Using the Institute of Medicine (2003) competencies for nursing, QSEN faculty have defined pre-licensure and graduate quality and safety competencies for nursing and proposed targets for the knowledge, skills, and attitudes to be developed in nursing pre-licensure programs for each competency. Competencies Using the Institute of Medicine (2003) competencies for nursing, QSEN faculty have defined pre-licensure and graduate quality and safety competencies for nursing and proposed targets for the knowledge, skills, and attitudes to be developed in nursing pre-licensure programs for each competency. Patient-Centered Care Teamwork & Collaboration Evidence-Based Practice Quality Improvement Safety Informatics Led by a national advisory board and distinguished faculty, QSEN pursues strategies to build will and develop effective teaching approaches to assure that future graduates develop competencies in patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. Acknowledgments The QSEN Institute gratefully acknowledges the following QSEN faculty and Advisory Board members for their contributions to the development of the competency definitions and KSAs: Paul Batalden , MD, (Dartmouth) Geraldine Bednash, PhD, RN, FAAN, (American Association of Colleges of Nursing) Jean Blackwell, MLS (UNC-Chapel Hill) Linda Cronenwett, PhD, RN, FAAN (UNC Chapel Hill) Lisa Day, PhD, RN (UC-San Francisco) Karen Drenkard, PhD, RN, CNAA, (Inova Health System) Carol Durham , EdD(c), MSN, RN, (UNC-Chapel Hill) Leslie Hall, MD (U Missouri-Columbia) Pamela Ironside, PhD, RN, FAAN, (Indiana University) Jean Johnson, PhD, RN, FAAN (George Washington University) Mary (Polly) Johnson , MSN, RN, FAAN (NC Board of Nursing) Maryjoan Ladden, PhD, RN, (Harvard) Shirley Moore, PhD, RN, FAAN, (Case Western Reserve University) Audrey Nelson , PhD, RN, FAAN (Veterans Administration-Tampa) Gwen Sherwood, PhD, RN, FAAN (UNC Chapel Hill) Elaine Smith , EdD(c), MBA, MSN, RN, CNAA (UNC-Chapel Hill) M. Elaine Tagliareni, EdD, RN (Community College of Philadelphia) The QSEN Institute gratefully acknowledges the following for their contributions to the Spanish translation of the competency definitions: Nilda Peragallo-Montano, Dean, School of Nursing (UNC-Chapel Hill) Claudia Giraldo , Bilingual Executive Assistant to the Dean, School of Nursing (UNC-Chapel Hill) QS EN Competencies translated in Spanish QSEN Competencias de Pre-Licenciatura, Perspectiva de Enfermería, mayo-junio de 2007 y Translation provided by Claudia S. Lizcano Giraldo, Translator, UNC Chapel Hill School of Nursing Rea d More QSEN Competencies translated in Portuguese Competências para o ensino sobre qualidade e segurança em enfermagem (Competências QSEN) Translation provided by Juliana Santana de Freitas Read More QSEN SES translated in Portuguese Instrumento de avaliação do estudante quanto ao ensino sobre qualidade e segurança em enfermagem (QSEN SES BR) Translation provided by Juliana Santana de Freitas Read More The QSEN Institute gratefully acknowledges the following for their contributions to the Turkish translation of the competency definitions: Dr. Öğr. Üye. Merve TARHAN , Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü Merve TARHAN , Asst. Prof., Health Sciences Faculty, Department of Nursing QS EN Competencies translated in Turkish Translation provided by Dr. Öğr. Üye. Merve TARHAN Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü Merve TARHAN, Asst. Prof. Health Sciences Faculty, Department of Nursing Rea d More

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A variety of methods that can be used to contact the QSEN Institute. QSEN Awards Linda Cronenwett QSEN Leadership Award ABOUT THE AWARD This award is named in honor of Linda Cronenwett PhD, RN, FAAN, for her dedicated contributions to quality and safety education in the nursing community. Dr. Cronenwett was one of the founders of the Quality and Safety Education for Nurses (QSEN) initiative and served as the Principal Investigator on the Robert Wood Johnson grant that supported QSEN. For more information Jane Barnsteiner & Joanne Disch QSEN Innovation Award ABOUT THE AWARD This award is named in honor of Jane Barnsteiner, PhD, RN, FAAN and Joanne Disch PhD, RN, FAAN, for their dedicated contributions to Quality and Safety Education for Nurses (QSEN). As two of the founders of the QSEN project, Dr. Barnsteiner, a nurse educator and practitioner, and Dr. Disch, a clinical leader continue to inspire the spirit of innovation for improving healthcare across academic and clinical institutions. For more information QSEN Research Award PURPOSE The QSEN Research Award recognizes an emerging nurse researcher who has significantly contributed to the body of knowledge for quality and safety education for nurses through continued and sustained exploration to increase understanding and implementation of quality and safety competency in professional nursing. For more information QSEN International Forum Poster Awards PURPOSE The purpose of the 2020 QSEN International Forum Poster Awards is to recognize excellence in disseminating the QSEN competencies in both academic and practice settings. FOR MORE INFORMATION Christa Koffel Scholarship PURPOSE The QSEN Academic-Clinical Partnership Award honors a nurse who embodies academic and clinical leadership to improve quality and safety. FOR MORE INFORMATION CONTACT INFORMATION For further information or to make a contribution to fund this award, please contact qsen.institute@gmail.com .

Published Back to Strategy Search Strategy Submission Schizophrenia Unfolding Case Study Author: Amanda Eymard, Co-Author: Linda Manfrin-Ledet Title: Associate Professor Coauthors: Institution: Nicholls State University College of Nursing and Allied Health Email: amanda.eymard@nicholls.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 Strategy Type: Independent Study Learning Objectives: This unfolding case study was designed to provide opportunities for nursing students to make decisions regarding a patient diagnosed with schizophrenia. There are KSA safety questions, teamwork questions (especially involving the use of SBAR), medication questions (including safety), a math problem, a video to illustrate schizophrenia, quality improvement questions, and also theory bursts are included. Strategy Overview: The strategy is an unfolding case study involving a man diagnosed with schizophrenia. It begins with him encountering the police and evolves as he is transported to the emergency department and then to a psychiatric facility, and ends with his discharge. His family is involved in the patient-centered care scenario. Restraints, medication use, delegation, teamwork, communication, reflection, assessment, and laboratory/diagnostics are all included. It is designed to be an interactive, engaging exercise with students enrolled in a mental health nursing course. Questions and scenarios are posed, and then the next slide provides the answers. Theory bursts are also included. Submitted Materials: Schizophrenia-Unfolding-Case-Study_2.ppt - https://drive.google.com/open?id=1-xNAUmNfVJmD3Zwv7nZ44oXcYhd53i0i&usp=drive_copy Atypical-Antipsychotics-and-Metabolic-article.pdf - https://drive.google.com/open?id=1tshbJ4ljXk9TdySiRsw2xlqb-O3Tx5Oo&usp=drive_copy Emyard-246-TS-final-approved.pdf - https://drive.google.com/open?id=1dHs32ZW2Jo_mRRNrZ-dFVgDosO1Ua6fu&usp=drive_copy Additional Materials: Evaluation Description: This unfolding case study is presented in the classroom to senior-level nursing students enrolled in a mental health nursing course. The students are encouraged to participate by answering questions and collaborating regarding their answers. The students responded this semester with much enthusiasm; they were very engaged. They initially struggled with the SBAR activities when asked to notify a physician or other team member. This activity has been identified as a weakness in many new grads and was included in the case study for this very reason. As the case study progressed, the students became more confident with making the phone calls.

Published Back to Strategy Search Strategy Submission “Elder” Centered Care: Flipping the concept map Author: Kimberly Silver Dunker DNP, RN Title: Assistant Professor of Nursing Coauthors: Institution: UMASS Graduate School of Nursing Worcester Email: kimberly.silver@umassmed.edu Competency Categories: Patient-Centered Care Learner Level(s): Graduate Students, Pre-Licensure ADN/Diploma Learner Setting(s): Clinical Setting Strategy Type: General Strategy Learning Objectives: Upon completion of this activity the students will be able to: Identify an elderly client in clinical (who is 65 years or older, has poly-pharmacy, dementia or delirium, a fall, or end of life care issues) and create a patient centered plan of care. Synthesize the needs of their client to identify specific interventions to their elderly and family while at clinical. Utilize their patient centered elder plan of care to provide specific nursing care, interventions, and teaching to their client while at clinical. Strategy Overview: This clinical activity is used to teach students to create an elder centered plan of care. In preparing to understand more about elders the student will review the following learning modules (Knowledge) produced by UMMS (University of Massachusetts Medical School) Senior Patient Navigator Program ©. href="http://www.umassmed.edu/uploadedFiles/AGE/Navigator/Navigator%202013-Mod%20I.pdf">Module I: Communicating with Older Adults href="http://www.umassmed.edu/uploadedFiles/AGE/Navigator/Navigator%202013-Mod%20II.pdf">Module II: Geriatric Prescribing href="http://www.umassmed.edu/uploadedFiles/AGE/Navigator/Navigator%202013-Mod%20III.pdf">Module III: Geriatric Specialty-Specific Considerations href="http://www.umassmed.edu/uploadedFiles/AGE/Navigator/Navigator%202013-Mod%20IV.pdf" Module IV: End-of-Life Care and Considerations Quality Improvement Students will identify an elderly client (see criteria below) while at clinical. They will identify the aged related changes and the body system changes that occur (Knowledge, Skills). Older than 65 years Has a recurrent hospitalization due to chronic illness Poly-pharmacy or medication reconciliation concerns End of life care Dementia/Delirium/Alzheimer’s disease Falls Client information that is gathered will help the student to prepare a case study presentation (Knowledge, Skills). The students identify the role of the nurse and hospital team in providing elder specific care, valuing what the team identifies as specific and specialized needs for elderly clients within the acute care environment. (Attitudes) Utilizing a standard concept map format the student will create a geriatric focused plan of care including patient centered interventions and present their case to the clinical group in post conference (Knowledge, Skills). Patient Centered Care Students will gain knowledge, understanding, and value their client by learning the preferences and expressed needs of their elder, family, and community. (Knowledge, Skills, Attitudes). Students will discuss in their presentation and paper how they provided elder specific nursing care, interventions, and goals, which promoted a more patient-centered environment (Knowledge, Skills). Submitted Materials: Additional Materials: Module 1 "Communicating with Older Adults" Hyperlink: http://www.umassmed.edu/uploadedFiles/AGE/Navigator/Navigator%202013-Mod%20I.pdf Module 2 "Geriatric Prescribing" Hyperlink: http://www.umassmed.edu/uploadedFiles/AGE/Navigator/Navigator%202013-Mod%20II.pdf Module 3 "Geriatric Specialty-Specific Experiences & Considerations Hyperlink: http://www.umassmed.edu/uploadedFiles/AGE/Navigator/Navigator%202013-Mod%20III.pdf Module 4 "End of life Care & Considerations" Hyperlink: http://www.umassmed.edu/uploadedFiles/AGE/Navigator/Navigator%202013-Mod%20IV.pdf Evaluation Description: Each student presented their elder case study to the clinical group at an assigned date and time during post conference. Presentations were 15-20 minutes, 5 minutes for NCLEX question review, and 5 minutes for questions. This presentation was a PowerPoint presentation with handouts and references. The students completed a concept map (see example) including: top 3-5 nursing diagnoses, subjective & objective assessment, medications, laboratory and diagnostics, nursing interventions (actions, teaching, collaborative), goals and outcomes for the patient and evaluation of their nursing care. Above all, the care plan must have an “Elder centered care focus.” The students must focus the aspects of patient centered care of the older. The students need to ask themselves: “Did their care plan and nursing interventions make a difference in their elder patient’s outcome?” (See attached template and examples). Lastly the students included 3-5 NCLEX questions related to their cases to discuss with the group. The NCLEX questions focused on the elder care plan and nursing interventions specific to elders. A grading rubric was utilized for evaluating the concept maps. Students had to receive a 95% or greater to successfully pass this assignment. Anecdotal information: This assignment was utilized in a graduate level program with pre-licensure nursing students. The assignment is designed for an adult medical-surgical, gerontology course, or chronic care course. Prior to integrating elderly specific nursing care into the standardized care plan; the students previously developed concept maps, which only addressed standardized acute concerns. However, as many patients in the acute hospital setting have multiple concerns and elder care issues, it is evident the students must create a patient centered care to include the needs of the geriatric population. Feedback from this assignment has been positive. Students were able to learn about the elder client transforming their care to be more patient centered. This assignment reinforced geriatric concepts taught in the classroom and integrated geriatric assessment into the clinical practice environment. As a result, students reported having an increased knowledge of elder specific concerns, more skill in providing quality patient centered care, and a greater value for the geriatric population.

Published Back to Strategy Search Strategy Submission SBAR Memory Card Strategy Author: Elizabeth C. Kudzma DNSc, MPH, RNC Title: Professor, Division of Nursing Coauthors: Maureen L. Murphy Phd edM CNM, Cathleen C. Santos MSN RN, Linda M. Caldwell DNSc APRN BC Institution: Curry College Email: ekudzma@curry.edu Competency Categories: Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure BSN Learner Setting(s): Clinical Setting, Skills or Simulation Laboratories Strategy Type: Case Studies Learning Objectives: Learning Objectives (modified from QSEN): Identify effective strategies to reduce reliance on memory Initiate requests for help when appropriate to situation Develop own communication style Examine strategies to support team functioning Follow communication practices that minimize risks associated with handoffs among providers and across transitions in care Choose communication styles that minimize the risks associated with authority gradients among team members. Strategy Overview: Standardized methods of communicating between nurses, physicians and other health care givers promote patient quality and safety. Standardized communication also furthers optimal teamwork among health care providers, reduces human error, and institutes a form of high reliability system. Nurses (and nursing students) should use standardized methods to share what is important about a patient. Nursing students need to be introduced to specialized communication methods early in their nursing program. Standardized communication improves efficiency because patient information can be discussed in a concise, complete and fairly rapid manner. SBAR stands for Situation, Background, Assessment and Recommendation. Standardized communication bridges the gap in hand-off communication during changes in shift, patient transfers, and when changes in patient status occur. The Joint Commission on Accreditation of Hospitals has added a statement to Goal 2 in the Patient Safety Goals (2007) that states “implement a standardized approach to hand-off communications, including an opportunity to ask and respond to questions”. Patient transfers and hand-offs are areas of communication/teamwork where less than adequate communication has led to preventable harm to patients. The Institute for Healthcare Improvement has an extensive web site (http://www.ihi.org/IHI/Topics/PatientSafety/SafetyGeneral/Tools/) which contains Techniques for SBAR Communication, Sample SBAR Communication Tools, SBAR Toolkit, and Safety Briefings (an IHI tool). There are case studies and patient scenarios which can be adopted to practice SBAR with students. The memory cards which we created for student use include SBAR, rights of medication administration and an edited form of rapid response team patient status triggers. At present we begin distribution of the cards in the second semester clinical courses. There is also media for the students to view which illustrates the use of SBAR. The cards have been fashioned for the students as neck tags on breakaway cords, but they can also be prepared as pocket cards. Lanyards with school/ college identification can be used. Many of our collaborating clinical agencies use similar neck tags and pocket cards for graduates and resident physicians. Students will be educated to use the cards to report off, during the clinical day when changes in status are noted, and at every opportunity where concise communication is needed with team members. Submitted Materials: Additional Materials: Evaluation Description: The strategy is discussed in class when the cards are distributed. Students like the neck tag format and the similarity to tags worn by graduate nurses. Students ask many questions about the use of standardized communication, when it is appropriate, and how to use it when there is a change in patient status and in reporting off. The use of the cards emphasizes the importance of concise communication and planning (along with documentation) during “hand-offs” in patient care. The student is required to focus the information they communicate to others and to include all relevant facts which could lead to clinical recommendations. Faculty in various nursing courses have added their comments and modified the information placed on the cards. In the senior clinical practicum, nursing students prior to graduation have the experience of discussing discharge plans with physicians and more opportunities to use the cards. Clinical experiences where the students have used the memory cards in post conferences form a focus for discussion. Test questions, both multiple choice and essay, can be constructed around the use of SBAR in specific clinical scenarios.

Published Back to Strategy Search Strategy Submission Nurturing Affective Development and Reflective Thought: Two Immersive COVID-19 Themed, Instructor-led Scenarios Author: David Foley PhD, MSN, RN-BC, CNE, MPA Title: Research Associate Coauthors: Susan Painter, DNP, PMHNP, PMHCNS, BC Institution: Case Western Reserve University Frances Payne Bolton School of Nursing Email: dmf106@case.edu Competency Categories: Informatics, Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration Learner Level(s): Advanced Practice Providers, 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, Clinical Setting Strategy Type: General Strategy Learning Objectives: As a reflective exercise, this scenario thus promotes affective development by immersing learners in a low-incidence/high-risk clinical scenario involving the discovery of a COVID-19 positive patient in a ‘low risk’ care setting. Three key QSEN Competencies (Patient-Centered Care, Teamwork and Collaboration, Safety) provide the framework for effective development through reflective thought and discussion: 1. Through reflective thought and discussion, the learner will affirm the importance of patient-centered care for patients and caregivers during the COVID-19 pandemic. 2. Through reflective thought and discussion, the learner will identify opportunities to enhance effective teamwork/collaboration within a stressful COVID-19 patient care scenario. 3. Through reflective thought and discussion, the learner will identify patient and caregiver safety as a top priority in COVID-19 related patient care scenarios. Strategy Overview: Pre-licensure education is a complex process that involves the acquisition of knowledge, psychomotor skill, and affective ability within the didactic classroom nursing skills lab, and clinical settings, respectively. Although students often clearly recall efforts to assist them with gaining knowledge and skills through classroom exercises and lab ‘test-outs’, they may be less aware of efforts to promote growth within the more nebulous affective domain. Many educators may adhere to tried-and-true pedagogy that focuses on knowledge acquisition and psychomotor expertise, especially since they themselves were not encouraged to utilize reflective thinking as a cognitive analytical tool. The QSEN competencies provide an ideal framework to promote opportunities for effective development through reflection. In the case of this scenario, the lead characters perform in a competent manner as they provide appropriate care for an unexpectedly COVID19 positive patient. Despite the circumstances and their varied reactions, they strive for Safety, as they utilize Teamwork and Collaboration to provide effective Patient-Centered Care. In short, most nurses bring effective knowledge and skill to the workplace but in today’s ‘COVID-19’ workplace, much emphasis has been placed on the only implementation of safety and infection control protocols and psychomotor skills. This scenario focuses more on reflective thought as to the emotional impact of the stress caused by COVID-19 on nurses and their patients. As tips for educators, the mechanics of this unit thus provide opportunities for affective development within the framework of three key QSEN competencies that: o Learners have the opportunity to read the actions and thoughts/perceptions of two registered nurses presented in hour-by-hour increments within an 8-hour shift. o Reflective questions are strategically inserted following key events and are intended to be discussed—with corresponding instructor/peer feedback—in a synchronous manner. o Whether in the classroom or clinical setting, learners should be granted no prior access to the scenario but given approximately one-half hour to read it independently, with peer interaction followed by instructor-facilitated discussion immediately following. o A written Reflective Journal assignment follows the exercise’s conclusion and should be prepared and submitted to the instructor prior to the next classroom/clinical, or staff development session. The Reflective Journal is completed asynchronously and thus gives students a more discrete format to present the thoughts they might not have felt comfortable sharing in a public forum. Submitted Materials: QSEN-TS-288-with-additional-material.docx - https://drive.google.com/open?id=15LXi5xvhJlC-epZFxDcDD-4C5vfLEEtH&usp=drive_copy QSEN-TS-288-1.docx - https://drive.google.com/open?id=15T6BJ58GEW69gVKCOJ3QUL_EfYTtRaw6&usp=drive_copy Additional Materials: Inpatient Unit COVID-19 Isolation Protocol Reflective Journal Format Critical Reflection Journal Template Oops! My Bad….He’s Positive! Case study Nursing Self-Help Mental Health Screening and Wellness Toolkit (teaching aid) Evaluation Description: 1. Written instructor feedback to evidence of affective development in Reflective Journal questions, each of which is tied to a learning objective/QSEN competency. 2. Student to peer and instructor-peer verbal feedback regarding evidence of affective development as tied to learning objectives/QSEN competencies in classroom sessions, clinical pre- or post-conference discussion, staff development, or any other group as facilitated by a nurse educator.

Published Back to Strategy Search Strategy Submission SOAP Note Assignments to Demonstrate FNP Independent Practice Readiness Author: Jodi Allen DNP, FNP-C Title: FNP Program Coordinator/Assistant Professor Coauthors: Institution: Purdue University Northwest Email: jgallen@pnw.edu Competency Categories: Evidence-Based Practice, Patient-Centered Care Learner Level(s): Graduate Students Learner Setting(s): Clinical Setting Strategy Type: Learning Objectives: Describe evidence-based practice to include the components of research evidence, clinical expertise, and patient/family values. (Knowledge) Role model clinical decision making based on evidence, clinical expertise and patient/family preferences. (Skills) Value the need for continuous improvement in clinical practice based on new knowledge. (Attitudes) Strategy Overview: Family Nurse Practitioner (FNP) students need to be proficient in assessment of patients and identification and management of the most common primary care acute and chronic disease processes. Competency based education requires demonstration of student ability to practice independently, managing previously diagnosed and undiagnosed patients within the full spectrum of health care services. Structured SOAP note assignments that require FNP students to address the most common primary care diagnoses were created for each of their practicum courses. FNP student’s initial practicum and SOAP notes focus on health promotion/disease prevention. The second practicum and SOAP notes focuses on clinical management of the young family (including women’s health), while the third practicum and SOAP notes focus on clinical management of the aging family. The final clinical synthesis and SOAP notes focus on the culmination of all other clinical experiences, including complex, co-morbid conditions and collaborative needs of the patient. Instructors, all seasoned nurse practitioners, provide feedback to ensure continued improvement in clinical application of evidence-based practice. Submitted Materials: 254.1FNP-SOAP-Note-Topic-List-All-Clinical-SemestersFinal.docx - https://drive.google.com/open?id=1qub_8M3p4f0wOGeBYl683TXUeKOyue1g&usp=drive_copy QSEN-254.0-SOAP-Strategy-SubmissionFinal-.docx - https://drive.google.com/open?id=12-lN24Lm4KGJk55NPVFlWJRQ1vWgXbB3&usp=drive_copy QSEN-254.2-Semester-Four-SOAP-Grading-RubricFinal.docx - https://drive.google.com/open?id=127pkYgBoNcS_AqgKajgYIWXCz_GOIlcy&usp=drive_copy QSEN-254.4-Semester-Three-SOAP-Gradeing-RubricFinal-.docx - https://drive.google.com/open?id=127qwflL2sDUHdOCvCvMRTzQQasjqI3pi&usp=drive_copy Additional Materials: The list of required SOAP notes and each practicum grading rubric is attached. Evaluation Description: FNP students are evaluated using a rubric specific to the structured SOAP note assignment and equivalent to their level of learning within the FNP program. The rubrics level up with each new clinical experience, culminating in their final clinical synthesis.

Published Back to Strategy Search Strategy Submission Student Officer of Patient Safety (SOS) Author: Marie Everhart MSN, RN, CNE Title: Assistant Professor of Nursing Coauthors: Institution: Northampton Community College Email: meverhart@northampton.edu Competency Categories: Safety, Teamwork and Collaboration Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Clinical Setting Strategy Type: Case Studies Learning Objectives: The student will: (S) Demonstrate the effective use of technology and standardized practices that support safety and quality. (S) Communicate observations or concerns related to hazards and errors to patients, families and the healthcare team. (A) Value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the healthcare team. Strategy Overview: Objective : The objective of this assignment is for the student nurse to gain awareness of the continuous need for playing an active role in patient safety and participate in a leadership role to promote patient safety on the clinical unit through the utilization of informatics, collaboration with team members, communication skills and appropriate delegation of tasks. Assignment : Each student will have an opportunity to serve as the SOS. The SOS will obtain a report on all patients assigned to student nurses in their clinical group. The SOS will utilize informatics (electronic medical records & medication profile) and research all patients assigned to the clinical group. After obtaining report from the assigned student and the student’s research of the electronic medical record and medication profile, the SOS will determine the need for all color coded safety bracelets, obtain a fall risk assessment and IV therapy for all patients assigned. The SOS will meet with all assigned patients, assess their knowledge of colored coded bracelets, verify the placement of the appropriate color coded bracelet, assess IV sites, and perform an environment assessment for patient safety and available interventions based on the documented fall assessment. If a discrepancy occurs, the SOS will utilize appropriate communication skills and verify the information with the primary nurse. The SOS will then delegate the task required to the student nurse caring for the patient to rectify the situation. The SOS will follow-up on the delegated task within 20 minutes. If the task was not completed by the student, the SOS will complete the task and then a conference will occur to review the situation between the student, SOS and clinical faculty. If the SOS determines that the patient is at immediate risk for injury the SOS must address the situation immediately. Documentation Required: The SOS will keep a chart listing patient initials, fall risk assessment, coded bracelets required, coded bracelets actually on patient, can the patient/significant other recite the purpose of the bracelets, delegated task required, condition of environment (call bell in reach, free of clutter, bed/chair alarms on, IV site condition), interventions and challenges experienced. The SOS is also required to document in the patients electronic medical record any teaching performed. The SOS will prepare to present their findings in post-conference. The presentation will include a reflection addressing the following: 1. Describe what you observed about gaps in patient safety. 2. What are the potential implications of the gaps observed? 3. How can nurses incorporate what you learned into their daily practice? 4. How might the student’s observations impact patient outcomes? The remaining students in the clinical group will provide feedback to the SOS on their interactions and findings. Special Note : This is a leadership experience. It is expected that all NCC nursing students practice patient safety as a priority in their nursing care. The expectation is immediately following the students initial assessment of the patient, a focus will be placed on patient safety factors. Each student is responsible to observe patient safety factors and rectify any discrepancies immediately during all clinical experiences; they include but are not limited to: fall risk assessments, Braden scores, IV therapy site condition, O2, color coded safety bracelets on as required, call bell, room clutter, spills, bed/chair alarms on, patient rounds q1h, etc…. The student should contact their clinical instructor for assistance/clarification as needed. Submitted Materials: 115.-60-SOS-Documentation.doc - https://drive.google.com/open?id=1n2JkfiPECmbp6oAtiFaSwpbE23mfGPmG&usp=drive_copy Additional Materials: The student should contact their clinical instructor for clarification or assistance as needed. Evaluation Description: The SOS will present their findings and address the following questions in post-conference Describe what you observed about gaps in patient safety. What are the potential implications of the gaps observed? How can nurses incorporate what you learned into their daily practice? How might the student’s observations impact patient outcomes? The clinical group will: Provide feedback to the SOS addressing performance, alternative actions and or interventions.

Published Back to Strategy Search Strategy Submission Clinical Conference and the One Minute Safety Check Author: Kim Amer PhD, RN Title: Associate Professor Coauthors: Institution: DePaul University Email: kamer@depaul.edu Competency Categories: Safety Learner Level(s): New Graduates/Transition to Practice Learner Setting(s): Clinical Setting Strategy Type: General Strategy Learning Objectives: Assess safety risks each time student enters a patient's room Describe prioritization of care with the one minute safety check (integrate abc's of physiologic safety) Verbalize the mental process of reviewing the critical assessment of patient's breathing, risk of falling, emergency equipment check, and immediate threats to safety Strategy Overview: Students will discuss the quality and safety check in the classroom. During the clinical experience the students will be asked to report on their findings of the one minute safety check. The most critical assessment measures will be evaluated for the appropriate prioritization. The instructor will accompany the student in the room to discuss whether the safety assessment was appropriately done. Submitted Materials: Safety-one-minute-check-sheet.doc - https://drive.google.com/open?id=1pom9BkTfYIQjzu6Qf5b3ohNVZoInvrsf&usp=drive_copy Additional Materials: Evaluation Description: Clinical evaluation instruments have been revised to include the 1 minute safety check. The students should be able to talk through their priority assessment including: 1. assessment of airway, work of breathing, and circulation 2. knowledge of emergency equipment including airway, ambu bag, oxygen, weight and age of patient, risk of falling, name bracelet on, and environmental assessment of risk such as water on floor. 3. Integration of the "all at once" ability to talk with the patient, deliver quality care, and also observe for safety issues in the environment. Publication Date

Published Back to Strategy Search Strategy Submission Safe Patient Handling and Movement Curriculum Author: Carol F. Durham Ed.D.(c.), RN Title: Director Clinical Education & Resource Center and Clinical Associate Professor Coauthors: Audrey Nelson, PhD, RN, FAAN, Director, VA Patient Safety Research Center, Tampa, FL, USA Nancy N. Menzel, PhD, RN, Associate Professor, School of Nursing University of Nevada Las Vegas, La Institution: UNC-Chapel Hill School of Nursing Email: Carol_Durham@unc.edu Competency Categories: Evidence-Based Practice, Safety Learner Level(s): Pre-Licensure BSN Learner Setting(s): Skills or Simulation Laboratories Strategy Type: General Strategy Learning Objectives: The teaching strategy is designed to evaluate the following Evidence-based Practice KSAs: Knowledge: Discriminate between valid and invalid reasons for modifying clinical practice based on clinical expertise or patient/family preferences. Attitude: Acknowledge own limitations in knowledge and clinical expertise before determining when to deviate from best clinical practices. Skill: Consult with clinical experts to decide when to deviate from best clinical practices. The teaching strategy is designed to evaluate the following Safety KSAs: Knowledge: Discuss potential and actual impact of national patient safety resources, initiatives and regulations. Attitude: Value relationship between national safety campaigns and implementation in local practices and practice settings. Skill: Use available resources such as VISN 8 Patient Safety Center for professional development and to focus attention on assuring safe practice. Strategy Overview: As part of ANA’s Handle with Care campaign, the School of Nursing at The University of North Carolina at Chapel Hill was chosen as one of 26 schools in the United States to participate in a pilot project titled “Effectiveness of an Evidence-Based Curriculum Module in Nursing Schools Targeting Safe Patient Handling And Movement.” The project was developed by principal investigator Audrey Nelson, RN, PhD, FAAN, Director of the Patient Safety Research Center in Tampa, Florida, in collaboration with the American Nurses Association (ANA) and the National Institute for Occupational Safety and Health (NIOSH). UNC-Chapel Hill was the only school in North Carolina to be chosen for the project. The SPHM curriculum is designed to teach nursing students about the risks involved in manually lifting patients and to educate students on safe patient handling and movement. The new curriculum moves away from the traditional curriculum of body mechanics and manual lifting to an evidence-based curriculum that focuses on specific patient assessment and the use of algorithms to determine the safest way to lift and move each individual patient. Prior to lab, students had to do readings and watch a video on the CD-ROM, as prepared by Dr. Nancy N Menzel, RN, PhD, the University of Nevada Las Vegas School of Nursing (insert SPHM packet here). When students arrive at lab they were given a packet containing four assessment forms and the algorithms. To prepare for clinical rotations, each student practiced selecting and using each device in simulated patient care scenarios following a two-step process. First, the students assess the patient and the environment using key assessment criteria. Second, using the algorithms, the students select the appropriate equipment or assistive device to use and the number of caregivers needed to complete the task safely. Under the supervision of faculty or teaching assistants, students practice with the different types of mechanic lifting equipment. The students rotate through three rooms in groups of 8-10 students. Each have different simulated patient scenarios and types of equipment, requiring students to use critical thinking to perform their patient and environment assessment and to determine the correct algorithm to follow (insert SPHM scenarios here). The emphasis is on patient safety as well as nurse safety. Ergonomic hazards exist for nurses when handling patients and equipment. Ergonomic hazards refer to a combination of stressors or workplace conditions that may cause harm to a worker. Patient handling and movement have been recognized as the primary cause for musculoskeletal disorders among nurses. Nursing often requires lifting, transferring, and repositioning patients, and these activities have traditionally been performed manually. Other activities that can put nurses at risk include feeding, bathing, dressing and weighing patients. Long-term, continuous manual performance of these nursing tasks causes undue strain and leads to injury. The physical environment in health care, such as room design and size and the placement of furniture and equipment, also contributes to musculoskeletal injuries (ANA, 2003). The development of patient handling equipment has made manual lifting essentially unnecessary in nursing. Safe patient handling equipment ranges from high dependency devices such as floor and ceiling mounted sling lifts, stand-assist lifts, transfer chairs, and lateral transfer devices, to lower-tech equipment such as friction reducing devices (ie. sliding sheets and transfer boards) and gait belts. A growing number of health care facilities have made SPHM programs a priority in their organization and have seen positive results in the reduction of injuries among nurses. The use of this equipment also has a positive impact on patient outcomes. Patient safety is improved because falls and skin tears are reduced, as these devices provide a more secure means of lifting, transferring, and repositioning patients. Activities such as toileting and skin care are also made easier with the use of these devices. The comfort and dignity of patients are drastically improved when using safe patient handling devices as opposed to manual lifting (ANA, 2003) The Safe Patient Handling and Movement training presentation can be downloaded at the NIOSH Web site: http://www.cdc.gov/niosh/docs/2009-127/ The Safe Patient Handling and Movement algorithms, didactic materials, and quiz can be downloaded at the Veterans Affairs Patient Safety Center of Inquiry Web site: http://www.visn8.va.gov/visn8/patientsafetycenter/safePtHandling/default.asp The NIOSH Contact Person: Dr. Thomas R. Waters, DART, Cincinnati, OH, twaters@cdc.gov Bringing about culture change is energizing as well as challenging. It is important for us who are the “walking wounded” to protect our beginning nurses from injuries. To ignore the strong evidence is negligent. Submitted Materials: Additional Materials: If you have questions about implementing this curricular change please contact Carol Durham, Director, Clinical Education & Resource Center at Carol_Durham@unc.edu and be CERTAIN to list in the subject line QSEN teaching otherwise the request may not be received. Evaluation Description: The pilot program was carried out fall semester 2005 with 177 undergraduate students. We continue to teach the evidenced-based curriculum. Quantitative evaluation of the curriculum implementation is forth coming.

Published Back to Strategy Search Strategy Submission Post-Clinical Conference Bedside Reporting: Utilizing Priority Frameworks with Patient Assignments Author: Heidi Benavides MSN, RN Title: Clinical Assistant Professor Coauthors: Institution: University of Texas Health Science Center San Antonio Email: benavidesh@uthscsa.edu Competency Categories: Teamwork and Collaboration Learner Level(s): Pre-Licensure ADN/Diploma, Pre-Licensure BSN Learner Setting(s): Clinical Setting Strategy Type: General Strategy Learning Objectives: 1.Demonstrate effective bedside reporting. 2.Acknowledge own potential to contribute to effective team functioning. 3.Acts with integrity, consistency, and respect for differing views. 4.Follow communication practices that minimizes risks associated with handoffs among nurses. 5.Apply concepts of quality patient care and safety to improve patient care outcomes in adults with health problems. 6.Prioritize patient care assignments based on priority frameworks. Strategy Overview: A post-clinical conference activity can be implemented to promote critical reasoning with prioritizing patient assignments utilizing priority frameworks. The pre-licensure nursing student activity can be utilized at any level of the nursing program with a goal of demonstrating an effective bedside report and prioritizing patient care assignments based on priority frameworks. The QSEN competency of knowledge, skills, and attitudes is teamwork and collaboration. Students will use their knowledge of nursing and priority setting frameworks to make appropriate decisions in evaluating which patients the student would assess first, second, third, etc. Students will practice an effective bedside report within a limited time frame. Students are introduced to or reinforced on concepts of bedside reporting, priority frameworks, and a handoff report during their clinical orientation. Students are assigned and care for a patient during their clinical day and fill out a handoff report sheet. Students are informed at the beginning of their clinical they will be participating in the assignment. In post-conference, four to five students are placed in each group, with one of the students in each group being a leader. The student leader is responsible for writing down each report and coordinating the group discussion. The other students will take their assigned group to their patient’s room to give a bedside report. The student leader will time the report and give each student a total of five minutes. The students will then go to the next patient room and do the same report. The students will all return to their post-conference room and discuss the patients within their group. The discussion should be focused on which patient should be seen first, second, third, etc. by the oncoming nurse. The student responses need to be referenced with which priority frameworks were utilized. Once the decisions are made within the groups, each group will present to the whole clinical group. The assignment should take approximately 45 minutes for ten nursing students on a medical-surgical clinical course. It may take longer for students in earlier clinical courses. Students state this exercise allows them to start prioritizing patient care assignments, practicing a bedside report which helps improve patient safety, and how the discussion among the other students stimulates critical reasoning of priority frameworks. Submitted Materials: Priority-Frameworks-1.pptx - https://drive.google.com/open?id=11pr8LzppRC0LGJVd2w6tdjC82gbQRqz9&usp=drive_copy Post-Clinical-Conference-Bedside-Reporting-Faculty-Guide-2.docx - https://drive.google.com/open?id=1MPtYfQCPtxb9Nd4qitHRvyVpPcGx9tsW&usp=drive_copy Post-Clinical-Conference-Bedside-Reporting-Utilizing-Priority-Frameworks-with-Patient-Assignments.docx - https://drive.google.com/open?id=1MKXpJzt6CmGF6kjvdtaemCkeXdXnSyR4&usp=drive_copy Evaluation-Rubric-Bedside-Reporting.docx - https://drive.google.com/open?id=1HbQB7frvQFpBqsQJTJWr30Yhtqz--aWG&usp=drive_copy Teaching-Strategy-Handoff-Report-1.docx - https://drive.google.com/open?id=1Q2VtCjILbZCVbeAYTAEeasmDmSgKXIId&usp=drive_copy Additional Materials: Additional Materials Evaluation Description: This activity is evaluated through the course clinical evaluation tool. Faculty can give feedback to individual students as well as within the groups throughout the process of the activity.