QSEN Case Western Frances Payne Bolton School of Nursing

Quality and Safety Education for Nurses

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Mr. Potato Head: A LEAN, Mean Quality Improvement Teaching Machine!

Posted by on Nov 15, 2014 in Teaching Strategies |

This is a simulation teaching strategy used to illustrate Quality Improvement.  This strategy can be used with:     Medical Students, Residents, Faculty, Nurses, other health care providers and team members Anyone!  Has been done successfully with 9 year learners at summer camp, as well as industrial engineers!   Number of Participants Needed: Ideal number is 7-8 members per team Has been done with as few as 4 participants, or 125 students in teams of 8-10 members.   A bus filled with 16 Potato Head family members is in a terrible crash!  At the scene of the accident, Emergency Medical Services arrives to find only scattered body parts.  Luckily, one of the family members was carrying a photo album with a photo of each family member. There are men, women, children, and pets on the bus. A health care team is waiting in the emergency room to correctly assemble as many family members as possible in 7 minutes. On the health care team, two of the members are designated “Implantation Specialists” (a.k.a. trauma surgeons). Only they can “implant” the parts into the potato bodies. The number of correctly assembled Potato Heads and the number of errors are tracked through each PDSA cycle....

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Test Taking Strategies

Posted by on Sep 15, 2014 in Teaching Strategies |

It is apparent that there is a continual necessity to develop strategies to help engage the online learner and promote successful progression of their learning needs. For the purpose of this project, test-taking strategies are utilized in specific relation to becoming proficient in NCLEX style questions. The NCLEX review course is presented in either the classroom or online forum. Sessions are two hours in length and for the purpose of this project were held via the Adobe Connect system. This can be an effective avenue for study in preparation for the HESI exit examination and for alumni students wishing to review material in preparation of their Ohio Board of Nursing examination. A two-hour session consists of NCLEX review questions and detailed power point presentations teaching students the strategies of test taking. Several topics are covered such as study techniques, anxiety reduction strategies, and specific tools to be a successful test taker. Students are able to participate via a chat room and they can hear the instructor via audio. Students can respond and interact by typing into the chat room. In utilizing the following test taking strategies, students can increase their success as a test-taker specifically concentrating on NCLEX style questions. The major strategies implemented are: POW-put it in your own words (rewording the question) KEY WORDS-pick out key words to prioritize responses (best, most, first, initial) ELIMINATION-using the process of elimination to take out the incorrect responses and derive the correct answer MASLOW’S HEIRARCHY OF NEEDS-utilization of Maslow’s Hierarchy of Needs to determine priority questions (What does the nurse do first?) ERIKSONS STAGES OF PSYCHOSOCIAL DEVELOPMENT-to determine age specific questions based on developmental milestones ADPIE-deriving the correct response by using the nursing process (we assess before we implement) ABC’s-determining the appropriate answer to a priority question by using Airway-Breathing-Circulation (we protect the airway first) PHAN-Priority-Hierarchy-ABC’s-Nursing Process (the order in which we use the strategies in a priority...

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Writing Assignment Linking QSEN competencies with a Perioperative Clinical Experience

Posted by on Aug 12, 2014 in Teaching Strategies |

The purpose of this assignment is for the student to write a professional paper, utilize APA formatting, enhance understanding of hospital systems, and have the opportunity to reflect on a surgical experience from the patient’s perspective. First year nursing students are assigned a patient in the preoperative period and are expected to follow this patient until they have arrived to the postoperative unit.  The following day students provide postoperative care to this same patient.  Students are instructed to review the criteria for the paper so they are familiar with what they are observing for.  Students then write a professional paper addressing all the required components explicitly laid out in the assignment instructions.  Students are encouraged to seek information from staff and clarification from faculty when needed. This assignment addresses each of the six QSEN competencies.  The competency of patient centered care is met by students remaining with the patient throughout their surgical experience enabling them to understand the healthcare situation “through patient eyes” and when they evaluate communication they observe.  The competency of teamwork and collaboration is addressed when students describe the roles of healthcare team members.  By reviewing an article and identifying whether actual practice matched evidence based practice students meet the competency of evidence-based practice.  Quality improvement is met when students discuss the value of their and others’ contribution to patient care experience in the care setting.  The competencies of safety and informatics are addressed when students discuss the system used for medication administration.  Students must also discuss the use of the electronic health record in the preoperative period.  In all this assignment allows students to see the patient’s perspective while also being introduced to the systems perspective of hospital care....

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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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