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Strategy Submission

“QOO” Quality Observation Opportunity: Safely Floating a Student in Clinical


Kimberly Silver Dunker



Assistant Professor of Nursing



UMASS Graduate School of Nursing Worcester


Competency Categories:

Evidence-Based Practice, Quality Improvement, Safety

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:

After viewing this video vignette the students will be able to: Observe how a student will safely float to a “ QOO” (Quality Observation Opportunity) while in a clinical setting. Identify their own roles in communicating essential information about the observation role when floating off the clinical unit to a “ QOO” (Quality Observation Opportunity). Discuss the importance of the learning outcomes of the clinical course and how the observational experience meets required course learning objectives. Communicate their role as an observer and collaborate as a team member while away from the clinical unit and during a Quality Observational Opportunity.

Strategy Overview:

Online Video Vignette: This vignette was designed for students to discover opportunities for QOO (Quality Observation Opportunities) while in clinical and how they can leave the clinical unit for a patient observational opportunity. The vignette demonstrates to students how to clearly identify learning objectives for their clinical rotation and to link them to QOO. This vignette also provides an example of how faculty may prepare a student prior for an observational experience and the importance of linking the observation to the role of the registered nurse. Strategy Activity: Prior to beginning clinical the students with their clinical faculty will view the vignette in the nursing lab.  Then the student will discuss the clinical objectives and what the appropriate QOOs they might encounter while they are in clinical.  This discussion will help the students to identify the importance of the learning outcomes for the clinical and how the QOO might meet those objectives.  The discussion will include the role of the student while in “observation,” mode and away from the clinical unit.  This discussion will allow the faculty to clearly articulate the importance of this role and emphasizes the role of the student is observation only.  Furthermore, this activity will help faculty to coach the students to gather information while on QOO, and to bring essential information from the experience back to the post clinical/conference discussion. Safety Students understand and are able to prepare their patients for a test/diagnostics procedure/ or off the unit examination.  The students will care for their patients while off the unit.  (Knowledge/Skill) The students will be in observation mode while the patient are having their procedure/exam/test. (Knowledge, Attitudes) Teamwork/Collaboration Students will gather subjective and objective patient data, and will communicate to their faculty member the procedures that their patients are going off the unit for, what the role of the nurse is during the procedure, and nursing care during the procedure.  (Knowledge, Skills, Attitudes) Students will clearly understand their role as an observer and be able to articulate this to the nurse/physician/technician with whom they will be engaged during the observation experience. (Knowledge, Attitudes). Students will demonstrate teamwork/collaboration as a member of the patients healthcare team during the observation experience by listening and observing their patient while off the clinical unit.   Submitted Materials  1) Observation for Nursing Students  2) CVC Observation  3) Echo Obs 4) Cardiac & Pulm Rehab Obs. 5) EP Obs.  

Submitted Materials:

Evaluation Description:

This activity was used as a strategy to teach nursing students the importance of the QOO, and to help both students and faculty understand how the clinical objectives are related to the QOO.  The faculty can help the students make all QOO meaningful, while teaching the student their role to increase safety of their patient while away from the unit, and communicate their role as an observer.   The students will have clear role expectations while away from the faculty and understand the importance of articulating their role when they are on observation.  Ultimately by viewing the video vignette both the faculty and student were on the same page as to the expectations are during a QOO.   Anecdotal information: This assignment was utilized with pre-licensure nursing students.  This video taught both faculty and students how to link the course syllabus objectives with observational experiences.  It helped faculty to communicate clearly with students about the expectations while on an observational experience.  It helped the student know their expectations as a student observer while away from the clinical unit.  These clear expectations maintained good teamwork/collaboration between the academic clinical group and the clinical partner.  It also maintained a safe practice environment for the student. Secondarily, new clinical faculty also viewed this video vignette as part of their orientation to clinical.  The faculty, were able to see what the expectations were for their students who are in clinical, and how to float a student for a QOO. Feedback from both the clinical faculty and the students was positive. This activity helped increase confidence in both students and faculty in taking advantage of  opportunities in clinical, ultimately encouraging students to demonstrate greater critical thinking skills through QOO.   This exercise has bridged the clinical practice environment with theory. As a result, clinical nursing faculty have reported feeling they are competent in understanding the syllabus and the clinical objectives and outcomes.  This increased knowledge empowered both the faculty and students to incorporate QOOs while in clinical.  There was greater safety while in clinical and excellent communication when students left their units for QOO.
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