interdependent manner. Students had limited ability to see the relationship between the competencies when applied to real life clinical problem solving. It was observed that student insight was enhanced when current quality improvement projects in the clinical setting were used to demonstrate the interdependency of the competencies. In order for students to appreciate the interdependency of the model, they must first value the professional nurse’s foundational role and contributions to the quality improvement process. Research is needed to explore the benefits of teaching students to value the competencies, their interdependent relationship, and their contribution to safe, quality outcomes.

Published Back to Strategy Search Strategy Submission Student Innovator Award Author: Sharen Ziska MSN, RN Title: Nursing Instructor I Coauthors: Darla Mack, MSN, RN, Nursing Instructor I Elaine Patalski, CRNP, MSN, Nursing Instructor II Institution: University of Pittsburgh Medical Center (UPMC) Shadyside School of Nursing Email: ziskasa@upmc.edu Competency Categories: Quality Improvement Learner Level(s): Pre-Licensure ADN/Diploma Learner Setting(s): Classroom, Clinical Setting Strategy Type: Case Studies Learning Objectives: Learning objectives Students will: Demonstrate a comprehensive understanding of rapid-cycle improvement concepts Identify clinical implications for improving safety and quality of patient care Implement work redesign initiatives for improving patient safety in the practice environment Function as a change agent while working within an active quality collaborative Practice leadership behaviors that strengthen teamwork and promote patient safety QSEN Quality Improvement KSA’s: K = Describe approaches for changing process of care. S = Design a small test of change in daily work (using an experiential learning method such as Plan-Do-Check-Act) S = Use measures to evaluate the effect of change A = Appreciate the value of what individuals and team can do to improve care Strategy Overview: A student innovator award was developed to recognize the professional role transition student who demonstrated a commitment to improving the quality and safety of patient care by showing outstanding initiative and leadership qualities in the development and evaluation of a test of change project. The award was modeled after the nationally recognized Josie King Patient Safety Award and provides a foundation for professional development. TCAB rapid-cycle quality improvement concepts have been integrated into classroom and clinical educational methods during this senior-level course. Classroom instruction consists of a brainstorming session designed to help the students identify clinical implications for improving safety and quality of patient care. Students are then instructed on the PDSA rapid-cycle improvement concepts to create work redesign initiatives for improving patient safety in the practice environment. During clinical application, students function as change agents as they collaborate with nursing and inter-professional teams to implement and evaluate their identified test of change project. The students perform a poster presentation of their test of change projects to the class as a course requirement. At the completion of the class presentations, faculty nominate students for the student innovator award based on specific process improvement criteria. The student nominees are then required to present their test of change projects to a selection committee consisting of two nurse mangers from TCAB designated units, one improvement specialist, and two professional role transitions course coordinators. The winner is chosen based on specific process improvement criteria, collaboration and sustainability of test of change and is presented with an award during the graduation ceremony. Submitted Materials: QSEN_Upload__Student_Innovator_Award.pdf - https://drive.google.com/open?id=1VdE9NQpNjwEkvInRT3tXq6MtADYWimHk&usp=drive_copy Additional Materials: Evaluation Description: Since January 2007, there have been 221 graduate nurses exposed to the TCAB process improvement methodologies, completing 91 improvement projects on 35 nursing units in 7 different system hospitals. With the introduction of a student innovator award in June 2008 faculty have documented a significant improvement in the quality of improvement projects, level of student commitment and a greater impact on improving patient care. Students have demonstrated a more comprehensive understanding of process improvement principles with the ability to carry these concepts into their professional practice. The nurse managers and improvement specialist who participated on the selection committee were impressed by the students’ passion for creating a safer environment for patients and plan to implement the student project ideas on their own units.