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Quality and Safety Education for Nurses

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A Universal Template for Designing QSEN Learning Activities: Setting Expectations Using KSAs

Posted by on Oct 11, 2011 in News |

It is a goal of nursing faculty for students to integrate didactic content into the clinical setting. Taken one step farther, in her recent publication Educating Nurses: a Radical Transformation, Dr. Patricia Benner recommends moving toward “situated learning”, or learning that takes place in the same context in which it is applied. For example, a Clinical Activity Template that was developed around the QSEN competency of EBP required second semester pre-licensure students to research the CDC recommendations regarding prevention of catheter-associated UTIs, assess whether the facility was following the bundle protocol on their assigned patients, implement the bundled interventions, and debrief afterward. The faculty reported that this experience for the students has been far more enriching than simply explaining the importance of each intervention (or task) individually, as was the case prior to implementing the EBP activity. During the QSEN curriculum integration process, there is even more demand to reach the goal of creating an environment or activities in which situated learning can take place. During this time, faculty is creating new learning activities, finding pre-existing activities online, and sharing ideas with each other. The Universal Template tool was created to aid in providing consistency among faculty throughout the QSEN learning activity development process and subsequent student activity assignment process. It has gone through multiple iterations since its initial design and implementation in Spring 2010. It has also been adapted and modified for use in alternative settings, such as a Professional Partnership (preceptor) Program and New Graduate RN Program. The Universal Template tool itself provides placeholders for vital information differentiating each course, category, and activity. Clinical or course objectives may be indicated when applicable. More importantly, it provides a uniform structure, stating the faculty’s expectations in a “universal language” – the QSEN KSAs. This template also helps faculty to write more focused activities. For example, a clinical activity may help in the selection of the most appropriate KSAs, while selection of the KSAs may spark creative clinical activity ideas. Alternatively, faculty may choose to leave the “activity” box blank and require the student to show competency in that area by offering the ways in which they met the KSA...

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Preventing Catheter-Associated UTIs: Implementing a “Clinical Activity Template” to Incorporate EBP

Posted by on Sep 12, 2011 in News |

Research shows that by implementing a specific set of nursing interventions (a bundle) with patients who have indwelling catheters, catheter-associated urinary tract infections (CAUTIs) can be prevented. Nursing students must be prepared to integrate this knowledge into the clinical setting by seeking out necessary resources to find the evidence, comparing those findings to current practice on the nursing unit, and implementing the interventions according to eidence-based practice and patient-centered care. As Medicare/Medicaid reimbursement decreases, healthcare reform takes shape, and patient acuity worsens, healthcare organizations across the nation are focusing on prevention now more than ever. Preventable complications such as CAUTIs have now made the Center for Medicare & Medicaid Services’ (CMS) list of “Never Events”. This makes CAUTIs part of every RN and Hospital Administrator’s vocabulary, so it is expected that the students are aware of this, as well. This Clinical Activity Template (CAT) for evidence-based practice has been completed based on the Universal Template tool, which was previously submitted. This design and KSA format allows faculty to assess student competency in the stated KSAs, as well as providing students with the opportunity to assess themselves. The “Knowledge” must be completed prior to entering the clinical setting, since this is the foundational concept of situated learning. The “Skills” are the activities that occur throughout the clinical experience. The “Attitude” component is assessed during post-conference verbally through discussion. This is one of the most important aspects of implementation, as it allows the students to apply the knowledge acquired during the pre-planning and clinical experience. Additionally, it allows the faculty to pose questions for discussion which incorporate systems thinking, as opposed to focusing on the task that was performed on their assigned patient(s). It is during post-conference debrief and the written self reflection that follows where the instructor can observe/assess the students’ “attitude”. I recommend a structured self-reflective model to organize the students’ thinking process. In our program we utilized Dr. Christine Tanner’s Model for Clinical Judgment (2006) to assess clinical judgment and competency in the affective domain. The students can use this worksheet in any clinical setting to guide their experience. Instructors can likewise define this worksheet as a performance...

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Health Literacy: Incorporating QSEN (Quality and Safety Education in Nursing) Competencies into a Senior Capstone Project and Paper

Posted by on Apr 13, 2011 in Teaching Strategies |

This is an integrative project that requires the student to connect and relate what they have learned throughout the nursing program. The product to be turned in is a paper that is scholarly, evidence based, and experiential. Two parts of the paper are turned in. The first part is scholarly and evidence based and can be turned in by the fourth week of the semester. The second part is experiential and should be turned in by the twelfth week of the semester. Directions Part 1 You will be doing a two part paper/project on Health Literacy integrating the QSEN competencies into your performance and then writing a paper reporting on that project. After reading a minimum of four original research articles, identify and discuss in your paper the best current evidence on health literacy. In the introduction to your paper, define health literacy, explain why health literacy is important in today’s healthcare environment, provide the rationale for ensuring that patients should become more health literate. Identify particular barriers to health literacy that you expect you will encounter in the particular population of patients that you are dealing with i.e. oncology patients,  ICU patients, elder patients, children, etc. This is determined by your clinical assignment and the unit that you are on. When you write, use your own words as much as possible so that you demonstrate that you understand health literacy and how it relates to your patient population. You are encouraged to use cause-effect diagrams and flow charts to help make your discussion more clear. Directions Part 2 Among the patients who you are assigned to this semester, identify a patient with limited health literacy. Using the language of the QSEN (Knowledge, Skills & Attitudes) KSA’s, discuss your interventions  to improve the patient’s  (and perhaps family’s) health literacy . The goal is to show that you improved at least one aspect of this patient’s understanding of their disease management. Do not make it a litany of the entire patient teaching that you did for a patient. (Read Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., and Warren, J. (2007). Quality and safety education for...

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Integration of QSEN competencies when designing simulation scenarios

Posted by on Jul 23, 2010 in News |

Task analysis is a detailed examination of the knowledge, skills and attitudes (KSAs) that are essential to job performance and an important first step in the process of developing learning outcomes for simulation-based training. QSEN offered a detailed list of KSAs that are critical to the nursing profession. We used this information to design learning activities and simulation events that would elicit such KSAs from students. This strategy describes a planning process which has helped our nursing faculty share ideas and craft scenarios best suited to the needs of their students. First, QSEN competencies were associated with examples of learning activities and events that might occur before, during and after simulation scenarios (see Summary). For instructors new to simulation, the summary offered a preview of possible learning outcomes and in some cases, inspiration to engage in the process. It also led to discoveries which are likely to influence our future plans for simulation scenarios. For example, we noted that KSAs related to Quality Improvement had been overlooked. In addition, we identified a need for more advanced communication challenges such as the need to consider boundaries of therapeutic relationships, barriers to active patient involvement and conflict resolution. Next, we examined key elements of our existing simulation scenarios, in relation to QSEN competencies. Five simulation scenarios serving first-year students in medical-surgical settings have been analyzed using this framework (see Table). From this analysis, we identified core features that were emphasized in every simulation, along with special features that made each scenario unique. We expect to adopt a similar approach to planning scenarios as our simulation program expands to meet the needs of more advanced students and nursing specialty...

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Developing A QSEN Competency Checklist for Simulation Experiences

Posted by on Jun 7, 2010 in News |

This strategy utilizes the QSEN Competency Checklist for Simulation Experiences developed by LRC Faculty at The Frances Payne Bolton School of Nursing. The checklist incorporates the six QSEN competencies and their related KSAs. This tool guides faculty in the design, implementation, and evaluation of simulation experiences for undergraduate nursing students. The checklist ensures the inclusion of QSEN competencies and related KSAs for every simulation experience. Faculty have used this checklist in conjunction with The NLN’s Simulation Design Template to guide their simulation...

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