QSEN Case Western Frances Payne Bolton School of Nursing

Quality and Safety Education for Nurses

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Enhancing Medication Safety in Clinical: A Video for Students and Nursing Faculty

Posted by on Jul 1, 2014 in Teaching Strategies |

Video Link: Click Here  This vignette was designed for both faculty and students to learn how to administer medications safely in clinical settings. The vignette demonstrates to nursing faculty how to manage more than one student in clinical and how to manage a medication administration pass for a student while in clinical. This vignette also is designed to explicate teaching strategies for student and faculty when the student isn’t quite prepared or ready to administer medications. This vignette also reviews how to question a student prior to approaching the patient at the bedside and then demonstrates how to empower the students while working with their patients at the bedside. The student demonstrates how to administer the medications safely and ensures the five rights during the process. Strategy Activity: Prior to engaging in clinical experiences, the students and or clinical faculty will view the vignette in the nursing lab. Then the students will discuss the aspects of safe medication administration and the five rights of medication administration. The students will be given a MAR (Medication Administration Record) to look up medications (see example). While in the nursing skills lab, the students will prepare the medications and administer medications to their patients. They will utilize drug guide resources and other e-tools to gather important information about their patients. They will also discuss the right situation for these medications, medication reconciliation, and patient data to connect essential patient information. This activity will help the students to learn how to safely administer medications to their patients prior to going live in the clinical setting. Patient Centered Care Students will gather information of the medications they are to prepare for their patients in clinical. (Knowledge) Students will value their knowledge and how dissemination of essential information about their patients’ current medications create a more patient-centered environment. (Knowledge, Attitudes) Safety Students will utilize drug guides and other e-tools, learn how gather essential information about their medications and be confident when communicating with their clinical instructors about their patients and their medications. (Knowledge, Attitudes) Students will demonstrate the five rights of medication administration while administering medications in clinical. (Skill) Students will value own role in providing safe...

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Hand-off Strategies for Maternity (L&D/MBC) Clinical Practice: SBAR/Assessment Tools and More Effective Hand-off Timing

Posted by on Jun 27, 2014 in Teaching Strategies |

A hand-off is a transfer and acceptance of patient care responsibility achieved through effective communication. It is a real-time process of passing patient specific information from one caregiver to another or from one team of caregivers to another for the purpose of ensuring the continuity and safety of the patient’s care. Student nurses are involved in some manner of hand-off communication prior to initiating care and at the conclusion of their clinical day. Observations of our students during hand-offs in the clinical setting revealed a process replete with potential for error. For example, when students listened to hand-offs between staff nurses, they were often unable to get close enough to clearly hear the report or to understand the medical jargon nurses used. Hand-offs were frequently interrupted by occurrences happening at shift change and nurses were sometimes unable to review patient data with students due to the responsibilities of shift change. Implementation of the Strategy: The Joint Commission Hand-off Communication Failures includes several strategies that might be helpful to student nurses. These strategies involve the development and use of standardized forms, including SBAR tools, establishing a workspace or setting that is conducive for sharing information about patients, and examining the work flow of health care workers to ensure a successful hand-off, focusing on the system, not just the people. Similar adaptations were made for our students, including the timing of hand-offs to a less stressful time for staff nurses. Nursing staff were surveyed regarding when hand-off communication to students would work best in their schedule. Staff agreed that a clinical start time approximately one hour after usual shift change would be the least stressful time. A later clinical start time was implemented with our students. An SBAR/Assessment tool was also developed specifically for students to use during hand-off communication with staff nurses. This SBAR/Assessment tool (one page front and back) served multiple purposes, as it included space for continuing data collection, nursing diagnoses, interventions and evaluation of...

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Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses

Posted by on Apr 3, 2014 in News |

Sex trafficking is an issue that nurses in the United States need to be aware of in order to provide the best care to their clients.   It was estimated in 2005 by the U.S. Department of Justice that there were between 100,000 and 150,000 people living and working as sex slaves in the United States, and these numbers are only rising.  It is imperative that nurses know how to recognize signs of trafficking and know how to intervene in order to protect the health and safety of the clients that they work with. In order for nurses to confidently and successfully intervene when they find themselves in situations where trafficking is suspected, they must be educated.  I propose that utilizing the Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses could be very beneficial in this endeavor.  Accessible at www.nursingstrafficking.web.unc.edu, the module was developed to be learner-focused to meet each individual’s stylistic learning needs, including: a lecture on the topic with resources provided to reflect evidence based practice guidelines, assessment of potential victims, and interventions related to sex trafficking in various formats; two case studies, both of which are adaptable for use as simulations, and pre- and post-tests reflecting module content. The intended use for the Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses is for incorporation into the registered nurse curriculum, particularly as an addition to the public health nursing course.  Faculty would follow-up in a variety of ways, which they can tailor to the needs of their students.  Educators could use the module quizzes as an assessment of module understanding for a grade in their courses.  The case-studies could be distributed as an essay discussion assignment or could be used to assess understanding as part of a simulation or class discussion; participation and understanding may be evaluated as strictly as the educator sees fit, no rubric is included in the module for case-study grading purposes.    Furthermore, the module could be an efficacious teaching tool used as continuing education units for graduate students, nurses in practice, as well as other healthcare providers. The content included in the lecture portion of the module is intended to define sex...

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Teaching Pre-licensure Nursing Students to Communicate in SBAR in the Clinical Setting

Posted by on Apr 2, 2014 in News |

Online Video Vignette http://onlinetraining.umassmed.edu/sbarcommunication/ This vignette was designed for both faculty and students to learn how to communicate using SBAR.  The vignette demonstrates to nursing faculty how to manage more than one student in clinical and how to direct each student to gather and then disseminate information in a clear, concise manner utilizing the SBAR format. The vignette demonstrates to nursing students how they can gather information in clinical and put patient information together to develop a clear and concise communication strategy to speak with other health care team members.   Strategy Activity: After the students and or faculty have viewed the vignette while in clinical the student needs to practice this skill.  At some point in the clinical day, the student will actually call the clinical faculty on the telephone.  The faculty will role play a health care provider either a nurse practitioner or physician.  The student will communicate in SBAR essential information to their faculty member/healthcare provider.   The faculty/physician will give the student an order or intervention for the student to transcribe.  At the conclusion of this role-play the faculty member and student will debrief and review the verbal encounter and transcription order.  This activity will help the student to learn how to communicate in SBAR and take a verbal physicians order. Patient Centered Care Students will identify patient concerns and abnormal findings and communicate in SBAR their assessment.  (Knowledge, Attitudes) Safety Students will discover how gather essential information and be confident when communicating their findings to the physicians, nurse practitioners, nurses, and physicians assistants. (Knowledge, Attitudes) Teamwork/Communication Students will gather subjective and objective patient data, and will communicate using SBAR a concern or abnormal finding to the physicians, nurse practitioners, nurses, and physicians assistants.  (Knowledge, Skills, Attitudes)...

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Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses

Posted by on Mar 6, 2014 in Teaching Strategies |

Sex trafficking is an issue that nurses in the United States need to be aware of in order to provide the best care to their clients.   It was estimated in 2005 by the U.S. Department of Justice that there were between 100,000 and 150,000 people living and working as sex slaves in the United States, and these numbers are only rising.  It is imperative that nurses know how to recognize signs of trafficking and know how to intervene in order to protect the health and safety of the clients that they work with. In order for nurses to confidently and successfully intervene when they find themselves in situations where trafficking is suspected, they must be educated.  I propose that utilizing the Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses could be very beneficial in this endeavor.  Accessible at www.nursingstrafficking.web.unc.edu, the module was developed to be learner-focused to meet each individual’s stylistic learning needs, including: a lecture on the topic with resources provided to reflect evidence based practice guidelines, assessment of potential victims, and interventions related to sex trafficking in various formats; two case studies, both of which are adaptable for use as simulations, and pre- and post-tests reflecting module content. The intended use for the Sex Trafficking and the Nursing Role: An Online Educational Module for Nurses is for incorporation into the registered nurse curriculum, particularly as an addition to the public health nursing course.  Faculty would follow-up in a variety of ways, which they can tailor to the needs of their students.  Educators could use the module quizzes as an assessment of module understanding for a grade in their courses.  The case-studies could be distributed as an essay discussion assignment or could be used to assess understanding as part of a simulation or class discussion; participation and understanding may be evaluated as strictly as the educator sees fit, no rubric is included in the module for case-study grading purposes.    Furthermore, the module could be an efficacious teaching tool used as continuing education units for graduate students, nurses in practice, as well as other healthcare providers. The content included in the lecture portion of the module...

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