QSEN Case Western Frances Payne Bolton School of Nursing

Quality and Safety Education for Nurses

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SAFETY Bundle Simulation Day

Posted by on Feb 14, 2017 in News | 0 comments

At conclusion of junior year, students completed course theory in Nursing Foundations and Adult Health and Illness pertaining to but not limited to peri-operative nursing, SBAR communication, patient safety risks, cardiopulmonary resuscitation, and medication delivery. Students had one semester of medical surgical clinical and also completed their foundation skills competencies through-out the year in labs. Safety Bundle Day was constructed to apply a full day simulation experience in lieu of the last clinical day for the entire junior class. The purpose was to apply the culmination of content learned to clinical practice in a safe controlled environment, provide an opportunity to apply new skills in the mock code, collaborate with one another and with interdisciplinary persons. In a cost effective planning approach, faculty organized the simulation utilizing available materials in lab, and resources within the college at large, and personnel, i.e.: simulation operating room facility The activity ran multiple times through-out the day with student groups pre-assigned. 1. Operating room: Surgeon (interdisciplinary teamwork and collaboration) provided group of students’ discussion on various nursing roles in operating room, circulating nurse, scrub nurse, nurse anesthetist and/or anesthesiologist. Students scrubbed and gowned, maintaining sterility (safety and QI) Students opened sterile drapes and equipment, identified safety concerns in operating room, patient positioning, oxygenation, and fluid volume. Surgeon role play of time out procedure (QI and EBP) and discussed sutures, dressings, specimen collection, and blood loss. Students role played SBAR report to one another for recovery room transport (Communication, Safety). Recommend utilization of unique resource opportunities, facilities, and interdisciplinary care providers to enrich simulation experience and student interaction. This exercise can be basic or further developed according to available resources and learning objectives. Additional interdisciplinary roles could include medical techs, surgical techs, medical residents, physician assistants, nurse practitioners, certified nurse anesthetists, anesthesiologist, for further elaborate simulation scenario. 2. Patient Bedside Environment: Similar to “House of Horror, or “Little Room of Errors” students enter lab to find 4 patient rooms with various safety risks for patient, self, and others. One section relates to intravenous tubing, central line dressing, oxygen, and tracheostomy risks on a mannequin. Another section has basic patient safety risks related to side-rails,...

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Using Beers Criteriato Prevent Medication Related Problems in Older Adults

Posted by on Feb 6, 2017 in News |

This strategy can be used for either pre-licensure or RN to BSN students utilizing the clinical setting and either group or individual work in class, in post-clinical conference, or via online discussions or blogs. Prior to clinical, students are assigned the American Geriatric Society 2015 updated Beers Criteria for potentially inappropriate medication use for older adults link for review, the Hartford Geriatric Nursing Beers you-tube for viewing, and the ConsultGeri.org Try This Series site for regarding the Beers Criteria for reading. On the clinical day, a brief discussion can be held in pre-conference about Beers Criteria with a review of definitions for quality and strength of evidence and a brief account of methods used to analyze the evidence and to make recommendations. Students will be instructed to select an older adult patient over age 65 with 8 or more medications. In clinical, students are to record basic patient information like the client’s medical diagnoses, prescribed, routine, prn and over the counter medications as well as vitamin and mineral supplements. They will record these on the first section of the QSEN Beers Learning Strategy Form. After the clinical experience, students are instructed to complete the second section of the form requiring students to utilize the Beers Criteria to analyze the patient’s medications using the 5 tables in the Beers document to review the strength and quality of evidence, rationale, recommendations, safety concerns, risks, etc. The third part of the form includes questions about teamwork and collaboration interventions and appropriate patient centered interventions relevant for the completed evaluation of medications. This third part can be done in writing (individually or as a small group), on-line as part of a blog or discussion board or as part of a clinical post-conference session. The strategy focuses on the application of evidence to practice in the geriatric setting regarding medication safety. Attention is given to quality and safety by focusing on risk reduction and prevention of medication related problems for the older adult vulnerable population. Patient centered care is addressed with individualized interventions based upon the medication evaluation using Beers Criteria. Students are asked to formulate teamwork and collaboration strategies to address medication...

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QSEN TEACHING STRATEGY: USING AN AQUARIUM AND PUMP TO DEMONSTRATE CARDIAC FUNCTION

Posted by on Feb 6, 2017 in News |

Students were asked to troubleshoot cardiac function problems demonstrated with an aquarium and pump. The following principles were demonstrated: First, the aquarium pump is electrical. Therefore, the pump must be plugged in to receive an electrical charge. Positive cations (such as magnesium, potassium, calcium, and sodium) provide the electrical charge to the heart, which is represented by the plugging the pump into the electrical outlet. To help students retain normal laboratory values, students were taught the 2X4 Rule: representing ideal serum magnesium and potassium levels for cardiac electrical function being a serum magnesium 2 mg/dL and serum potassium 4 mEq/L. The extension cord was labeled with “K” and “MG” for demonstration. Second, the pump requires sufficient volume (preload) to produce cardiac output. This is demonstrated by adding water from a container marked preload. The pump cannot function effectively or efficiently with a volume deficit or fluid overload. This is demonstrated by either submerging the pump or lifting the pump out of the water. Third, the pump must be able to accommodate resistance (afterload) that is demonstrated by using an obstacle to obstruct outflow. Follow-up discussion addressed the effects of vasodilator and vasoconstrictor medications. Finally, the (plastic) fish do not die from lack of water, but lack of oxygen (due to low perfusion). Follow-up discussion addressed cardiac perfusion, including differences in ventilation and perfusion, which were identified as difficult concepts for the...

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Using QSEN to Get Off the Teaching Hamster Wheel

Using QSEN to Get Off the Teaching Hamster Wheel

Posted by on Jan 25, 2017 in News | 2 comments

Submitted by: Nancy Ebersole PhD, RN, Marion Frost DNP, RN and Pamela Delis PhD, RN Salem State University   The students are so excited to be going to clinical, simulation, and doing active learning projects. They have developed their own groups for studying, getting to and from clinical, etc. Life is great until they realize that they have reached the point in their academic studies where they must take their final writing course, an evidence-based practice course, in order to earn their BSN. Suddenly their enthusiasm turns to dread, and anxiety replaces their aura of confidence. We as faculty were faced with breathing new life into this writing requirement and QSEN provided the focus for identifying strategies that are presently transforming this course. A deep-dive into evidence-based practice takes place in our nursing research course. It is also the third in the required sequence of writing courses within the curriculum. Editing a paper is not met with the same enthusiasm as a clinical course and we knew we had to rethink our strategy of putting our students on this hamster wheel of writing and rewriting. We recognized that having the students work together would get them more focused on the assignments and the objective of sustained engagement in the writing process. It didn’t take long to realize that the QSEN competencies of Teamwork & Collaboration, along with Quality Improvement, would provide us with the focus to reformat this course. Teamwork and collaboration:  In keeping with the criteria for this writing intensive course we added peer reviews of each other’s writing.  This required helping the students to value not only their writing but also that of their classmates. They had to deliver their critique of someone else’s work and also figure out how to receive a critique in a way that helps them with their own writing. Additionally faculty had to collaborate with students to ensure they knew the expectations of the assignment for writing their own paper. Quality improvement: Two levels of quality improvement occurred, one at the course level, and one at the student level.  At the course level, we determined that restructuring the rubrics was in order....

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International Forum on Quality & Safety

Posted by on Dec 19, 2016 in News |

View Website  April 26-28, 2017 | London  The London 2017 program contains a number of sessions of particular interest to nurses with a focus on how a collaborative approach, involving multiprofessional teams, combined with an engaged community, can provide sustainable, patient-centered care at a reduced cost. Through the program participants will learn to identify where change needs to happen and co-produce imaginative...

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Heath Informatics and Technology: Professional Responsibilities

Posted by on Dec 14, 2016 in News | 1 comment

This learning program is a an online self-paced module created for pre-licensure ADN/Diploma/BSN nursing students. The program provides a general introduction to health informatics including the benefits of health informatics as well as the professional responsibilities related to privacy and confidentiality. In addition, the program explores the use of social health care technology/media and its potential impact on professional relationships with patients, colleagues, and employers. The program is interactive and includes links to a short video clip and professional...

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