2022: Presentation Sessions

2022 QSEN International Forum

June 1-3, 2022


(please select the plus + sign to the right to see additional details about each session)

June 1, 2022

Preconference Sessions
Session Time: 8:30 AM – 11:30 AM

8:30 AM – 9:30 AM
THE POWER OF PAUSING, PRESENCE, AND COMPASSIONATE CONNECTION

Coming Wednesday, June 1, 2022
Session Time: 8:30 AM – 9:30 AM
Presentation Time: 8:30 AM – 9:30 AM
THE POWER OF PAUSING, PRESENCE, AND COMPASSIONATE CONNECTION
Preconference Presenter: Simcha S. Zevit, MA – Hospital of University of Pennsylvania

9:30 AM – 11:30 AM
MINDSTRONG

Wednesday, June 1, 2022
Session Time: 9:30 AM – 11:30 AM
Presentation Time: 9:30 AM – 11:30 AM
Silver
MINDSTRONG
Preconference Presenter: Jacqueline Hoying, PhD, RN, NBC-HWC – the Ohio State University
Co-Author: Bernadette Melnyk, APRN-CNP, FAANP, FNAP, FAAN


Special Session

12:00 PM – 12:30 PM
Healing Space: Mindfulness Moments- A Model for Wellness Rounds

Wednesday, June 1, 2022
Session Time: 12:00 PM – 12:30 PM
Presentation Time: 12:00 PM – 12:30 PM
Tower D
Healing Space: Mindfulness Moments- A Model for Wellness Rounds
Presenter: Simcha S. Zevit, MA – Hospital of University of Pennsylvania

3:00 PM – 3:30 PM
Healing Space: The “Art” of Healing

Wednesday, June 1, 2022
Session Time: 3:00 PM – 5:00 PM
Presentation Time: 3:00 PM – 3:30 PM
Tower D
Healing Space: The “Art” of Healing
Presenter: Simcha S. Zevit, MA – Hospital of University of Pennsylvania

3:30 PM – 5:00 PM
Healing Space: Chaplain and Collegial Support Drop in

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 5:00 PM
Tower D
Healing Space: Chaplain and Collegial Support Drop in
Presenter: Simcha S. Zevit, MA – Hospital of University of Pennsylvania


12:00 PM – 12:50 PM South Foyer – Exhibit Hall & Registration

1:00 PM – 1:10 PM Grand Ballroom – Welcome – Presenter: Mary A. Dolansky, PhD, RN, FAAN – CWRU Presenter: Amy Barton

Keynotes

1:10 PM – 1:20 PM
Welcome:
Alignment of the AACN Re-envisioned Essentials with the QSEN Competencies

Wednesday, June 1, 2022
Session Time: 1:10 PM – 1:20 PM
Presentation Time: 1:10 PM – 1:20 PM
Grand Ballroom
Alignment of the AACN Re-envisioned Essentials with the QSEN Competencies
Keynote Speaker: Kathy McGuinn – American Association of Colleges of Nursing

1:20 PM – 2:15 PM
Moving the Needle on Meaningful Assessment of Competence

Wednesday, June 1, 2022
Session Time: 1:20 PM – 2:15 PM
Presentation Time: 1:20 PM – 2:15 PM
Grand Ballroom
Moving the Needle on Meaningful Assessment of Competence
Keynote Speaker: Robert Englander, MD, MPH

2:15 PM – 3:30 PM
The Intersection of QSEN, the Essentials, and Competency-Based Education

Wednesday, June 1, 2022
Session Time: 2:15 PM – 3:30 PM
Presentation Time: 2:15 PM – 3:00 PM
Grand Ballroom
The Intersection of QSEN, the Essentials, and Competency-Based Education
Keynote Speaker: Gerry Altmiller, EdD, APRN, ACNS-BC, ANEF, FAAN – The College of New Jersey

Wednesday, June 1, 2022 – Time: 3:00 PM – 3:30 PM South Foyer – Break with Food and Exhibits

Concurrent Session 1
Session Time: 3:30 PM – 5:00 PM

Session 1 A

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 4:00 PM
Tower A
Track: Quality Improvement
Barriers and Facilitators of QI Engagement by Frontline Nurses and Leaders
Lead Author: Catherine Alexander, DNP MPH RN – San Francisco VA Medical Center
Co-Author: Dana Tschannen, PhD, BSN – University of Michigan School of Nursing
Co-Author: Hasna Hakim, DNP,MPH, RN CCRN – Brigham and Women’s Hospital
Co-Author: Debora Argetsinger, DNP – Metro Health-University of Michigan Health
Co-Author: Kerry Milner, DNSc, RN, EBP-C – Sacred Heart University

Abstract Background: High quality care and patient outcomes are linked to nursing care at the frontline, but nurses remain one of the most underutilized assets in QI efforts. It is unclear as to why nurse engagement in QI remains low despite studies that demonstrate nurse engagement in QI is associated with improved fall rates, pressure injuries, central line infections, operational efficiencies, and nurse retention. The purpose of this study was to understand the facilitators and barriers of QI from the perspective of frontline nurses and leaders.

Abstract Methods: A descriptive qualitative design was used. Purposive sampling identified 32 frontline nurses (e.g., registered nurses) and leaders (e.g., nurse educators, nurse practitioners, nurse managers, supervisors) from one Midwest Magnet recognized academic medical center. A semi-structured interview protocol was followed for all 6 focus groups. Interview audio files were transcribed and analyzed using inductive content analysis.

Abstract Evaluation/Results: Facilitators 1) A leader’s influence on a QI culture. Sub-themes of creating buy-in, support of a just culture, and working in partnership with nurses. Barriers 1) Barriers in organizational culture for nurses to lead QI. Sub-themes of hierarchy, absence of a just culture, nurses’ role not valued, lack of accountability for QI in nursing role, and resistance to change 2) Barriers in organizational structure for nurses to lead QI. Sub-themes of manager disengagement, time pressure, lack of access to timely data, lack of QI knowledge, siloed departments, and lack of QI experts. Nurses and leaders shared similar views about facilitators and barriers.

Abstract Implications: To improve frontline nurse engagement leaders are needed who can build and sustain a QI culture where nurses engage in the habitual application of QI knowledge and skills. Leaders need to be present and engaged at the frontline where they can model QI behaviors, facilitate teams to tackle daily clinical challenges and remove structural barriers to QI in real-time. Future research is needed to evaluate the strategies that have the greatest impact on frontline nurses’ routine engagement in QI.

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Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:00 PM – 4:30 PM
Tower A
Track: Quality Improvement
Frontline perceptions of the factors that influence system level performance in MS care quality
Lead Author: Catherine Alexander, DNP MPH RN – San Francisco VA Medical Center
Co-Author: Hasna Hakim, DNP,MPH, RN CCRN – Brigham and Women’s Hospital
Co-Author: Falguni Mehta, MS, MBA, CPHQ, CPPS – Chronic Health Improvement Research, Dartmouth Health
Co-Author: Brant Oliver, PhD, MS, MPH, FNP-BC, PMHNP-BC – Dartmouth

Abstract Background: The Multiple Sclerosis Continuous Quality Improvement Collaborative (MS-CQI) study (2017-2020) was the first improvement science research collaborative for multiple sclerosis (MS). MS-CQI conducted studies of system-level performance in MS care quality, utilization and outcomes across four centers to study the effect of continuous quality improvement (CQI) on system level outcomes in centers randomized to CQI (intervention) versus control (usual care). One goal for centers randomized to (CQI) was to create the conditions (readiness, capability) for successful CQI. We sought to understand the experiences of the leaders and staff who participated in MS-CQI. We explored four factors that could influence CQI capability: (1) leadership; (2) burnout; (3) resiliency; and (4) effects of COVID-19 on CQI efforts.

Abstract Methods: We used a cross-sectional descriptive design and recruited a purposive sample of eight participants from each of the four MSCQI centers. Eight semi-structured interviews were conducted. Thematic analysis methods were employed with consensus coding achieved by two raters.

Abstract Evaluation/Results: In the leadership category, collaboration (working in partnership with staff) is critical for team engagement. Leadership attributes that foster collaboration included, support for the team, fair mindedness, QI knowledge, and leader engagement. Barriers included leader entrenchment, lack of flexibility and lack of ability to listen. For the Burnout category, participation in QI was found to be a protective factor against burnout. For Resiliency, collaboration with team members created higher levels of resiliency. In the COVID 19 category, telemedicine visits during the pandemic had a beneficial modifying effect on CQI efforts described as a patient-centric model of care that improved patient engagement and provider reach.

Abstract Implications: Leader participation in QI is critical for successful improvement efforts. Collaboration led to higher levels of engagement in QI. Working in partnership with leaders was a significant finding with implications for QI practice. Resiliency, described as a protective factor against burnout, was a key finding, and will need to be explored further. Finally, the COVID pandemic, although disruptive at times to the study, was also described as a positive outcome in that it stimulated development of telehealth approaches and strengthened the team’s ability to continue their QI work.

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Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:30 PM – 5:00 PM
Tower A
Track: All of the above
Bibliometric Analysis Assessing QSEN’s Global Impact to Guide Future Directions
Lead Author: Gwen Sherwood, PhD, RN, FAAN, ANEF – University of North Carolina at Chapel Hill
Co-Author: Cheryl Jones, PhD, RN, FAAN – University of North Carolina at Chapel Hill
Co-Author: Jamie Conklin, MS – University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7585
Co-Author: Adam Dodd, MS – University of North Carolina at Chapel Hill Chapel Hill, NC 27599-7585

Abstract Background: Since 2005 QSEN has guided nurses’ preparation to alleviate preventable patient harm and improve delivery of quality, safe care. Now QSEN sits at the nexus of education and care delivery, firmly embedded in the 10 domains of the 2021 American Association for Colleges of Nursing (AACN) Essentials. To assess QSEN’s reach, persistence and spread, including global penetration, this innovative first bibliometric analysis describes publication patterns of extant QSEN literature, maps implementation, and identifies dissemination gaps.

Abstract Methods: Two QSEN experts and two health sciences librarians searched PubMed, CINAHL, Scopus and Web of Science to identify papers with keywords “QSEN” or “Quality and Safety Education for Nursing”. Publications were included if they were: 1) QSEN-specific; and 2) published in peer reviewed journals, yielding 741 references. After removing 470 duplicates, two researchers independently reviewed titles and abstracts, then full-texts for inclusion criteria leaving a final sample of 201 QSEN specific references. Data extraction included article type (research, descriptive/review, project/case study, statement, editorial), focus (clinical practice, leadership/administration, education, professional development, combination), first-author details, and number of authors. Researchers reviewed 20% of the same references to ensure interrater reliability.

Abstract Evaluation/Results: We illustrate four bibliometric analyses in separate databases using data visualizations developed with Microsoft Excel and VOSviewer: 1) keyword topic network, 2) country and co-authorships, 3) article characteristics, type, and author, and 4) research focus. Among the findings, since initial publications in 2007, average annual QSEN publications were 14.5, with 26 publications in 2017. Eight US based authors account for 64 articles. Article types were research (n=71), descriptive/reviews (n=71), quality improvement/case studies (n=26), editorials (n=19), and professional statements (n=11). Primary focus was 161 education (emphasis teaching strategies) and 34 clinical practice. Fourteen journals published three or more articles; eight were education journals.

Abstract Implications: QSEN’s value disseminated through scholarly publications reflects QSEN’s impact on the field and collaborations among authors and institutions. Findings reveal gaps in QSEN penetration in clinical practice, research assessing outcomes and impact, and global collaboration to aid understanding QSEN’s cultural implications for diversity and inclusion. Findings can guide faculty and clinicians incorporating AACN Essentials to improve patient outcomes, and inform future directions for QSEN implementation.

Session 1 B

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 4:00 PM
Tower B
Track: Informatics
Reduction of CLABSI incidence using a Central Line Maintenance Best Practice Advisory
Lead Author: Robert Kozlenko, MSN-ED, RN-BC – NYU Langone Health
Co-Author: Karen Delorenzo, MSN, RN, CHCR – NYU Langone Health
Co-Author: Meg Ferrauiola, BA – NYU Langone Health

Abstract Background: In the first 5 months of 2021, the MICU in this urban full-service teaching hospital had 808 combined Central Venous Line (CVL) days with a monthly CLABSI incidence rate of 9.1. The goal was to reduce the catheter line associated blood infection (CLABSI) incidence rate in the MICU to zero and maintain that rate by utilizing clinical decision support (CDS) features located in Epic, the institution’s EMR.

Abstract Methods: Quality/Informatics used its existing evidence-based practice (EBP) CVL maintenance order set and CDS systems to implement practice changes to eliminate CLABSIs in the MICU. We focused on prevention as the primary way to accomplish this. The CVL maintenance order set includes the use of CHG dressings and saline flush protocols. We observed that CVL maintenance orders were not always in place after CVL insertion. Therefore, we leveraged best practice advisories (BPAs), CDS alerts that display when triggered by an action. The BPA was set to appear after documenting placement of a CVL. When the provider signs the note, the CVL placement order is placed and the BPA triggers. It reminds them of the CVL maintenance order set with a shortcut to place it. IT created the BPA and tested it by monitoring the triggers for the right action and role. Go-live was on May 19, 2021.

Abstract Evaluation/Results: The team evaluated the BPA periodically after implementation. The BPA fired in the MICU for 28 unique patients during the June – September evaluative period. Of those 28 patients, in 20(71%), the provider placed a maintenance order; 7(25%), the provider chose the acknowledgement reason indicating that they placed the order outside of the BPA; and in 1(4%) case the provider indicated they would place the order in the BPA but no order was found. The outcome measurement was the CLABSI incidence rate in the MICU which dropped to zero. The MICU had 235 combined CVL days during this evaluative period.

Abstract Implications: Combining EBP for CVL care and CDS contributed to a reduced CLABSI incidence rate in the MICU. Implementation of the BPA provided nurses with the EBP-based CVL maintenance orders needed to promote positive patient outcomes.

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Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:00 PM – 4:30 PM
Tower B
Track: All of the above
The Use of Descriptive Analytics to Improve Bar Code Medication Administration
Lead Author: Stefania Granados, Bachelors in Business Administration, LSSYB – Baptist Health South Florida
Lead Author: Cristina Lopez, B.A, MHA, LSSGB – Baptist Health South Florida
Co-Author: Gloria Arteaga – Baptist Health South Florida
Co-Author: David Sealey – Baptist Health South Florida
Co-Author: Carolina Perezleguizamo – Baptist Health South Florida
Co-Author: Janisse Post – Baptist Outpatient Services
Co-Author: Elyse Garcia – baptist health south florida
Co-Author: Drew Tilson – Baptist Health South Florida

Abstract Background: Bar Code Medication Administration (BCMA) has been shown to reduce medication errors and improve patient outcomes. BCMA technology also allows nursing staff to bypass or override features creating the potential for medication errors. The objective of this study was to examine the impact of utilizing descriptive analytics across Baptist Outpatient Services (BOS) for BCMA reporting to improve nursing compliance with patient and medication scanning and decrease nursing overrides to improve patient safety.

Abstract Methods: In March 2021, baseline data revealed overall BCMA compliance for BOS was 90% with only 3 out of 20 nursing units meeting the 95% benchmark. A three-prong approach was implemented: 1) Optimization of current data file utilizing descriptive analytics for BCMA reporting, 2) engagement of nursing staff and leadership, and 3) redesign of nursing workflows to address overrides and bypassing of safety features to improve BCMA compliance. The data file was modified to include interactive pivot tables, which allowed nursing educators to follow-up with individual nursing staff who were below the target of 95% and overriding medication scanning features. The data set included: total medications scanned and not scanned, patient scanned and not scanned; override reasons by nurse and nursing unit; and an interactive timeline to track and trend historical data with current performance rates. Data reporting frequency was changed from monthly to weekly, which facilitated proactive discussions between nursing educators, leaders and nursing staff.

Abstract Evaluation/Results: Utilization of interactive pivot tables and slicers within the BCMA data file allowed for cogent conversations between nursing educators and staff to review areas of opportunity, barriers, override reasons, and technical reasons why medications could not be scanned. Initial analysis of the data revealed significant variability across each center with 700 plus override entries; overall BCMA compliance was 90%. After implementation of the revised data file in October 2021, variability across each center decreased from 6% to 1%, BCMA compliance improved to >97% and a 50% reduction in overrode entries were noted.

Abstract Implications: Utilizing innovative data solutions for BCMA to bridge the gap between nursing education and practice can improve engagement, accountability, quality, and patient safety.

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Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:30 PM – 5:00 PM
Tower B
Track: Informatics
“In God We Trust, All Others Bring Data” – Using Dashboards to Drive Change
Lead Author: David H. James, RN, NPD-BC, CCNS – UAB Medicine
Co-Author: Jadalyn P. Story – UAB – HospitalCo-Author: Emily Simmons – UAB Medicine

Abstract Background: The Institute for Healthcare Improvement (IHI) Age-Friendly initiative uses the “4Ms” (What Matters; Medications; Mobility; Mentation) as a framework to improve the care of older adults. Addressing the 4Ms requires systematic changes in care delivery. The implementation and sustainment of these changes require access to timely and relevant data. The purpose of this presentation is to discuss the creation of Age-Friendly specific dashboards that allow stakeholders to design, implement, and evaluate quality improvement initiatives that address the 4Ms.

Abstract Methods: Through iterative Plan, Do, Study, Act (PDSA) cycles, the mobility dashboard was refined to its current state, including filters for the unit, data, race, age, gender, and discharge service. In addition, from the electronic health record, line charts for compliance percentage with Mobility Scale documentation for both first and second shifts are displayed. Line graphs detailing the percentage of mobility scores (MS) consistent with ambulation (MS > / = 6) are displayed. Ultimately, the dashboard monitors the unit’s progress through the five phases of the organization’s safe mobility program. The mobility dashboard further serves as a template for other 4Ms related dashboards. For example, an additional dashboard was developed to support a Geriatric Emergency Department certification, and a Mentation dashboard was developed with a focus on key delirium metrics.

Abstract Evaluation/Results: Three dashboards were created to support the organization’s Age-Friendly initiatives. Each dashboard was created with feedback from diverse stakeholders and designed to provide actionable data to drive change. Highlighted outcomes from our Age-Friendly initiatives, supported by the dashboards, include geriatric certification for an Emergency Department and improvements in compliance with mobility score documentation. In addition, there was an increase in the percentage of patients with mobility scores consistent with ambulation on units engaged with the safe mobility program.

Abstract Implications: Organizations implementing evidence-based practices to create Age-Friendly healthcare systems will need structures and processes to reduce variability and sustain improvements. As one of the core tenets of quality improvement work, organizations must use data to drive change. These dashboards reflect QSEN competencies as they lay a foundation for addressing the 4Ms of care.

Session 1 C

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 4:00 PM
Tower C
Track: Patient Centered Care
Ensuring Quality in Nursing Education: Teaching New Clinical Faculty to Teach
Lead Author: Wendy B. Hansbrough, PhD, RN, CNE – California State University San Marcos
Co-Author: Kimberly Dunker, DNP, RN, CNE, CNEcl – Pacific Union College
Co-Author: Melissa Duprey – UMass Dartmouth
Co-Author: April Lawrence – California State University San Marcos

Abstract Background: The quality of pre-licensure nursing education is heavily reliant on nursing school clinical faculty who teach students the integration of practice knowledge, skills, and attitudes. Students’ development of nursing care competency as described in the 2021 AACN Essentials, occurs in the context of patient care, during clinical experiences. Clinical instructors must foster clinical judgement, critique competence acquisition, guide professional nurse role development, and support confidence building in their students. More recently, nursing faculty have had to respond to changes in pre-licensure nursing education brought about by stress on healthcare systems due to the COVID pandemic. Faculty must navigate more complex teaching situations and effectively use simulation and academic support software to facilitate student learning when direct patient care clinical experiences are limited. New nursing clinical faculty are often hired because they possess clinical expertise. However, they are also often novice nurse educators without academic instructional skills and knowledge. Schools of Nursing are charged with providing support for new faculty who are transitioning roles from bedside nurse to teacher. Yet, little is known about minimal hiring requirements, how role transition is supported, or how the quality of instruction is evaluated

Abstract Methods: Nursing school faculty, Chairs, Directors, or Deans were solicited through snowball sampling to respond to a 40-question online survey. Invitations to participate were distributed through professional nursing organizations including the QSEN Academic Clinical Practice Task Force, Sigma Theta Tau International, professional organization online discussion boards, and through contact with Schools of Nursing Dean’s. Two separate surveys were distributed: one sought information from faculty and the other from School of Nursing leaders. Data collection occurred from November 2021 through January 2022. Analysis will be completed in Spring 2022.

Abstract Evaluation/Results: Data collection occurred from November 2021 through January 2022. Analysis will be completed in Spring 2022.

Abstract Implications: The results of this study will provide Schools of Nursing with information about the fiscal, contractual, and personnel resources being used to onboard new faculty and support their role transition from clinician to competency-based nurse educator.

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Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:00 PM – 4:30 PM
Tower C
Track: Teamwork and Collaboration
Interprofessional Essentials: Expanding IP Education and Leadership Through Faculty Development
Lead Author: Penni Watts, PhD, RN, CHSE-A, FSSH, FAAN – University of Alabama at Birmingham
Co-Author: Allison Shorten, PhD, RN, FACM, FNAP, FAAN – University of Alabama at Birmingham
Co-Author: Peter A. Bosworth, MBA – University of Alabama at Birmingham
Co-Author: Shelly Camp – University of Alabama at Birmingham

Abstract Background: Effective Interprofessional (IP) Teams improve patient safety and enhance quality patient healthcare experiences. Delivering IP Education (IPE) to numerous and diverse learners requires active participation of teachers in both educational and clinical settings. We will describe our model for implementing IPE across a large institution and describe how our activities meet the AACN Essentials IPE requirements and support the QSEN Teamwork and Collaboration competency

Abstract Methods: In 2018 the university-wide Office of Interprofessional Curriculum (OIPC) developed a foundational series of workshops in partnership with the Center for Teaching and Learning (CTL), to provide faculty with tools and resource materials targeted to integrating IPEC sub-competencies into professional programs. Building upon this series, an Interprofessional Leadership Fellows (IPL) program was launched to annually select and training faculty to provide faculty mentoring and lead IPE initiatives across the institution. Building upon these two core programs, multiple strategies were implemented to engage faculty in IPE, bridging pre-licensure training across to health system IP teams, to increase the number of faculty engaging in IPE to create a comprehensive workforce development program. A PDSA approach was adopted for sustaining quality improvement of this multi-faceted program.

Abstract Evaluation/Results: Gaining momentum over three years, the comprehensive faculty development program has increased the number of faculty and professions promoting IPE and practice across the institution. In FY2021, a total of 91 educators participated in IPE workshops from 12 professions, with 29 earning their certification for “teaching interprofessional teams in healthcare”, selecting from a series of 15 workshops. Our center had appointed 73 scholars and the IP leadership fellows program has further expanded scholarship in IPE, training 20 fellows across professions of nursing, medicine, public health, social work, clinical laboratory sciences, physical therapy and healthcare administration

Abstract Implications: Adding a comprehensive Faculty Development program to promote Interprofessional Education and Practice has the potential to accelerate integration of IPE for healthcare-related learners. Engagement of faculty in IPE has been able to increase integration of IP competencies across the continuum of education for multiple professions to meet accreditation standards in interprofessional practice

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Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:30 PM – 5:00 PM
Tower C
Track: Safety
The Nurse Educators SBAR for Connecting Patient Safety to Nurse Wellbeing
Lead Author: Jamie L. Russell, DNP, RN, FHEA – Utah Valley University
Co-Author: Candice Brunger, MSN, RN, FHEA – Utah Valley University
Co-Author: Natalie Monson, MSN, RN, FHEA – Utah Valley University

Abstract Background: This presentation will discuss the correlation of negative patient outcomes to nurse wellbeing and what obligations educators have in producing resilient nurses. Nurse educators can contribute to a culture of safety by promoting self-care and personal health and well-being in students. Attendees will acquire several practical strategies they can implement into their teaching practice.

Abstract Methods: What obligation do nurse educators have in producing resilient nurses? In this presentation, we discuss current contributing factors and their implication on patient quality and safety (Melnyk et al., 2021), spotlight best practices from the literature (Riegel et al., 2019), and offer pathways for infusing wellness into the nursing curriculum.

Abstract Evaluation/Results: Nursing students experience a substantial amount of stress and anxiety, known to negatively impact learning and their overall well-being (Turner & McCarthy, 2017). Therefore, it can be argued that promotion of self-care and resiliency strategies, need to be both initiated at the outset of any nursing program, and continued throughout the individual’s academic journey. In the absence of education or focus on wellness, this self-care knowledge gap can lead students to use unhealthy stress management strategies (Labrague et al., 2017). Studies have indicated that maladaptive coping mechanisms used by nursing students are often carried into practice (Kovner et al., 2016; Wolfe et al., 2014). Nurses entering the profession ill-equipped to handle its rigors has implications interconnected to patient safety. With the vast loads of nursing curriculum to cover, educators lack time to teach students self-care strategies and can benefit from innovative methods to increase their knowledge around wellness and resiliency.

Abstract Implications: Gaps in healthcare safety can be attributed to the increased complexity of care. It is necessary to address barriers and contributors of quality and safety at individual and system levels (AACN, 2021). Developing nurses to effectively manage stress and the workload of patient care management would improve the nursing workforce’s overall wellbeing, thus reducing preventative medical errors, burnout, and turnover (Melnyk et al., 2021). The beneficial effects of self-care incorporated early into nursing programs in both the US and globally has the potential of strengthening and building resilience within nursing work environments.


Concurrent Session 1
Rapid Fire Session
Session Time: 3:30 PM – 5:00 PM

3:30 PM – 3:45 PM
Developing A VA Dashboard for Operational Communication

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 3:45 PM
Windows
Track: Quality Improvement
Developing A VA Dashboard for Operational Communication
Lead Author: Dionne A. Williams, PhD(c), RN – The Atlanta VA Health Care System
Co-Author: Anne M. Tomolo, MD, MPH – The Atlanta VA Health Care System
Co-Author: Corrine Abraham, DNP, RN – Emory University

Abstract Background: The Veterans Health Administration (VHA) is on a journey to become a high reliability organization by putting procedures and protocols in place to maximize safety and minimize harm. To support this mission locally, our Chief of Staff and supporting leadership communicate daily to report color-coded operational status and discuss ongoing matters during a morning huddle conference call. The purpose of the morning huddle is to identify and mitigate potential barriers to Veteran patient care. Leadership concerns include insufficient participation, and inaccurate and unstandardized reporting of operational status. This quality improvement project applied evidence-based practice in informatics to develop a dashboard for improving leadership communication and participation from 68% to 90% in 5 months.

Abstract Methods: Through interprofessional collaboration, a process analysis was conducted, and the Model for Improvement framework was used to develop, test, and implement change leading to improvement. Four Plan-Do-Study-Act Cycles were conducted for over three months. The cycles included simplification and electronic recording of color-coded operational status; design of a standardized electronic form for leaders to report their operational status; creation of a dashboard prototype with feedback from end-users; production of the dashboard. The process measure, usability, was the end-user perspective on system ease of use as measured by the System Usability Scale. Two reviewers verified scores to ensure inter-rater reliability. The outcome measure, compliance rate, was an ongoing digital recording of the percentage of staff who reported their operational status.

Abstract Evaluation/Results: The System Usability Scale was above average with a score of 93/100. The compliance rate increased from 68% to 85% post intervention. The simplified system distinguished concerns related to staffing, equipment, supplies, and the overall operational status. A daily printout of data was provided to the executive team immediately following morning huddle.

Abstract Implications: Technology can be used to identify and track ongoing concerns in the delivery of healthcare. Implementation of facility-wide electronic dashboards should be considered to standardize communication. Healthcare leaders and stakeholders should explore the usability of electronic systems and the potential impact on the overall quality and safety of patient care.

3:45 PM – 4:00 PM
Quality Improvement Project to Improve Dyspnea Palliation at End-of-Life

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:45 PM – 4:00 PM
Windows
Track: Quality Improvement
Quality Improvement Project to Improve Dyspnea Palliation at End-of-Life
Lead Author: Alaina Wirt, DNP, RN, AGCNS-BC – UCHealth
Co-Author: Heather Coats – University of Colorado, College of Nursing

Abstract Background: Dyspnea is known to be a common and often distressing symptom for patients who are nearing death. The evidence is clear regarding utility in opioids for the palliation of dyspnea. Among the organization’s patients, 70% experience dyspnea in the last week of life. This project aimed to decrease the average Edmonton Symptom Assessment Scale (ESAS) shortness of breath (SOB) scores by one point and increase the percentage of patients experiencing dyspnea for whom opioids are filled in the month preceding death by 10%.

Abstract Methods: An interprofessional team implemented an evidence-based educational intervention which was provided to hospice clinicians regarding palliation of dyspnea, including the recommendation opioids be used. Data from medical records were compiled pre- and post-intervention. Data included the highest documented ESAS SOB score in the last week of life and whether opioids were filled in the month preceding death. Clinician confidence and knowledge were elucidated using pre- and post-intervention surveys

Abstract Evaluation/Results: Documented ESAS scores for shortness of breath decreased after the intervention, but did not reach the project’s goal and were not sustained. Opioids were filled on behalf of 77% of patients experiencing dyspnea, though fill rates were variable over the project period. Providing education to clinicians regarding dyspnea palliation is imperative, but insufficient to sustain desired outcomes. Additional practice change modalities are indicated.

Abstract Implications: Providing education to clinicians regarding dyspnea palliation is imperative, but insufficient to sustain desired outcomes. Additional practice change modalities are indicated. This project relates directly to the fourth of the new AACN Essentials, which is the provision of hospice, palliative, and supportive care in the context of serious illness and end-of-life.

4:00 PM – 4:15 PM
Decreasing the Incidence of Postoperative Corneal Abrasions

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:00 PM – 4:15 PM
Windows
Track: Quality Improvement
Decreasing the Incidence of Postoperative Corneal Abrasions
Lead Author: Cindy Kwok – MD Anderson

Abstract Background: The purpose of this quality improvement initiative was to implement an ocular protection guideline for registered nurses (RNs) caring for patients recovering from anesthesia in the postoperative care unit (PACU) in order to improve ocular care and decrease the incidence of corneal abrasions (CAs). There is a lack of a standardized educational approach regarding evidence based ocular care to the PACU staff on ocular protection techniques and prevention of corneal abrasions.

Abstract Methods: BACKGROUND: The project was implemented in an outpatient community surgical center. Their baseline incidence rate of CAs was 0.17%. The national average is 0.03 – 0.17% (Palte, 2018). METHODOLOGY: Surveys of PACU staff were conducted prior to project implementation to evaluate ocular protection techniques and knowledge. A guideline was created based on survey results, input from key stakeholders, and a literature review on ocular protection. Staff were educated on the guideline prior to implementation. Changes to the program were employed according to the Plan-Do-Study-Act quality improvement method. Post implementation data collection included staff observation using an audit tool to evaluate if PACU RNs were following the guideline and the incidence of CAs.

Abstract Evaluation/Results: RESULTS: Post implementation the incidence rate of CAs was 0%, which exceeded the goal of decreasing the incidence rate to 0.03%. Staff adherence to the ocular protection guideline was 89% which also exceeded the goal of 75%. IMPLICATIONS Standardizing ocular protection techniques in PACU can contribute to decreasing the incidence of CAs for patients recovering from anesthesia. Corneal abrasions can occur anytime during the perioperative period. Therefore prevention of CAs is optimized when all providers involved are educated and actively engaged in CA prevention (Malfa, Coleman, Bowman & Rohrich, 2016)

Abstract Implications: Evaluating the academic culture of the project site can help guide implementation strategies for staff. In non-academic institutions it may be necessary to use other strategies to motivate staff to follow, implement, and sustain the quality initiative. In institutions that promote quality improvement initiatives and where quality improvement has become part of the cultural norm of the organization, medical and nursing staff are more accepting of change, quality improvement initiatives, and application of evidence based practice.

4:15 PM – 4:30 PM
Doll therapy for dementia patients to reduce neuropsychiatric symptoms (NPS) and reduce falls

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:15 PM – 4:30 PM
Windows
Track: Safety
Doll therapy for dementia patients to reduce neuropsychiatric symptoms (NPS) and reduce falls
Lead Author: Angie D. Filipiak, MSN, RN, NEA-BC – Angie’s Purpose LLC

Abstract Background: Doll Therapy reduces NPS of dementia and the need for restrictive and costly interventions including restraints, medications, and safety sitters. Doll therapy is utilized in long-term care facilities, but scant research in acute care is available and no studies have determined if doll therapy reduces falls. Research was done to determine if doll therapy vs. no doll therapy decreased NPS and reduced falls in the acute care setting. NPS include restlessness, agitation, wandering, sleeplessness, wandering, screaming, anxiety, hyperactivity, and sometimes violent behavior. These behaviors increase the intensity of nursing care needed and resources to keep patients safe.

Abstract Methods: Doll Therapy was implemented at 6 hospitals in a health system on 30 participating units. Data was collected logging behavioral symptoms before and after the doll therapy intervention. Dementia fall rates were calculated/1,000 dementia patient days (DPD). Individual patient-level data was not available; therefore, the average length of stay was used to calculate patient days. Sample size 132 dolls given to females during study timeframe and 19 dolls given to males during study timeframe. To determine whether evidence suggests the doll therapy had a positive impact on patients suffering from dementia, a binomial exact test was utilized.

Abstract Evaluation/Results: 83% of females and 74% of male patients showed a reduction in NPS. The test results suggest that the probability of a patient experiencing a positive effect when provided a doll is greater than mere chance (p < 0.01, 95% CI = [0.76, 1.00]). Control data fall rates without the doll therapy intervention was 9.2 dementia falls/1,000 (DPD) compared to 8.8 dementia falls/1,000 DPD during the study timeframe. The fall rate for patients who had dolls was significantly lower at 1.1 dementia falls/1,000 DPD. 85% of nurses surveyed reported doll therapy was not time consuming and recommend implementing doll therapy in the acute care setting.

Abstract Implications: Doll therapy increases patient safety and decreases the cost of healthcare for patients with dementia by reducing NPS and falls in the acute care setting. It is a low-cost innovative intervention to utilize in the acute care and long-term care settings to improve quality, experience, and decrease cost.

4:30 PM – 4:45 PM
Increasing Kangaroo Mother Care by Identifying Barriers and Standardizing KMC Processes

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:30 PM – 4:45 PM
Windows
Track: Quality Improvement
Increasing Kangaroo Mother Care by Identifying Barriers and Standardizing KMC Processes
Lead Author: Sherita Etheridge, DNP, CPNP, CNE – University of Alabama at Birmingham

Abstract Background: Premature birth along with prolong hospitalization in the neonatal intensive care unit (NICU) can result in complications including cognitive, visual, and hearing impairment in addition to other learning difficulties. Kangaroo Mother Care (KMC) is the process of placing the stable premature infant directly onto the skin surface of the parent’s chest and provides physiological, behavioral, and neurodevelopmental benefits for premature infants. KMC also reduces parental anxiety and increases parental confidence when providing infant care in the NICU. There is a gap in consistent utilization of KMC practices. The purpose of this DNP project was to identify barriers, increase the use of KMC in a Level IV NICU, and improve communication.

Abstract Methods: This DNP project involved a pre-intervention NICU nurse survey, chart review of KMC practices and documentation, revisions to current KMC protocol, implementation of prompted documentation tabs in the electronic medical record (EMR), and post-intervention nurse surveys and chart reviews. The DNP team collaborated with the unit leaders to implement prompted documentation tabs in the electronic medical record to identify patients who qualify for KMC, frequency of KMC sessions, and rationales for withholding KMC. Chart reviews were performed on 50 patient charts to evaluate pre and post KMC rates and identify barriers.

Abstract Evaluation/Results: Pre-Implementation nurses survey (N=39) noted 87% of nurses agreed KMC was essential, and 100% were aware of KMC benefits. Post-implementation survey (N=24) noted 70.8% of nurses agreed project increased their KMC awareness, and 70.8% agreed project improved communication. Post intervention outcomes showed increased incidences in KMC practices and improved consistency of documentation. Pre-implementation 36% of patients received KMC, and there was poor documentation of the intervention. Post-implementation of project 64% of patients received KMC. Out of the 238 possible opportunities for KMC, there was a 99% documentation rate.

Abstract Implications: KMC practices improved in the NICU through electronic documentation. The guided prompts reminded nurses of the need to document KMC. Further improvement initiatives are needed to address parental barriers to KMC. The use of electronic medical records can identify specific parental barriers and continued strategies to assist parents in this important task for bonding.

4:45 PM – 5:00 PM
Emergency Department Medication Reconciliations: A Quality Improvement Project on Medication Safety

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:45 PM – 5:00 PM
Windows
Track: Quality Improvement
Emergency Department Medication Reconciliations: A Quality Improvement Project on Medication Safety
Lead Author: Kisha D. Pickford – DNP student, University of South Alabama
Co-Author: Jennifer Miller – University of South Alabama
Co-Author: Katrina Hutton – Baptist Memphis Hospital

Abstract Background: Medication reconciliations are often not performed accurately in an emergency department (ED) setting. At least one medication error happens each day on an average patient hospitalization, and approximately 32% of these errors are discovered at hospital discharge. Discharged ED patients are in great position for obtaining and updating medication histories. Currently, an urban area 56-bed ED does not have a formal process for capturing medication reconciliations on discharged adult patients. A quality improvement project was conducted to 1) identify and correct medication errors in patients’ electronic health records, 2) reinforce the importance of treating clinicians to perform medication reconciliations, and 3) identify a consistent process for obtaining accurate medication information as patients discharge from the ED.

Abstract Methods: Employing a universal medication tool, a total of 100 participants were selected at ED discharge to complete a home medication list for comparison to their electronic medication record. After comparisons, identified discrepancies were corrected once participants clarified medication errors and the treating clinician approved the medication change to correct in the system.

Abstract Evaluation/Results: After a 15-week period, it was discovered that an average of 2.58 (SD + 1.16) medications were documented incorrectly in the electronic record. After noting these discrepancies, 74% of the participants’ records were corrected and updated medication forms were given to the participant for continued use.

Abstract Implications: The project’s outcomes highlighted an improvement at the organization in obtaining accurate medication reconciliations by utilizing Institute for Healthcare Improvement’s (IHI) universal medication form and IPRO’s medication discrepancy tool for detecting erroneously documented medications in the patient’s electronic record. Additionally, this improvement in reconciled mediations offered a better insight on patients’ overall health and helped clinicians in deciding effective and safe treatment options.


Concurrent Session 1
Workshop
Session Time: 3:30 PM – 5:00 PM

3:30 PM – 5:00 PM
Implementing AACN Essentials Toolkits

Wednesday, June 1, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 5:00 PM
Silver
Implementing AACN Essentials Toolkits
Presenter: Judy A. Didion, PhD, RN – Oakland University
Co-Presenter: Gail Armstrong – Oregon Health & Science University School of Nursing


June 2, 2022

7:00 AM – 8:00 AM South Lobby – Registration, Breakfast, and Exhibits (South Foyer)

Special Session
Session Time: 7:30 AM – 8:30 AM

7:30 AM – 8:30 AM
A Culture of Safety and High Reliability Organizations – The RaDonda Vaught Case

Thursday, June 2, 2022
Session Time: 7:30 AM – 8:30 AM
Presentation Time: 7:30 AM – 8:30 AM
Grand Ballroom
A Culture of Safety and High Reliability Organizations -The RaDonda Vaught Case
Lead Author: Mary A. Dolansky, PhD, RN, FAAN – CWRU
Co-Presenter: Kathy BurkeCo-Presenter: Cynthia Oster


Concurrent Session 2
Session Time: 8:30 AM – 10:00 AM

Session 2 A

Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 8:30 AM – 9:00 AM
Tower A
Track: All of the above
Development of a Clinical Competency Assessment Rubric for Competency-Based Orientation
Lead Author: Carrie MdDermott, PhD, RN, APRN, ACNS-BC – Emory Healthcare

Abstract Background: The AACN Essentials endorse a competency-based model to prepare nurses for the future. To progress newly licenses nurses using a competency-based framework performance outcomes must be clearly delineated. An outcomes-based orientation instead of a time-based orientation requires frequent and consistent assessment. The purpose of this project was to develop a method for serial assessments of competency development in alignment with QSEN for competency-based orientation (CBO) and to progress newly licensed nurses to independent practice based on performance outcomes.

Abstract Methods: To identify the essential competencies, we reviewed the extant literature on competency assessment and examined the existing organizational orientation tools. Nine high-level competency domains were identified as performance outcomes essential for the role of an RN in inpatient settings. Four competency domains were adapted from the Lasater Clinical Judgement Rubric and five new domains were developed to incorporate all of the QSEN competencies into The Clinical Competency Assessment Rubric (CCAR). The CCAR was developed for use with newly licensed RNs as a weekly assessment of clinical competency development.

Abstract Evaluation/Results: A pilot test completed in July-December of 2020 with newly licensed RNs (n=134) revealed the average weekly CCAR scores ranged from 14.96 on week 1 to 31.92 on week 12. Preceptors and educators reported their satisfaction with the CCAR as a useful tool for progressing nurses on orientation and more than 80% of the newly licensed RNs reported satisfaction with the length of their orientation. While utilizing the CCAR for CBO, the length of medical-surgical nurses’ (n=74) orientation decreased from 17.5 weeks to 11.82 weeks. The decreased time in orientation represents an estimated a cost savings of $352,657.00.

Abstract Implications: The CCAR appears to be an effective tool to incorporate the QSEN Competencies and the AACN Essentials into CBO. Outcomes-based rather than time-based orientation can decrease cost without decreasing satisfaction with orientation. Future research should include studies to establish the psychometric properties of the CCAR in medical-surgical nursing and other settings, including prelicensure clinical education.

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Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 9:00 AM – 9:30 AM
Tower A
Track: All of the above
A QSEN-Centered Teaching Approach to Promote Effective Care for the Transgendered Patient
Lead Author: David M. Foley, PhD, MSN, RN-BC, CNE, MPA – Case Western Reserve University and Hondros College, Respectively
Co-Author: Morgan Wiggins, DNP, APRN, PMHNP-BC – Ursuline College, The Breen School of Nursing and Health Professions

Abstract Background: The Institute of Medicine has prioritized research into the health needs of LGBT communities with specific emphasis on those of transgender individuals (Institute of Medicine, 2011). Rampant descrimination exists for these patients, potentially depriving them of needed care or detering them from accessing the health care system altogether (Koch, Ritz, Morrow, Grier, & McMillian-Bohler, 2021). Educational tools for effective care practices for this population are highly limited, especially within the context of the QSEN Competencies.

Abstract Methods: A careful review of available QSEN Teaching and Practice Strategies revealed a lack of resources targeting the transgendered population. To address this need, we authored an immersive simulation entitled “Call Me Amy: An Immersive Role Play Highlighting the Needs of the Transgendered Patient” that is currently under review for publication as a QSEN Teaching Strategy. With student participation and as moderated by effective Socratic faculty instruction, the goals of the role play follow the Unit Objecives as well as the Global QSEN Competency Objective. An acompanying “Tips Sheet” discusses evidence-based care practices and a “Faculty Guidelines” section presents strategies for effective implementaiton.

Abstract Evaluation/Results: Although completion of a pilot study may not be feasiable in time for the 2022 QSEN Conference, the authors feel this topic is timely and thus in need of a high level of discussion and a general “call for research and action.”

Abstract Implications: Abstract Implications: Quality, safe, patient-centered care rooted in evidence-based practice should be assured for all patients, not just those that fit into a binary gender schema. With national research agendas’ prioritizing LBG and specifically transgender healthcare needs, it is time to incorporate this concept into the fold of QSEN’s priorities. Nursing is the largest workforce sector within US healthcare and enjoys historic levels of public trust. As such, we must be on the forefront of the important discussions beginning to abound on transgender healthcare needs. The following teaching strategy develops nursing instruction to that end.

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Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 9:30 AM – 10:00 AM
Tower A
Track: Patient Centered Care
Piloting an Outcome-Based Continuing Education Preceptor Program in an International Hospital
Lead Author: Gayle M. Petty, DNP, NP, MSN, BSN, RN – Cleveland Clinic Abu Dhabi

Abstract Background: The nursing profession has used nurse preceptors in both academic and patient care settings for decades. During a 2020 annual continuing educational program review, it was noted that our preceptor development program consisted of a six-hour workshop, without including any reliable or valid clinical evaluation methods/outcomes. This realization was alarming, which triggered this piloted project. The purpose of this piloted project was to redesign a clinical preceptor program at an international hospital utilizing the American Nurses Credentialing Center (ANCC) Outcomes-Based Continuing Education (OB-CE) Model. The OB-CE credit system does not utilize a time-based metric, but instead requires validation of learner engagement and performance for Levels one to five; from basic knowledge to full integrated performance and impact (2019). Three project goals were identified. The first was to professionally develop both learners and faculty using the ANCC OB-CE model in the clinical environment. The second was to evaluate the congruency between outcomes and methods of evaluation for Levels one to four. The third was to increase the number of Nursing Institute competent preceptors.

Abstract Methods: A planning committee was formed led by a Nurse Planner, and included four Nurse Education Specialists and two staff nurses. Each member was expected to review the information from the Accredited Provider Outcome-Based CE manual version 1. 01.28.2019. Twice weekly, meetings were held to discuss each OB-CE Levels and to formulate outcomes, and tools to facilitate/evaluate learner achievement.

Abstract Evaluation/Results: The first and third goals were met. Four faculty were fully engaged in the process. Sixty-five learners obtained the OB-CE Level three; additionally, 34 learners achieved the OB-CE level four during 2021. The second goal was also met. One outcome example for each level is as follows: Level 1: Completed eight CE HRSA preceptor tutorials to learn the theoretical underpinning of the preceptorship role. Level 2: Summarized three examples of a “Just-in-Time Teaching” Level 3: Participated in a “Clinical Practice Rounding” simulation learning activity Level 4: Precepted a new on-boarding nurse for a minimum of eight clinical shifts

Abstract Implications: In summary, this model shifts the education focus from passive learning to experiential, and allows learners to achieve at their pace.

Session 2 B

Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 8:30 AM – 9:00 AM
Tower B
Track: Patient Centered Care
Patient-Centered Fall Prevention in a Community Hospital
Lead Author: Beata Kusnierz, DNP, RN, CMSRN – Rush University
Co-Author: Ben Inventor, PhD, CNP – Rush University Medical Center
Co-Author: Angela Cooper – Rush Oak Park Hospital
Co-Author: Mary C. Zonsius, PhD, RN – Rush University, College of Nursing

Abstract Background: Falls during hospitalization may result in injury, prolonged stay, increased healthcare cost, or death, particularly in older adult patients. In a 39-bed medical-surgical unit of a suburban community hospital, there were 25.1 falls per 1000 patient bed days and 4.8 falls with injury per 1000 patient bed days from February 2020 to June 2020. The purpose of this quality improvement initiative was to reduce fall rates and prevent falls with injury by implementing an evidence-based patient-centered fall prevention program.

Abstract Methods: A post-test design was used, and the Iowa model of evidence-based practice guided the implementation of this initiative. A fall prevention committee conducted a literature review and decided to implement Fall TIPS, a hospital-specific patient-centered fall prevention program. The setting was a medical-surgical unit with 39 beds. The participants were nursing staff, patient care technicians, and all admitted patients who scored 45 and above on the MORSE fall risk scale. The nursing staff and patient care technicians received a one-hour training on the Fall TIPS program. Knowledge gained on fall prevention strategies was measured by administrating a post-test. Staff compliance with the program was evaluated monthly. Fall rates and falls with injury were monitored monthly.

Abstract Evaluation/Results: Over a month, 79 out of 98 (80%) members of the nursing staff and patient care technicians were trained on the program. All staff members complied with the program, and the entire group earned a passing score of at least 80% on the post-training. After five months of implementation, falls significantly decreased to 12.6 per 1000 hospital bed days from a high of 25.1 per 1000 hospital bed days ,and there were no falls with injury.

Abstract Implications: This project showed that the education of staff and patients is critical for preventing hospital falls. There is emerging evidence that patient education on falls in hospitals reduces both falls in general and falls with injuries. Fall TIPS is an effective evidence-based program for reducing falls and falls with injuries in a medical-surgical unit of a community hospital. The reason for this program’s success was that the Fall TIPS tool could be used to customize education for each patient.

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Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 9:00 AM – 9:30 AM
Tower B
Track: Teamwork and Collaboration
Standardizing Discharge Care to Improve Teamwork Collaboration and Interprofessional Partnerships
Lead Author: Michelle Skinner, DNP, APRN, CPNP-AC – Oregon Health & Science University
Co-Author: Gail Armstrong – Oregon Health & Science University School of Nursing

Abstract Background: Inadequate transitional care and gaps in communication lead to fragmented patient care with increased frequency of errors and care coordination failures. The purpose of this quality improvement (QI) project was to standardize the transitional care of hematopoietic cell transplant (HCT) patients at the time of discharge and improve inpatient and outpatient handover. Furthermore, this project illustrated the overlap between QSEN’s Teamwork and Collaboration competency, and AACN’s Interprofessional Partnership competency. This project was based on evidence that the use of a standardized discharge summary results in a reduction of errors in patient handoff and increased provider satisfaction.

Abstract Methods: This QI project consists of a standardized discharge summary template using a modified I-PASS model (illness severity, patient summary, action list, situational awareness/contingency plans, and synthesis by receiver). Elements of the project include an electronic health record smart phrase to standardize documentation and improve team communication, and pre- and post-intervention data to measure satisfaction, quality, and utility of the intervention. Data analysis includes measurement of errors in discharge note (e.g. medications, inaccurate or missing details in plan of care) and readmissions within the first month after discharge.

Abstract Evaluation/Results: Baseline data was collected from the six months prior to implementation of the intervention and post-implementation data from July-November 2021. Initial findings indicate the discharge template increased inclusion of key elements for follow-up care and a statistically significant reduction in errors by 38% (p = 0.00782). Readmission rate in the first month post-HCT discharge was reduced by 16%. Of the outpatient survey respondents, 71% strongly agreed the discharge template provided the vital information needed to assume care of the patient post-discharge.

Abstract Implications: This QI project addresses several overlapping elements of the QSEN competencies and AACN essentials of teamwork, collaboration, and interprofessional partnerships, particularly related to facilitating improvements in handover communication across transitions of care among interprofessional team members. Findings suggest implementation of this standardized handoff tool is a safe, feasible, and effective method to increase the clarity of interprofessional communication and teamwork at a critical point in patient transitional care.

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Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 9:30 AM – 10:00 AM
Tower BTrack: Quality Improvement
A DNP Capstone Experience: Using QSEN competencies to improve mobility on an acute care unit
Co-Author: David H. James, RN, NPD-BC, CCNS – UAB MedicineLead Author: Jadalyn P. Story – UAB – Hospital

Abstract Background: As change agents, DNP-prepared nurses are expected to translate evidence into practice and achieve quality, patient-focused outcomes. The DNP capstone project is designed to showcase this skill set. For example, on an Acute Care for Elders (ACE) unit, baseline data revealed that only 43% of patients achieved mobility consistent with ambulation. The purpose of this presentation is to discuss how the QSEN competencies were used in a DNP capstone project to implement an organized process for addressing daily patient mobility goals on an acute care unit.

Abstract Methods: Throughout this eight-week quality improvement project, the Institute for Healthcare Improvement (IHI) Model for Improvement was used to incorporate a patient-specific goal-setting process on an ACE unit. Through the iterative plan, do, study, and act (PDSA) cycles, the Johns Hopkins-Highest Level of Mobility (JH-HLM) scale was incorporated into a laminated sheet as a standardized form for setting daily mobility goals. Process measures included weekly compliance using the laminated mobility goal sheet and mobility score documentation in the electronic health record (EHR). In addition, the weekly percentage of mobility scores consistent with ambulation and the monthly falls were monitored as the outcome and balancing measures, respectively.

Abstract Evaluation/Results: The highest compliance reached using the laminated goal sheet to set daily patient mobility goals was 81% by the last week of the implementation period, although the goal was 90%. Documentation of mobility scores in the EHR by day shift staff averaged 82%, which increased from the baseline of 77% and exceeded the goal of 80%. In addition, mobility scores consistent with ambulation reached 57% during the last week of the implementation period, thus increasing 32% from the ACE unit’s baseline of 43% and reaching the goal of 56%.

Abstract Implications: This project highlights the infusion of QSEN competencies into a DNP practice experience. Based on this project, the IHI’s Model for Improvement and iterative PDSA cycles provide the student with a solid foundation for quality improvement initiatives and the framework to determine if change indeed improves patient outcomes.

Session 2 C

Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 8:30 AM – 9:00 AM
Tower C
Track: Teamwork and Collaboration
Block the Clot: Reducing Healthcare-Related Venous Thromboembolism
Lead Author: Jeffrey R. Rehnlund – New York Presbyterian
Co-Author: Yuliya Panina – Presbyterian

Abstract Background: Healthcare-associated venous thromboembolism (HA-VTE) is a leading cause of preventable mortality and morbidity in acute care. Administration of pharmacologic prophylaxis can reduce HA-VTE by 70% (Lau et al, 2013), however it is estimated that between 10% and 30% of doses are not administered, with patient refusal documented as the leading cause of nonadministration (Wong et al, 2014). A low rate of VTE prophylaxis administration primarily due to patient refusal was noted in a small, urban hospital, and nursing and pharmacy representatives acknowledged the need to address the low rate to optimize care quality and prevent VTE events.

Abstract Methods: Nursing leads collaborated with pharmacists to identify major barriers to administration of VTE prophylaxis and reasons for refusal, and developed a pocket-sized reference card which supported nurses in addressing these barriers using a patient-centered approach. The card includes an algorithmic tool delineating steps a nurse can take when patients refuse VTE prophylaxis for commonly identified reasons, including use of the “halftime rule” in the safe rescheduling of prophylaxis if the patient refuses due to suboptimal timing. If frequency of injections is cited as a reason, the card provides recommendations to collaborate with the pharmacist to evaluate for drug changes that would result in fewer injections. In the case of other reasons, the card provides talking points to educate patients about the risks and benefits. The card, and inservices for nurses about its content and application, was piloted on a 20-bed post-surgical unit.

Abstract Evaluation/Results: From January-June 2021, before the intervention, the VTE rate was 4.82 per 1000 discharges on the pilot unit and in June 2021, the prophylaxis administration rate was 86.9%. Planning/implementation occurred July-August 2021, and from September-November 2021, the VTE rate on the pilot unit decreased to 3.44 and VTE prophylaxis rates increased to 96.3%.

Abstract Implications: Using a collaborative, patient-centered approach to addressing patient refusal and prophylaxis administration barriers optimized care quality and resulted in an increased rate of administration and a decreased rate of VTE.

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Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 9:00 AM – 9:30 AM
Tower C
Track: Safety
Call Me First
Lead Author: Tricia M. Santaniello, MSN, RN – NYU Langone Health Home Care
Co-Author: Jeanmarie Moorehead, EdD(c), MA, RN, NEA-BC – NYU Langone Health Home Care
Co-Author: Maureen Wolf – NYU Langone Health Home Care
Co-Author: Shaneeza Khan – NYU Lanogne Health Home Care
Co-Author: Laura I. Amendolare, BSN RN – NYU Langone Health Home Care
Co-Author: Sarojini Seemungal – NYU Langone Health Home Care
Co-Author: Kimberly Ross – Nyu Langone Health Home Care
Co-Author: Amanda Glover – NYU Langone Health Home Care
Co-Author: Yesenia Ortiz – NYU Langone Health Home Care

Abstract Background: Preventing readmissions is a top priority for Certified Home Health Agencies (CHHA) in the United States. Hospital readmissions are associated with poor patient outcomes and high costs (Chenjuan et al., 2018). In July 2021, the author’s CHHA’s 60-day readmission rate, measured by Strategic Health Care (SHP) was 16.2%. The CHHA’s readmission rate was higher than the national and state averages of 15% and 15.7% respectively. A SMART goal was set to decrease the CHHA’s 60-day readmissions by 3% by December 2021.

Abstract Methods: Using Plan-Do-Study-Act (PDSA) quality improvement methodology, the CHHA’s Unit-Based Nursing Council examined the percentage of 60-day readmissions. Subsequently, the Council created an intervention tool titled ‘Call Me First’, a five-point questionnaire to identify signs and symptoms of several common diagnoses. The patient is instructed to call and speak to a nurse if they answer “Yes” to any of the questions. To facilitate escalation of signs and symptoms, the questionnaire includes the 24-hour phone number of the CHHA. The registered nurse (RN) triages the phone call, and determines what the next step is for the patient. In August 2021, the tool was introduced to the home health RNs. Education was provided to the RNs to understand the purpose of the tool and how to educate the patients to answer the questions. The tool is supplied on the first homecare visit to every patient and reinforced with each subsequent visit.

Abstract Evaluation/Results: In December 2021, the CHHA’s readmission rate measured by SHP, decreased to 14.2%, a 9.5% decrease which exceeded the goal of 3%. Currently, the CHHA’s readmission rate is lower than the national and state averages.

Abstract Implications: By using the PDSA methodology and developing the “Call Me First” tool, the 60-day readmission rate has decreased. Education of the staff and patients on the utilization of the tool has prevented patients from being readmitted. Patients illustrate understanding of the education by verbal teach-back. When patients are asked, “What are you going to do if your legs are more swollen than usual?” they point to the tool and reply ‘Call Me First’.

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Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 9:30 AM – 10:00 AM
Tower C
Track: Quality Improvement
You have been Served!
Lead Author: Jodi Garcia, Ed.,D., MSN, RN – Trinidad State College
Co-Author: Lori Rae Hamilton, MSN, RN – Trinidad State College
Co-Author: Angie Medina, RN, MSN – Trinidad State College
Co-Author: Nathan Haslett, RN, MSN – Trinidad State College

Abstract Background: Tying together AACN Essential of Professionalism and QSENs Quality Improvement is the goal of this implementation. With the increase in nursing burnout and electronic documentation, it is becoming more important to emphasize the importance of quality documentation, constructive feedback, and understanding the consequences of actions. One educational innovation to accomplish this is the mock trial to help nursing students understand malpractice cases, their legal responsibilities, and the importance of quality documentation.

Abstract Methods: Students are required to practice documentation during simulation throughout the first year of nursing school. The students participate in simulation experiences throughout the nursing program, during the final semester the nursing faculty select from the saved documentation. Once the group is selected for “trial”. The “nurses” or defendant is then challenged in the mock trial setting. The remaining cohort watch while the case then unfolds as the “nurses” take the stand to testify while the prosecution and defense present arguments. This type of simulation experience is led by the nurse educator while allowing for real-life situation in a safe environment through active engagement. In addition, it is imperative that nursing students understand the legal implications of nursing practice and healthcare.

Abstract Evaluation/Results: All the nursing students are surveyed after the mock trail and debriefed. As a result of the mock trials, nursing students in their final semester have stated that they have gained valuable insight to the legal world of healthcare and nursing, clearly understand the importance of accurate documentation, how they can so quickly forget details that they thought they would remember, and much more.

Abstract Implications: The implications of this practice that has been done for over 10 years now, has led to alumni understanding the importance of setting limits on patient loads to allow for the needed time to elaborate on documentation, continued education on documentation after graduation, and the importance of working with those over the facilities electronic documentation to prompt fellow nurses for more detailed documentation. This practice also has enhanced critical thinking, built collaborative teamwork, leadership, and ultimately nursing success.


Concurrent Session 2
Workshops
Session Time: 8:30 AM – 10:00 AM

8:30 AM – 10:00 AM
Co-producing diagnostic safety. Innovations for embedding the patient and family as part of the interprofessional team.

Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 8:30 AM – 10:00 AM
Tower D
Co-producing diagnostic safety. Innovations for embedding the patient and family as part of the interprofessional team.
Presenter: Kelly M. Smith, PhD – University of Toronto
Co-Presenter: Gwen Sherwood, PhD, RN, FAAN, ANEF – University of North Carolina at Chapel Hill
Co-Presenter: Margie Shofer, BA – Agency for Healthcare Research and Quality

8:30 AM – 10:00 AM
Strategies for Implementing the Level 1 AACN Essentials into the Curriculum

Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 8:30 AM – 10:00 AM
Silver
Strategies for Implementing the Level 1 AACN Essentials into the Curriculum
Presenter: Gerry Altmiller, EdD, APRN, ACNS-BC, ANEF, FAAN – The College of New Jersey

8:30 AM – 10:00 AM
Charting a Path from the Graduate QSEN Competencies to the New Essentials

Thursday, June 2, 2022
Session Time: 8:30 AM – 10:00 AM
Presentation Time: 8:30 AM – 10:00 AM
Windows
Charting a Path from the Graduate QSEN Competencies to the New Essentials
Presenter: Brittany Hay – University of South Florida
Co-Presenter: Barb K. Tassell, DNP, RN, NPD-BC – Case Western Reserve University School of Medicine


Time: 10:00 AM – 10:30 AM – South Foyer – Break and Exhibitor


Concurrent Session 3
Session Time: 10:30 AM – 12:00 PM

Session 3 A

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 10:30 AM – 11:00 AM
Tower A
Track: All of the above
Impact of a Senior RN Student Virtual Clinical Practicum on QSEN Competencies
Lead Author: Rayna M. Letourneau, PhD, RN – University of South Florida College of NursingCo-Author: Valerie Halstead – TruMont

Abstract Background: COVID-19 suspended clinical experiences with direct patient care for nursing students. Faculty were challenged to find innovative ways to provide experiential learning activities to prepare students to enter the workforce. A virtual clinical practicum, focusing on QSEN competency domains that new nurses need to provide quality and safe patient care, was initiated in Spring 2020.

Abstract Methods: A quasi-experimental, pre-test post-test design was used to determine if students’ self-assessment of QSEN competencies changed significantly over time. Participants were recruited from a pre-licensure baccalaureate program at a public university in the southwest region of the U.S. The Nursing Quality and Safety Self-Inventory (NQSSI), an 18-item self-rated scale, was used to measure self-reported confidence regarding QSEN competencies.

Abstract Evaluation/Results: One hundred three students participated. A paired samples t-test was conducted to evaluate the impact of the Senior RN Student Virtual Practicum on students’ scores on the NQSSI. There was a statistically significant increase in overall NQSSI scores from Time 1 (M=109.74, SD=11.26) to Time 2 (M=116.47, SD=10.3), t (102)= -7.69, p= .000. Furthermore, there were statistically significant increases in scores of the subscales of the NQSSI: patient-centered care scores from Time 1 (M=18.51, SD=2.03) to Time 2 (M=19.5, SD=1.7), t (102)= -6.21, p= .000; teamwork and collaboration scores from Time 1 (M=18.57, SD=1.9) to Time 2 (M=19.63, SD=1.75), t (102) = -5.97, p= .000; evidence-based practice scores from Time 1 (M=17.84, SD=2.1) to Time 2 (M=19.25, SD=1.98), t (102)= -6.68, p= .000; quality improvement scores from Time 1 (M=17.9, SD=2.19) to Time 2 (M=19.27, SD=2.16), t (102)= -6.72, p= .000; safety scores from Time 1 (M=18.72, SD=2.27) to Time 2 (M=19.55, SD=1.84), t (102)= -3.89, p= .000; and informatics scores from Time 1 (M=18.19, SD=2.41) to Time 2 (M=19.26, SD=2.17), t (102)= -5.38, p= .000.

Abstract Implications: This project explored confidence in attaining QSEN competencies among senior RN students participating in a virtual clinical practicum used to replace traditional clinical placement during the COVID-19 pandemic. Findings indicate the virtual clinical practicum was an effective strategy to advance students’ QSEN competencies. Quality clinical practicums can lead to more confident, competent nurses and have a positive effect on patient outcomes.

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Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 11:00 AM – 11:30 AM
Tower A
Track: Patient Centered Care
Changing Stigmatizing Attitudes: HIV and Contact Tracing Virtual Patient Simulation
Lead Author: Cheryl Wilson, DNP, APRN, ANP-BC, FNP-BC, CHSE, CNE – Elsevier Shadow HealthCo-Author: Geralyn M Altmiller, EdD, APRN, ACNS-BC, ANEF, FAAN – The College of New JerseyCo-Author: Francisco Jimenez – Elsevier Shadow Health

Abstract Background: While significant advances have been made in the treatment and prevention of human immunodeficiency virus (HIV), people living with HIV (PLHIV) face significant stigma, particularly within the healthcare system, manifesting as prejudice, stereotyping, and discrimination from providers. Prevention and treatment are only part of the strategy when it comes to meeting the goal of the United Nations Joint Program of HIV/AIDS aiming to end HIV as a global epidemic by 2030 (Feyissa, et al., 2019). Stigma, bias, and discrimination related to HIV need to be appropriately addressed so that those at higher risk for acquiring HIV infection are comfortable seeking preventive therapies and PLHIV are able to access the healthcare system without fear of recrimination from healthcare providers and staff. Research indicates training regarding HIV stigma lowers stigmatizing attitudes in healthcare providers. This pilot study assessed the effect of a virtual patient simulation focused on providing care for a man diagnosed with HIV and conducting subsequent contact tracing, on the attitudes, beliefs, and behaviors of nursing students.

Abstract Methods: This IRB approved study used the validated Health Care Provider HIV/AIDs Stigma Scale (Wagner, et al., 2014) in a pretest-posttest nonequivalent groups design. Sixty-two junior nursing students in a BSN program were invited to participate; 30 students were assigned to the treatment group and 32 to the control group.

Abstract Evaluation/Results: R statistical package was used for summary statistics and one-way analysis of covariance. No statistical significance was found on scale level scores between the groups but trends at the subscale level and individual item level were notable. Treatment group, scores on the discrimination subscale decreased by 20% and scores on the prejudice subscale decreased by 10% after completing the virtual patient simulation, demonstrating a positive clinical effect.

Abstract Implications: Nurses are in a unique position and ethically obligated to reduce stigma and discrimination for PLHIV and other vulnerable groups. Nursing faculty need to employ innovative learning opportunities to address stigmatizing and discriminatory behaviors and help students reflect on attitudes and behaviors that negatively impact patients. Virtual patient simulation scenarios may be an effective method to provide the education needed to positively impact vulnerable groups.


Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 11:30 AM – 12:00 PM
Tower A
Track: Patient Centered Care
Using Virtual Simulation to Improve Clinical Judgment of Pre-Licensure Nursing Students
Lead Author: Jennifer T. Alderman, PhD, MSN, RN, CNL, CNE, CHSE – UNC Chapel Hill School of Nursing
Co-Author: Carol F. Durham, EdD, RN, ANEF, FSSH, FAAN – UNC Chapel Hill School of Nursing
Co-Author: Susana Barroso, PhD, RN – UNC Chapel Hill School of Nursing
Co-Author: Julie Page – UNC Chapel Hill School of Nursing

Abstract Background: In 2021, the AACN communicated a call-to-action for nursing education with the release of the New Essentials (2021). As reflected in Domain 5 of the New Essentials, quality and safety are critical components in the provision of nursing care (AACN, 2021). Clinical judgment is a featured concept in the New Essentials. Decision-making using sound clinical judgment is foundational to providing safe, quality, patient-centered nursing care. Upon entry into nursing practice, new graduate nurses are not prepared to perform at a high-level, ready to make sound decisions based on high-quality clinical judgment (Kavanagh & Sharpnack, 2021; Klenke-Borgman, 2020). Academic nurse educators must be accountable to clinical partners who expect to receive prepared new graduates. Innovation in nursing education is required to produce prepared, practice-ready new graduates. The purpose of this innovative teaching strategy was to improve the clinical judgment of pre-licensure nursing students in their last semester of nursing school.

Abstract Methods: Using a virtual simulation platform based on the Novice to Expert nursing education theoretical framework (NovEx) and robust debriefing format, we designed a teaching strategy aimed at improving clinical judgment of senior pre-licensure nursing students. NovEx is a virtual clinical unit housing up to 50 patients. Over the course of a semester, students care for a set of 4-6 patients each week. Participants included traditional BSN (n=103) and accelerated BSN (n=102) students.

Abstract Evaluation/Results: Comparing Pre- Post-Assessment results, students improved their ability to provide safe care based on clinical judgment emanating from evidence-based practices from a 14.1% pass rate to 57%, a 309% improvement. Students showed a 55.9% reduction in the number of patients they failed-to-rescue. Students improved in collecting relevant assessment data, prioritizing care, implementing appropriate nursing interventions, recognizing emergent situations, and providing safe care while addressing multiple competing priorities.

Abstract Implications: Educators are obligated to teach pre-licensure nursing students how to use sound clinical judgment to make safe, effective decisions about patient care. This teaching strategy resulted in gains in clinical judgment and application of knowledge directly to clinical practice. This strategy incorporates components of Domain 5 of the New Essentials (AACN, 2021) and the QSEN competencies safety and patient-centered care.

Session 3 B

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 10:30 AM – 11:00 AM
Tower B
Track: Patient Centered Care
Looking to the Future: Ambulatory Academic and Practice Partnership Guidelines
Lead Author: Laurel More, MS, RN, NPD-BC CPN – Children’s Hospital Colorado
Co-Author: Lillian Jessie Jones-Bell, MS Ed, RN, PHN – University of San Francisco
Co-Author: Portia J. Zaire, MSNEd, BSN, RN-CCCTM – The Ohio State University College of Nursing

Abstract Background: The Quality and Safety Education for Nurses (QSEN) project highlighted the need for preparing nurses with the “knowledge, skills and attitudes/abilities” (KSAs) that would improve the “quality and safety of healthcare systems”. The shift from acute care to ambulatory care drives the need to increase the pipeline of nurses who can competently and safely practice in multiple settings. The National Academy of Medicine Future of Nursing 2020-2030 publication and the updated American Association of Colleges of Nursing (AACN) Essentials highlight the push to strengthen and prepare the nursing workforce to incorporate equity, population health, and social determinants of health in patient care. This shift requires academic settings to provide students with ambulatory-based experiences that contribute to health promotion/management in diverse populations.

Abstract Methods: A national organization created a taskforce of academic and practice members, with expertise in Academic Practice Partnerships (APPs), to develop evidence-based guidelines advancing ambulatory clinical learning experiences. A literature review, along with a survey of subject matter experts pinpointed five guideline categories necessary to build ambulatory care APPs. The APP guidelines drive intentional collaboration by addressing academic, practice, and mutual priority recommendations. Guideline categories include partnership framework, academic and practice preparation, student preparation, workforce expansion, and partnerships during disasters and pandemics. Each guideline outlines important background information and definitions to strengthen the evidence-based recommendation. These recommendations assist the pre-licensure or newly transitioning nurse in developing the KSAs required to practice safely in ambulatory care settings.

Abstract Evaluation/Results: We will present current best practices for APPs and the results from a comprehensive survey of ambulatory AP partners which supported the guideline recommendations. These new guidelines can guide the partnership in the preparation of new nurses to deliver coordinated, holistic care that improves outcomes across the lifespan.

Abstract Implications: The new guidelines target the preparation of nurses to deliver competent, safe care to diverse patient populations in settings outside of acute care. Strong ambulatory academic-practice partnerships can positively impact patient outcomes and promote value in the lives of patients.

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Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 11:00 AM – 11:30 AM
Tower B
Track: Quality Improvement
Evidence-based Quality Improvement in Nursing Education: A Senior Practice Collaborative Course
Lead Author: Beth A. Vottero, PhD, RN, CNE – Purdue University Northwest
Co-Author: Marianne Schallmo, DNP, APRN, ANP-BC – Purdue University Northwest

Abstract Background: The updated AACN Essentials focuses on competency-based education which enables nursing students to demonstrate the requisite knowledge, skills, and attitudes needed for nursing practice in today’s complex healthcare environment. Using the new AACN Essentials as a guide, faculty developed a senior level experiential learning course focusing on collaboration in an academic-practice partnership. At the beginning of the semester, project managers submit health care problems occuring at their facility to the College of Nursing. Students then team up with the project manager and faculty mentor to solve the problem. The students apply basic project management principles along with evidence-based quality improvement techniques learned in previous courses.

Abstract Methods: The course is taught by two lead faculty who deliver the didactic content. In addition, there is one faculty mentor per student group consisting of 3-4 students. Throughout the semester, students and their faculty mentor meet with the project director at the facility where the project will take place.

Abstract Evaluation/Results: A commitment of resources by the College of Nursing in the form of additional faculty workload and dedicated funds is required to support this course. Outcomes include: Evidence of student competency in evidence-based quality improvement University funding over $7,000 in competitive undergraduate student grants College of Nursing funding of over $3,000 in nursing student grants Course evaluations significantly higher than other nursing courses Outcomes from projects completed by the student groups

Abstract Implications: This course started in 2008 and has since evolved into a practice synthesis immersion experience. Over 300 projects have been completed and implemented into practice. Examples of projects include interprofessional teamwork (collaboration with engineering students to design a pediatric ambulation isolation station), pure research (effectiveness of different types of masks using Schlieren photography), qualitative approaches (factors contributing to a fall from the patients’ perspective), and quality improvement (effectiveness of gastric pressure relief in infants receiving enteral feedings). Course design will be explained, including the impact of experiential learning on student learning and program objectives. Additionally, we will share the resources required to successfully implement the course, such as financial, networking contacts, and faculty mentoring.

_____

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 11:30 PM – 12:00 PM
Tower B
Track: Quality Improvement
Improving Undergraduate Nursing Students’ Knowledge, Skills, and Attitudes of Quality Improvement
Lead Author: Emily Patton, DNP, CRNP, FNP-C – University of Alabama at Birmingham
Co-Author: Cori C. Johnson, DNP, CRNP, AGNP-C – University of Alabama at Birmingham School of Nursing

Abstract Background: Identifying areas for improvement within a clinical microsystem is the first step of applying empirical evidence to evoke change in practice, including improvement of care quality. While registered nurses (RNs) are poised to lead quality improvement (QI) initiatives in various practice settings, undergraduate nursing students often lack opportunities to engage in QI efforts. The purpose of the Microsystem Analysis assignment is to provide pre-licensure nursing students with a better understanding of QI methods for use in practice-based improvement efforts in the primary care setting.

Abstract Methods: Students are assigned to a primary care clinic to complete 48 hours of clinical experience. Using the Institute for Excellence in Health and Social System’s Outpatient Primary Care Workbook and guidance from their preceptors, students analyze their assigned clinical microsystem. The assignment is split into three sections including Primary Care Practice Profile (PCPP), Workbook, and Written Narrative. The PCPP provides a broad overview of the “5 Ps” of a clinical microsystem: (1) Purpose, (2) Patients, (3) Professionals, (4) Processes, and (5) Patterns. After completing the PCPP, students then complete specific sections of the Outpatient Primary Care Workbook focusing on Patients, Professionals, and Processes. After the appropriate workbook pages have been completed, students provide a written narrative discussing findings from the analysis and recommendations for improvement supported by evidence from the literature.

Abstract Evaluation/Results: Nineteen students have successfully completed this assignment and presented findings and improvement recommendations to clinical faculty. Currently eleven more students are doing this project. This assignment was well received and served as an effective tool for students to apply QI skills in the practice setting. Using this assignment improves QI knowledge, skills, and attitudes in pre-licensure students.

Abstract Implications: Findings of this teaching strategy suggest students’ understanding of QI improves when they are given the opportunity to apply this information in clinical practice. Critical thinking skills are strengthened as students analyze clinical microsystems and determine steps for improvement. Students who feel confident in their understanding of QI efforts will likely be more inclined to use similar strategies as RNs in the clinical environment, ultimately leading to improved patient outcomes.


Concurrent Session 3
Rapid Fire Session
Session Time: 10:30 AM – 12:00 PM

10:30 AM – 10:45 AM
Interdisciplinary Studies in Palliative Care: Aligning QSEN and Essentials Competencies

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 10:30 AM – 10:45 AM
Tower C
Track: Teamwork and Collaboration
Interdisciplinary Studies in Palliative Care: Aligning QSEN and Essentials Competencies
Lead Author: Monica E. Hall – Illinois Wesleyan University
Co-Author: Victoria N. Folse, PhD, APRN – Illinois Wesleyan University

Abstract Background: Designing curricula and direct care experiences to align the QSEN competencies of Teamwork and Collaboration with the Essentials Domain 6: Interprofessional Partnerships is particularly challenging in institutions without academic medical centers, and in particular, exclusively undergraduate institutions. Strengthening connections between QSEN pre-licensure Patient-Centered Care knowledge, skills, and attitudes with the Essentials concepts of Communication and Compassionate Care are particularly important during this global pandemic. A pre-licensure course for nursing and pre-health majors at an exclusively undergraduate institution exemplifies the interface between QSEN and the Essentials.

Abstract Methods: An Interdisciplinary Studies in Palliative Care and Gerontology course was designed to explore barriers to quality palliative and gerontological care from an interdisciplinary perspective. Content included teamwork and communication skills, pain and symptom management, bereavement, final hours of life, and advance care planning. Focus was placed on the analysis of ethical dilemmas and the development of cultural competency. Recommendations from evidence-based practice publications (e.g., IOM’s Dying in America; The End-of-Life Nursing Education Consortium [ELNEC] modules) were incorporated. Two simulations assisted students in understanding the complexity of end-of-life care as members of an interprofessional healthcare team. Students who completed the course could expand application of content with competitive summer internships.

Abstract Evaluation/Results: The newly developed course was introduced May Term 2019 to 24 students in nine majors including biology, biochemistry, neuroscience, nursing, and psychology. Fifteen nursing, pre-medicine, pre-pharmacology, and pre-occupational therapy students completed summer internships. Despite the pandemic, 29 interdisciplinary students were remotely enrolled in May 2020 with nine students placed in hybrid summer internships. In May 2021, the course resumed a face-to-face format for 28 students, but internships were suspended due to the pandemic.

Abstract Implications: This innovative course exemplifies the alignment of QSEN and the 2021 AACN Essentials. Quantitative and qualitative evidence of meeting course objectives (e.g., evaluate own values and attitudes toward care of the serious ill and dying patient and their family; demonstrate active listening and mindful presence as essential skills for providing empathic care of patients and families) will be described. Lessons learned from offering the course three times will be shared allowing others to individualize the design for their academic or practice setting.

10:45 AM – 11:00 AM
Implementation of a Best Practice Advisory Clinical Workflow to Support Smoking Cessation

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 10:45 AM – 11:00 AM
Tower C
Track: Quality Improvement
Implementation of a Best Practice Advisory Clinical Workflow to Support Smoking Cessation
Lead Author: Katharine C. Ruestow – Rush University Medical Center

Abstract Background: Purpose: The purpose of the project is to (1) develop and establish the feasibility of an electronic medical record (EMR) facilitated clinical workflow for identifying smokers, advising them about smoking cessation, and connecting them to smoking cessation resources, and (2) evaluate the efficacy of this workflow relative to reach and engagement of patients.

Abstract Methods: Methods: This project is implemented based on the Ask-Advise-Assist approach. Three phases included: (1) training medical assistants to standardize assessment of smoking status at every patient visit, (2) developing and implementing an EPIC-based Best Practice Advisory (BPA) that alerts oncologists in real-time about patients who are smokers, encourages brief advice, and facilitates referral to cessation services via an Order SmartSet, (3) surveying provider experience. Providers have the option to either self-initiate a referral via the Tobacco Cessation Order SmartSet or defer this task to the nursing pool for phone-based follow-up.

Abstract Evaluation/Results: Results: The workflow was implemented in January 2021 through June 2021. Of 991 unique patients seen in clinics, 120 (14%) were current smokers (51% female, 47% White, 47% Black) and the majority were in active treatment. There were 186 BPA alerts, of which 38% were canceled by the provider, 23% were acknowledged as patient declines, 8% were acknowledged as already connected to resources, and 31% were deferred to the nursing pool. This resulted in 56 smokers (47% of all smokers) receiving follow-up; of these, 22 (39% of all smokers) accepted at least one smoking cessation resources. Nurse surveys demonstrate engagement and that smoking cessation follow-up is acceptable and feasible in their workflow.

Abstract Implications: Discussion: An EMR-facilitated clinical workflow that automates the process of identifying current smokes and facilitates connection to cessation services is efficient, feasible to implement, and largely acceptable to medical teams. Ongoing challenges include engaging physicians to initiate referral to cessation services (vs. deferring to nursing) and continued education for medical teams. Implementing this workflow cancer center wide may be beneficial to solidifying smoking cessation as a core prevention task in oncology and in helping a greater proportion of cancer patients who are smoking connect to cessation services.

11:00 AM – 11:15 AM
Enhancing Undergraduate Nursing Students’ QI Competency: A Diabetes Prevention Outreach Program

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 11:00 AM – 11:15 AM
Tower C
Track: Quality Improvement
Enhancing Undergraduate Nursing Students’ QI Competency: A Diabetes Prevention Outreach Program
Lead Author: Katherine Schade – Case Western Reserve University
Co-Author: Rebecca L. Mitchell, MSN, DNP – Case Western Reserve University
Co-Author: Marcus Harvey, BSN – Case Western Reserve University
Co-Author: Sophie Vilamara, BSN Student – Case Western Reserve University
Co-Author: Sumin Lee – Case Western Reserve University

Abstract Background: Innovative teaching strategies are needed to enhance quality improvement competencies in undergraduate education. A Northeast Ohio School of Nursing (SON) collaborated with a local Federally Qualified Health Center (FQHC) and a State-wide Diabetes Prevention Program (DPP) on a quality improvement initiative to build a primary care diabetes prevention telephone outreach program. Including students in the development and implementation of quality improvement builds knowledge, skill and attitudes for systems-based practice and quality improvement.

Abstract Methods: Students contacted at-risk FQHC patients and registered them for the DPP with the goal of reducing type 2 diabetes diagnoses in the community. The outreach process began with contacting eligible patients via a text messaged screening tool. Screening tool responses were sorted into low risk and medium/high risk categories. Medium/high risk patients were sent to students for telephone outreach. The students created process maps and educational documents, called patients, navigated barriers in the outreach process, and documented each outcome in the electronic health record. The project required continual education of SON collaborators regarding implementing the call process and registering patients for the DPP. Data were collected to evaluate patient contact efficacy, DPP registration rates, and effectiveness of SON education and call implementation. The curriculum guiding the project included the Institute for Healthcare Improvement modules and a 7-step quality improvement process based on the Model for Improvement.

Abstract Evaluation/Results: Formative evaluation, monitoring the data each week, led to adjustments in the process by altering texting and contact protocols. Of the 32 at risk patients referred to the students, the students were able to connect 50% to the DPP. Outreach methods performed by FQHC and SON will be documented with the intention of dissemination to, and collaboration with, other FQHCs.

Abstract Implications: Student involvement in the development and implementation of a quality improvement project contributed to competency achievement in both quality improvement and systems-based practice competencies and contributed to positive health outcomes for diabetes prevention. The activity also provided an opportunity for teamwork and collaboration by working with experts in nutrition and program development. The project serves as a model program that can be implemented to address other chronic diseases.

11:15 AM – 11:30 AM
Competency-based care transitions curricula for prelicensure nursing education

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 11:15 AM – 11:30 AM
Tower C
Track: Quality Improvement
Competency-based care transitions curricula for prelicensure nursing education
Lead Author: Michael K. Mosley, MSN RN, ANP-BC – University of Alabama at Birmingham
Co-Author: Rebecca S. Miltner, PhD, RN, CNL, NEA-BC – University of Alabama at Birmingham

Abstract Background: The American Association of Colleges of Nursing’s (AACN) competency-based essential framework for nursing education expects nursing student development of competencies and subcompetencies for nursing practice. Many of these involve components of care transitions, transitional care, and/or care coordination. This program evaluation attempts to cross the divide between health system needs and nursing curriculum to address competency development in entry to practice nurses in care coordination and transition management.

Abstract Methods: A competency-based model proposed by Frenk et al. (2010) recommends that input be gathered on health system needs to inform curricular design. The evaluation questions guiding this work are: 1) What are care transitions competency needs identified at the health system and academic levels? 2) In what ways does the academic curriculum content compare with health system needs? and 3) In what ways can the health system’s needs influence competency-based education to improve care transitions competency in entry-level nurses? Semi-structured interviews will be conducted to gather information on health system and academic stakeholders’ perception of competency, needs, and competency development in care transitions, transitional care, and/or care coordination for entry level nurses. Interviews will be conducted via Zoom and recorded with permission. Interviews are currently underway.

Abstract Evaluation/Results: Interview responses will be evaluated using rapid cycle qualitative analysis for inclusion of relevant AACN competencies and the AAACN Care Coordination and Transition Management domains. Curricular analysis of current course objectives, assignments, and module topics will be performed to identify current content in care coordination and transition management. A gap analysis will then be performed comparing the content being delivered at the academic level to the needs identified at the health system level. Evaluation findings and recommendations to improve curricular content will be communicated to key stakeholders at the school of nursing and the health system.

Abstract Implications: Better understanding of health system needs will foster improved academic curricular development in producing competent, entry-to-practice nurses. As Schools of Nursing adopt the 2021 Essentials, these evaluation methods could be applied to other AACN competencies beyond the ones related to care transitions and care coordination.

11:30 AM – 11:45 AM
Educational Quality Improvement and “Health for All”: Training-the-Trainer

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 11:30 AM – 11:45 AM
Tower C
Track: Quality Improvement
Educational Quality Improvement and “Health for All”: Training-the-Trainer
Lead Author: Stephanie Hammond, DNP,CRNP, ANP-BC, COHN-S – University of Alabama at Birmingham, School of Nursing
Co-Author: Nancy Rudner, DrPH, APRN – University of Alabama at Birmingham, School of Nursing
Co-Author: Sharon L. Holley, DNP, CNM, FACNM – University of Alabama at Birmingham, School of Nursing
Co-Author: Jennifer Harrison Deutsch, RN – University of Alabama at Birmingham, School of Public Health
Co-Author: Lisa Theus, MPH – University of Alabama at Birmingham, School of Nursing
Co-Author: Adelais Markaki, PhD, APRN-BC, FAAN – University of Alabama at Birmingham, School of Nursing

Abstract Background: The World Health Organization (WHO) mandate for “Health for All” has shifted the paradigm in nursing and midwifery. In 2018, a consortium of WHO Collaborating Centers developed an educational quality improvement (EQI) toolkit to strengthen the quality of nursing and midwifery education and practice for universal health and primary health care across the Americas. This project was designed to pilot test, evaluate, and enhance the use and dissemination of the English version of the EQI Toolkit resource in building capacity and leadership for nurse and midwife educators in the Caribbean region.

Abstract Methods: Based on the “Model for Sustainability in Global Nursing”, two pilot test sites were established with a Caribbean university. A team of nursing, midwifery, implementation science, and program evaluation experts from the host institution planned and executed a “train-the-trainer” program, in consultation with pilot participants. The team developed and recorded a narrated training webinar based on the toolkit, “A Plan for Nursing & Midwifery Education Quality Improvement in Universal Health and Primary Health Care”.

Abstract Evaluation/Results: A collaborative iterative process facilitated refinement and cultural adaptation of training materials. Through a series of three virtual coaching sessions, pilot participants identified areas for improvement and deployed the “Plan-Do-Study-Act” cycles to enhance nursing and midwifery curricula, plans of study, and programs. The “Model for Improvement”, a data-driven approach to performance analysis, will be evaluated. Cognitive debriefing will include qualitative feedback from pilot site nurse and midwifery educators regarding the ease, relevance, and applicability of toolkit materials. In addition, suggested cultural adaptations, as well as enablers and barriers to utilization will be captured.

Abstract Implications: This work in progress is expected to build QI capacity across nursing and midwifery programs, as well as enhance educational structures, processes, and outcomes relevant to primary health care and universal health. It will provide valuable information on innovations in education, professional development, and practice to enhance quality and safety in healthcare. It will also identify strategies for quality competency integration into undergraduate and graduate curricula, supporting domains 1, 2, 5, 7 and 10 of the “AACN Essentials: Core Competencies for Professional Nursing Education”.


Concurrent Session 3
Workshops
Session Time: 10:30 AM – 12:00 PM

10:30 AM – 12:00 PM
TeamSTEPPS® for Diagnosis Improvement

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 10:30 AM – 12:00 PM
Tower D
TeamSTEPPS® for Diagnosis Improvement
Presenter: Christine Goeschel, ScD, MPA, MPS, RN, FAAN – MedStar Health
Co-Author: Alberta Tran

10:30 AM – 12:00 PM
Competency Crosswalk: QSEN Competencies Continue to Support Pre-licensure Professional Nursing Curricula

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 10:30 AM – 12:00 PM
Grand Ballroom
Competency Crosswalk: QSEN Competencies Continue to Support Pre-licensure Professional Nursing Curricula
Presenter: Tracey Dick, PhD, RN, CNE, COI – University of Alabama at Birmingham
Co-Presenter: Elizabeth M. Byrd, PhD, RN, CCNS – University of Alabama at Birmingham
Co-Presenter: Shannon S. Layton, DNP, MSW, RN, CNL, NEA-BC, CWCN, LICSW, PIP – UAB School of Nursing
Co-Author: Elizabeth M. Byrd, PhD, RN, CCNS – University of Alabama at Birmingham
Co-Author: Shannon S. Layton, DNP, MSW, RN, CNL, NEA-BC, CWCN, LICSW, PIP – UAB School of Nursing

10:30 AM – 12:00 PM
Synergy for Change – Improvement and Implementation science to drive EBP: The Hirsh Institute at CWRU

Thursday, June 2, 2022
Session Time: 10:30 AM – 12:00 PM
Presentation Time: 10:30 AM – 12:00 PM
Windows
Track: All of the above
Synergy for Change – Improvement and Implementation science to drive EBP: The Hirsh Institute at CWRU
Presenter: Mary A. Dolansky, PhD, RN, FAAN – CWRU
Co-Presenter: Shanell Hill, MSNCo-Author: Pamela Bolton

Time: 12:00 PM – 1:00 PM – Grand Ballroom – Lunch


Time: 1:00 PM – 2:00 PM – South Foyer – Exhibit Hall Extravaganza!

Keynote
Session Time: 2:00 PM – 3:00 PM

2:00 PM – 3:00 PM
Traditional Clinical Outcomes in Pre-licensure Nursing Education: An Empty Systematic Review

Thursday, June 2, 2022
Session Time: 2:00 PM – 3:00 PM
Presentation Time: 2:00 PM – 3:00 PM
Grand Ballroom
Traditional Clinical Outcomes in Pre-licensure Nursing Education: An Empty Systematic Review
Keynote Speaker: Suzan Kardone-Edgren, PhD RN, ANEF, CHSE, FSSH, FAAN – MGH Institute of Health Professions

Time: 3:00 PM – 3:30 PM – South Foyer – Exhibits Main Level

Concurrent Session 4
Session Time: 3:30 PM – 5:00 PM

Session 4 A

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 4:00 PM
Tower A
Track: Quality Improvement
Change is Hard: Top 10 lessons learned from implementing a safe mobility program
Lead Author: David H. James, RN, NPD-BC, CCNS – UAB Medicine
Co-Author: Jadalyn P. Story – UAB – HospitalCo-Author: Valerie Labbe – UAB Medicine

Abstract Background: There is often a breakdown in communication between physical therapy and nursing regarding the responsibility of patient mobility. This communication problem contributes to mobility being the most frequently missed clinical intervention. A comprehensive safe mobility program was implemented at a large academic medical center to address this gap. The purpose of this presentation is to share lessons learned and key programmatic changes made based on our experience.

Abstract Methods: Using the Institute for Healthcare Improvement model and iterative Plan, Do, Study, Act (PDSA) cycles, the safe mobility program was refined to its current state, consisting of five phases. Each phase consists of activities designed to address both individual and system barriers. The six QSEN competencies were used as a framework to identify the top ten lessons learned from our three-year safe mobility journey. These ten lessons were identified from a review of our committee minutes, analysis of data trends, and discussion with key stakeholders.

Abstract Evaluation/Results: According to an analysis, the following were identified as the top ten lessons learned: 1) the value of Quality Improvement (QI) frameworks (Quality Improvement); 2) the need to prioritize safety and 3) the limitations of a mobility tech role (Safety); 4) the need for a data-driven process (Informatics); 5) the value of engaging patients and families in safe mobility (Patient-centered care), 6) the need to evaluate individual competency and 7) the need to create a culture of safe mobility (evidence-based practice); 8) the need to identify the right stakeholders and 9) the value of teaching QSEN competencies by engaging students in the process and 10) the need to define a plan for sustainability (teamwork and collaboration).

Abstract Implications: The lessons learned informed both previous and planned program revisions. Each lesson learned aligns with the QSEN competencies, thus providing a valuable framework for others designing a safe mobility program. The lessons learned continue to positively impact the program and heavily influence the quality of care patients receive.

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Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:00 PM – 4:30 PM
Tower ATrack: Quality Improvement
Let’s Get it Done with Quality 101
Lead Author: David C. Mulkey, DNP, RN, CPHQ, CCRN-K, CHSE – Denver Health & Hospital Authority
Co-Author: Mimi Ryan, MS, RN, NE-BC – Denver Health & Hospital Authority

Abstract Background: The nursing education and research department at an urban, safety-net, teaching hospital deployed a nursing strategic planning needs assessment, and it was discovered that most of the nursing leadership and clinical nursing staff did not understand data driven quality improvement. The purpose of this project was to create a voluntary, on-demand, online Quality 101 course for nursing leaders and clinical nurses to improve knowledge, skills, and attitudes about quality improvement processes.

Abstract Methods: The first step was to create a business proposal and to get stakeholder approval. Once approval was received, subject matter experts were selected to develop the curriculum based on credentials, experience, and passion for quality improvement. The curriculum was developed based on the graduate QSEN competencies. The QSEN competencies were integrated throughout the curriculum and drove the content presented. Knowledge, skills, and attitudes were measured pre and post using the valid and reliable Beliefs, Attitudes, Skills, and Confidence in Quality Improvement (BASIC-QI) Scale. Participants were assigned a participant number to compare pre and post results using a paired sample t-test. The number of quality improvement projects were tracked using an already existing tracking document to see if there was an increase in projects pre and post implementation of the educational course.

Abstract Evaluation/Results: Total of 50 participants completed the course. A two-tailed paired samples t-test was conducted to examine the mean differences of the three BASIC-QI subscales. The results of the knowledge subscale were significant based on the alpha value of 0.05, p = .002. The results of the skills subscale were significant, p = .016. The results of the attitudes subscale were not significant, p = .290. The number of quality improvement projects increased from 3 the previous year to 17.

Abstract Implications: Quality improvement training is an important component of nursing education that ensures nurses can contribute to the advancement of patient safety. Quality improvement competence is important for the development of appropriate educational programs that will help facilitate nursing care delivery and involvement in quality improvement initiatives. Integrating graduate QSEN competencies into an on-demand, online quality 101 course showed to improve the knowledge and skills towards quality improvement.

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Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:30 PM – 5:00 PM
Tower A
Track: Quality Improvement
Evaluation of an IHI Quality Improvement Training: Advancing QSEN Competencies during the Pandemic
Lead Author: Mary C. Zonsius, PhD, RN – Rush University, College of Nursing
Co-Author: Kathryn Swartwout,, PhD, APRN, FNP BC – Rush University, College of Nursing
Co-Author: Arlene M. Miller PhD, RN, FAAN, PhD, RN, FAAN – Rush University, College of Nursing
Co-Author: Mary Heitschmidt PhD, APRN, CCRN-K, FAHA – Rush University Medical Center
Co-Author: Bonnie Ewald, MA – Rush University Medical Center

Abstract Background: Background: Improved health outcomes occur when interprofessional teams employ systematic quality improvement (QI) processes. An accountable care organization sponsored an Institute for Healthcare Improvement (IHI)-led QI training workshop for thirteen partner agencies. Participants completed a pre-training workshop QI confidence survey. The project purpose was to evaluate the impact of the IHI QI training workshop using the RE-AIM Program Evaluation Model and the QSEN competencies.

Abstract Methods: Methods: Pretest-posttest design; project occurred during COVID-19 pandemic. Two virtual focus groups were held. Focus group proceedings were transcribed and analyzed using Dedoose software. A 35-item self-report survey to identify post-workshop change was created based on themes from the focus groups and selected IHI pre-training workshop QI confidence survey items. Quantitative data were analyzed using SPSS to report frequencies and matched comparisons of the pre- and post-training survey. Qualitative responses further illustrated survey findings.

Abstract Evaluation/Results: Results: Twenty-six interprofessional participants, representing eight of the thirteen agencies, completed the post-survey, including registered nurses, social workers, physicians, and administrators (e.g., MPH, MPA). Twenty-five participants (96.2%) reported using minimally one QI tool in the past year, including flow chart (69.2%), run chart (61.5%), driver diagram (42.3%), fishbone diagram (19.2%), and Pareto chart (15.4%). QI processes utilized included PDSA (Plan/Do/Study/Act) cycles (69%) and written objectives (85%) (QSEN QI competency). Facilitating factors to incorporate learned techniques included leadership support (65%), teamwork (54%), stakeholder buy-in (50%), QI champions (35%), dedicated time for QI (35%), and a spirit of perseverance (35%). Barriers identified included competing priorities (77%), time scarcity (62%), need for more training (27%), and insufficient teamwork (23%) (QSEN Teamwork/Collaboration competency). Twenty-one respondents completed both the pre- and post-workshop surveys. The items were scored 1= I have no knowledge of this concept/tool to 6 = I am confident and comfortable in explaining, applying, and teaching this concept/tool. Matched comparisons revealed improvement in overall mean scores of .48 for each item (pre-test 3.64; post-test 4.12).

Abstract Implications: Implications: QI training equipped interprofessional teams with QI and Teamwork/Collaboration QSEN competencies that successfully prepared them to manage change during a stressful pandemic. QSEN competencies supported interprofessional team development to lead and collaborate during difficult times.

Session 4 B

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 4:00 PM
Tower B
Track: Teamwork and Collaboration
Enhancing patient safety through a simulation focused on improving communication and self-awareness.
Lead Author: Jennifer T. Alderman, PhD, MSN, RN, CNL, CNE, CHSE – UNC Chapel Hill School of Nursing
Co-Author: Carol F. Durham, EdD, RN, ANEF, FSSH, FAAN – UNC Chapel Hill School of Nursing
Co-Author: Mindy Storrie – UNC Chapel Hill Kenan-Flagler School of Business

Abstract Background: AACN has determined that the 21st century nurse must practice as a skilled care coordinator across four spheres of care: disease prevention/promotion, chronic disease care, regenerative/restorative care, and hospice/palliative care while simultaneously maintaining safety and quality of care (AACN, 2021). Considering these expectations, nurses are met with many competing priorities while providing patient-centered care. Pre-licensure nurses often enter the workforce underprepared for these pressures. Educators are obligated to provide opportunities for pre-licensure nurses to practice leadership skills such as effective communication, managing conflict, and increasing self-awareness. The purpose of this leadership simulation was to improve communication, conflict management, and self-awareness knowledge, skills, and attitudes of pre-licensure nursing students.

Abstract Methods: In collaboration with the Business School, Nursing developed the Peak Performance leadership simulation to assist pre-licensure nursing students improve their leadership skills. The learner responds to a variety of patient care, team-based, and personal situations utilizing various means of communication in the context of six patient care rounds. Students must be time efficient while addressing multiple situations per round. Debriefing focused on student’s prioritization, conflict management, and self-awareness. Post debriefing, students completed a reflection workbook and had the opportunity for one-on-one coaching sessions with Business School executive coaches.

Abstract Evaluation/Results: Students completed pre/post assessments in which they evaluated their personal skills in self-awareness, communication, collaboration, openness, managing conflict and managing others. The reflection workbook provided qualitative data related to self-evaluation of the following core values: empathy, integrity, and respect, along with a 3-step Action Plan for improvement. Students noted improvement in knowledge and skills around communication and managing conflict, but frustration was expressed in the inability to complete all rounds of the simulation. Students were surprised by the complexity of care coordination awaiting them as they enter nursing practice.

Abstract Implications: Pre-licensure students increased their communication skills and obtained a better understanding of how to manage conflict in real-world circumstances fraught with competing priorities. Effective communication, conflict management, and self-awareness are critical to patient safety and providing quality care. Exposing students to the complex care coordination role of the nurse aligns well with the new AACN Essential Domains 2.9a-e and 5.2a-f. (AACN, 2021).

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Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:00 PM – 4:30 PM
Tower C
Track: Quality Improvement
Sustaining Patient Experience Care Transition Metrics: Leveraging Academic Practice Partnerships
Lead Author: Shannon S. Layton, DNP, MSW, RN, CNL, NEA-BC, CWCN, LICSW, PIP – UAB School of Nursing
Co-Author: Randy Moore, DNP, RN – UAB School of Nursing, Birmingham VA Healthcare System
Co-Author: Rebecca S. Miltner, PhD, RN, CNL, NEA-BC – University of Alabama at Birmingham

Abstract Background: The Birmingham VA Health Care System had poor performance in care transition metrics compared to other regional and national facilities. A team led by a VA Quality Scholar (VAQS) identified several opportunities for improvement including increasing Veteran engagement and knowledge retention with the discharge process. The primary aim of this project was increasing Veteran care transition (CT) experience scores from the lowest quintile to the fourth quintile nationally over one year. A secondary aim was creating a mechanism to sustain improvement.

Abstract Methods: A four-phase plan using the Model for Improvement was selected for project implementation. Phases 1-3 consisted of establishing an interprofessional workgroup to conduct rapid cycle quality improvement (RCQI) to develop and streamline an evidence-based Veteran and caregiver discharge bundle (VCDB). This included a discharge journey board (DJB) and companion website created to enhance knowledge retention. These actions improved Veterans’ experience with discharge planning; however, initial use of a third-party vendor was not sustainable to support the DJB and website. We sought additional sustainment opportunities, creating a partnership between the VAQS fellowship program, the VA Post Baccalaureate Registered Nurse Residency program (PB-RNR), and facility nurse leaders. Key stakeholders from each group were identified to continue this work. The PB-RNR Residents completed nine literature reviews and designed nine webpages to support the DJB website.

Abstract Evaluation/Results: Quarter 4 FY2021 CT scores increased nationally rising from the 5th (48) to 3rd quintile (79). Qualitative data from leadership rounds affirmed positive Veteran engagement with the DJB and website. Veterans reported satisfaction with DJB delivery and content. PB-RNR Residents found opportunities to participate in project sustainment meaningful and engaging. Residents participated in RCQI completing 9 EBP practice projects.

Abstract Implications: Veteran experience score improvements can be monitored and sustained through an academic practice partnership. In addition, nurse residents completed meaningful EBP projects while engaging in work that supports organizational and Veteran needs.

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Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:30 PM – 5:00 PM
Tower B
Track: Quality Improvement
Dispelling the Myths: The Real Impact of Incivility on Academic Performance in Nursing Education
Lead Author: Tammy Scott, PhD, RN, BC – Texas Tech University Health Sciences Center School of Nursing

Abstract Background: Incivility seriously impacts the teaching-learning environment and often results in dysfunctional student-faculty relationships. Reports of incivility within nursing education primarily focuses on student behaviors; however incivility is generally not one sided. In academia, incivility can occur in student to faculty, faculty to student, faculty to faculty, and student to student relationships. This study examined the relationship between perceived student and faculty incivility on perceived academic performance among undergraduate nursing students.

Abstract Methods: Utilizing Clark’s (2008) Conceptual Model For Fostering Civility in Nursing Education framework, a predictive correlational design was used to examine students’ perceptions of incivility. The research question: Is there a predictive relationship between perceived incivility by nursing student peers, and nursing faculty on student’s academic performance? The study population: Associate and Baccalaureate degree nursing students. Data collection tools: Demographic survey; the Perceived Academic Impact of Incivility in Nursing Education scale (PAINE); and the Incivility in Nursing Education scale, Revised (INE-R). Statistical analysis included Multiple regression and a Paired Samples t-test.

Abstract Evaluation/Results: Pre-licensure undergraduate nursing students (n=74) completed the PAINE Scale. 14.8% of respondents reported incivility by nursing faculty negatively affected their grade. 24.6% of respondents reported incivility by nursing faculty made them less confident in their ability to complete the nursing program. 27.4% of respondents reported incivility by nursing faculty caused them to consider leaving the nursing program. 25.68% of respondents reported incivility by nursing faculty made them afraid to ask questions in the classroom or clinical setting. 17.8% of respondents reported incivility by nursing faculty made them afraid to admit they didn’t know how to perform a procedure in the clinical setting. The findings (p=4.96E-09) indicate perceived faculty incivility has a greater impact on academic performance than perceived student incivility.

Abstract Implications: The implications of this study informs nursing education and nursing practice there is more to do in eradicating incivility within the nursing profession. Ensuring the AACN essentials are integrated through nursing curricula is crucial in this effort. Domain 2: Person -Centered Care, Domain 5: Quality and Safety and Domain 10: Personal, Professional, and Leadership Development are priority competencies to guide nurse educators in this endeavor.

Session 4 C

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 4:00 PM
Tower C
Track: All of the above
Content Validation of a QSEN Based Evaluation Instrument for NP Students
Lead Author: Mary Ann Dugan, DNP, FNP-BC – The College of New Jersey
Co-Author: Gerry Altmiller, EdD, APRN, ACNS-BC, ANEF, FAAN – The College of New Jersey

Abstract Background: Nurse practitioner student clinical performance is a high-stakes assessment and as such requires a validated instrument. The National Organization of Nurse Practitioner Faculties, American Association of Colleges of Nursing, and National Task Force on Quality Nurse Practitioner Education provide guidance for nurse practitioner programs, but currently there is no validated instrument endorsed for evaluating nurse practitioner student clinical performance. This presentation will describe the IRB approved study to established content validation of the newly developed Quality and Safety Framed Clinical Evaluation for nurse practitioner students. This instrument is framed in the advanced level QSEN competencies and is specifically designed to evaluate nurse practitioner student performance in multiple clinical specialty courses. Presenters will demonstrate how this valid and reliable instrument provides a consistent, standardized, authentic evaluation process that can be used by students, faculty, and clinical preceptors who are simultaneously working towards the achievement of nurse practitioner competencies. The instrument was piloted in a master’s level primary care program track and is currently used in all of the program’s nurse practitioner clinical courses. Since its inception, it has received national and international interest. It is currently being translated and studied by PhD students at the University of Beijing, China. This innovative nurse practitioner clinical evaluation instrument aligns with the AACN Essentials and is a one size fits all compendium, appropriate for use in wide variety of nurse practitioner programs, amplifying the many aspects of nurse practitioner education and capturing the underpinnings of all nurse practitioner education stakeholders.

Abstract Methods: Six expert nurse educators were recruited for the purpose of rating items for relevance for inclusion in the QSEN Clinical Evaluation Instrument for NP Students using the content validity index. The instrument was pilot tested in a primary care clinical course.

Abstract Evaluation/Results: Two rounds of review yielded a 34-item content validated instrument.

Abstract Implications: This innovative nurse practitioner clinical evaluation instrument aligns with the AACN Essentials and is a one size fits all compendium that reflects The National Organization of Nurse Practitioner Faculties, American Association of Colleges of Nursing, and National Task Force on Quality Nurse Practitioner Education guidance for nurse practitioner students.

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Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:00 PM – 4:30 PM
Tower C
Track: Teamwork and Collaboration
Summer BBQ Case Study: An exemplar for teaching QI concepts
Lead Author: David H. James, RN, NPD-BC, CCNS – UAB MedicineCo-Author: Marti Rice – UAB – School of Nursing

Abstract Background: Today’s healthcare system continues to be plagued by unsafe practices, ineffectiveness; provider-centric care; slow responsiveness; inefficiencies; and inequitable care. Given this current state, QSEN seeks to equip nurses with the knowledge, skills, and attitudes needed to redesign healthcare systems. However, many nurses struggle to apply the various quality improvement concepts and models used in improvement efforts. The purpose of this workshop is to present an interactive case study that allows participants to explore and apply various QI concepts and models to a familiar setting.

Abstract Methods: This case study was implemented in a Doctorate of Nursing Practice (DNP) course. The case study is presented as a synchronous virtual class. The case study has been refined to its current state through iterative Plan, Do, Study, Act (PDSA) cycles. The case study is framed as a summer BBQ in which participants are challenged to deliver medium rare grilled steaks. The case study addresses core concepts such as developing AIM statements, addressing the Institute for Health care Improvement (IHI) model’s three guiding questions, defining metrics, implementing PDSA cycles, and interpreting system variability.

Abstract Evaluation/Results: Feedback from participants has been positive. In addition, the interactive case study provides a foundation for subsequent assignments where students must demonstrate an application of the various concepts presented.

Abstract Implications: The case study provides a real-world context for learners to apply QI concepts and frameworks. The inclusion of discussion questions and data analysis embedded in the case study allows for formative learning assessment. It is designed to make it an appropriate teaching strategy for academic and practice settings.

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Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:30 PM – 5:00 PM
Tower D
Track: Informatics
Beyond Informatics KSAs: Developing Top-of-License Practice through Telehealth
Lead Author: Barb K. Tassell, DNP, RN, NPD-BC – Case Western Reserve University School of Medicine

Abstract Background: Telehealth is an important care modality that surged during the pandemic. With recommendations in the Future of Nursing Report (NAM, 2021), the Nursing Scope and Standards (ANA, 2021), and the 2021 AACN Essentials, nursing programs are including telehealth in their curriculum. The purpose of this presentation is to describe the implementation and evaluation of strategies that teach telehealth knowledge, skill, and application that achieve Top-of-License Practice.

Abstract Methods: This initiative focused on telehealth use by pre-license nursing students. Telehealth knowledge was developed through four online modules and classroom-based activities threaded across the curriculum. Telehealth skills were practiced in simulations with students serving as standardized patients and providers, as well as providing simulated telehealth care. Application during clinical experiences included asynchronous survey data collection on pre-diabetes risk and follow-up calls for registration in a diabetes prevention program. Clinical experiences provided the opportunity to combine telehealth ability with clinical judgment and patient-centered care to display Top-of-License thinking and practice.

Abstract Evaluation/Results: More than 425 students completed the modules with an average score of 96%. Slightly higher scores were seen in Sophomores and Juniors. Eleven themes were identified by students with a heavy focus on establishing telepresence and legal issues of telehealth care. Eighty-seven Freshman students completed a simulation experience in the 2020-2021 academic year. Evaluation data showed an increase of about 35% on pre/post-survey scores related to ability and confidence while narrative responses supported the use of simulation to gain a better understanding and confidence. Clinical evaluation from faculty revealed that students demonstrated the full scope of practice through clinical judgment, telehealth, communication, and patient education. In post-clinical conversations, students have clearly articulated how this experience allowed them to “connect the dots” between these competencies and not just complete tasks.

Abstract Implications: As telehealth becomes normal nursing care, students must learn how to safely deliver care and maintain their scope of practice. Through curriculum integration and threading, these competencies were developed and demonstrated. This initiative may also serve as an exemplar for further competency development and integration. Specifically in this work, AACN Essential competencies from Nursing Practice, Person-Centered Care, and Informatics domains have been incorporated.


Concurrent Session 4
Rapid Fire Session
Session Time: 3:30 PM – 5:00 PM

3:45 PM – 4:00 PM
The Feasibility of an Online Intervention to Increase End-of-Life Directives During a Pandemic

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:45 PM – 4:00 PM
Tower D
Track: Quality Improvement
The Feasibility of an Online Intervention to Increase End-of-Life Directives During a Pandemic
Lead Author: Benjamin J. Keigley, DNP, AGPCNP-BC, CHPN – Rush University
Co-Author: Ben Inventor, PhD, CNP – Rush University Medical Center
Co-Author: Lory Arquilla-Maltby, DNP, APRN, BC – Rush University Medical Center

Abstract Background: 49-100% of nursing home residents in the US do not have end-of-life directives. Care preferences are not honored when their health deteriorates, resulting in unnecessary hospitalizations, futile medical interventions, and suffering. Only 28% of residents have end-of-life directives in a 232-bed nursing home, so the leadership team decided to address this issue by providing a live educational program for staff based on Let Me Decide and Gold Standard Framework. The program was not offered when non-nursing home workers were prevented from entering the facility during the COVID-19 pandemic. The purpose of this quality improvement project was to examine the feasibility of an online educational intervention to increase end-of-life directives in a nursing home.

Abstract Methods: A pre and post-test design was used. The setting was a 232-bed nursing home with 92 patients, 33 nurses, and three social workers. A 1-hour digital educational program based on Let Me Decide and Gold Standards Framework was developed and provided online to participants. The participants were comprised of nurses and social workers. Participant knowledge about end-of-life directives and confidence to initiate goals of care conversations were measured before and after program participation using online surveys. Patient records were reviewed monthly for three months for end-of-life directives post-implementation.

Abstract Evaluation/Results: 12 participants (nurses, n=9; social workers, n=3) consented and completed the educational program. 83.3% of participants were female, and 16.7% were male. Participant knowledge increased from 78.2% to 81.7%. The percentage of participants who reported being strongly confident to initiate end-of-life discussions increased from 16.7% to 58.3%. End-of-life directives were completed in 24 residents three months after the training program. Participants’ positive feedback suggested providing opportunities to strengthen communication skills learned from the program.

Abstract Implications: A digital educational program for nurses and social workers is feasible to increase end-of-life directives among nursing home residents during a pandemic. This program can also serve as a model for future online training projects that focus on participant skill-building on goals of care conversations and education for patients and their families about end-of-life directives.

4:00 PM – 4:15 PM
Creating Antiracist Case Studies

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:00 PM – 4:15 PM
Tower DTrack: Patient Centered Care
Creating Antiracist Case Studies
Lead Author: Kathleen Mullen, DNP, MA, RNC, CNE – Columbia Unversity School of Nursing
Co-Author: Latisha Hanson, DNP, PMHNP-BC – Columbia University School of Nursing

Abstract Background: Case studies, a common teaching and learning strategy in nursing education in both didactic and clinical, allow an instructor to guide students through optimal clinical decision-making to achieve a quality patient outcome. However, in an attempt to teach cultural competence, didactic and clinical instructors may perpetuate racial stereotypes and normalize discriminatory healthcare practices embedded in a case study. Intentional and explicit antiracist design and evaluation of a case study can eliminate racism in the case as well as provide an opportunity to reveal health inequities and social determinants of health underlying or complicating achievement of optimal health outcomes. Employing a rubric during design and evaluation aids educators whose antiracist pedagogy is developing.

Abstract Methods: The Anti-Racist Clinical Case Rubric was developed for a university workshop offered to health professional educators. Following the workshop, the didactic faculty of the prelicensure program within the school of nursing implemented the rubric to evaluate existing case studies used in class activities, self-study modules, and assessments of the clinical nursing courses. Clinical instructors will be trained in the rubric in their upcoming annual orientation to ensure case studies presented during clinical are antiracist and consistent across the program.

Abstract Evaluation/Results: Faculty expressed satisfaction with the rubric and recognized the guidance it supplied in navigating antiracism pedagogy. Faculty expected to rely on the rubric as they designed new case studies. The clinical instructor qualitative evaluation of the rubric is expected in May.

Abstract Implications: Developing effective teaching and learning strategies is an ongoing process for nurse educators. Active engagement in identifying and mitigating unconscious bias and racial microaggressions in the teaching and learning strategy of case studies will improve curricula and can stimulate a deliberate examination of other teaching and learning strategies, as well as assessment methods in class and in clinical learning environments. Creating antiracist teaching and learning strategies addresses the Essentials concept of Diversity, Equity and Inclusion as well as sub-competencies in Domain 2 and Domain 10. Presentation Objectives: The attendee will be able to: 1. Describe antiracist pedagogy. 2. Examine a rubric for designing case studies. 3. Implement the rubric to analyze a case study for bias or microaggressions.

4:15 PM – 4:30 PM
Empowering Nurses to Activate Rapid Response Teams

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:15 PM – 4:30 PM
Tower D
Track: Safety
Empowering Nurses to Activate Rapid Response Teams
Lead Author: Elicia EgozcuOchoa, MSN, AGPCNP-BC, CNRN, SCRN, CV-RN, NPD-BC – Baptist Health South Florida

Abstract Background: The purpose of this study is to evaluate the effectiveness of simulation combined with clinical scripting scenarios on nurses’ confidence to initiate rapid response team (RRT). Failure to Rescue (FTR) related to delays in activation of is on the rise leading to poor patient outcomes. Reported FTR rates in 2017 were 12.5% in low mortality hospitals and 21.4% in high-mortality hospitals.

Abstract Methods: This quantitative pretest/posttest study used a convenience sample of registered nurses recruited via email, posted flyers, and personal invitation. Written consent provided followed by Rapid Response Team Survey (RRTS) which consists of 3 parts: part 1 knowledge assessment, part 2 assessment of confidence/attitudes, part 3 is demographics. Orientation to In Situ simulation setting and scenario was provided. Participation in 1 of 3 scenarios followed by debriefing and administration of the RRTS posttest. The posttest consisted of parts 1 and 2 only. The data was analyzed using Pearson’s correlation, Dependent t-test.

Abstract Evaluation/Results: Statistically significant differences between pretest and posttest average scores (higher scores on the posttest). In Situ simulation combined with scripting increased staff’s knowledge and confidence in early activation of RRTs. They reported feeling more confident and empowered to make future decisions regarding when calling RRT. They also reported more confidence in communicating with other healthcare colleagues. One participant shared “It makes us less worry about when to initiate the RRT and reassures us that it is better to be safe.”

Abstract Implications: Increasing staff’s knowledge and confidence in early activation of RRT prevents failure to rescue. The researchers recommend hospital organizations consider leveraging In Situ simulation with scripting as a tool to empower nurses in the clinical setting, potentially preventing FTR. In Situ Simulation also has great value as an educational tool in the clinical setting as it brings education to life in the practice setting.

4:30 PM – 4:45 PM
ReEngineered Discharge Initiative in Skilled Nursing Facility to Decrease 30-Day Re-admission Rates

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:30 PM – 4:45 PM
Tower D
Track: Quality Improvement
ReEngineered Discharge Initiative in Skilled Nursing Facility to Decrease 30-Day Re-admission Rates
Lead Author: Ruby R. Panju-Merali, MSN, FNP-C – George Washington University
Co-Author: Mary Jean Schumann

Abstract Background: The growing population of people over the age of 65 years, rising costs of healthcare combined with the surmounting medical complexities resulting in hospital re-admissions poses a significant challenge for our healthcare system. Review of literature shows various interventions inclusive of nursing driven discharge planning are increasing areas of focus to decrease hospital readmissions. The purpose of this Quality Improvement initiative is to improve the efficiency of the discharge process at a skilled nursing facility (SNF) by implementing a modified version of Project Re-engineered Discharge (RED) nurse-led discharge planning and evaluate the subsequent impact on all-cause 30-day hospital readmission rates from the SNF.

Abstract Methods: Pre-post chart review design of approximately 135 charts (n=73 pre-intervention, n=77 post-intervention) aimed to improve the efficiency of the current discharge process by implementing a modified version of Project ReEngineered Discharge (RED). Thirty-two nurses in a 45-bed Skilled Nursing and Rehabilitation Unit in a community hospital-based will participate in surveys utilized to gather information on nurses learning preferences and attitudes towards learning and the current discharge process. Nurses will receive education on the RED components to target patient centered education and readiness for discharge planning.

Abstract Evaluation/Results: The Self-Directed Learning Readiness Scale-Adult Learning Preference Assessment (SDLRS-A) questionnaire developed by Dr Lucy Guglielmino will be utilized to assess SNF nursing readiness to learn. Statistical Analysis using Independent t test, descriptive Statistics & Chi Square Analysis will be utilized to evaluate the impact of RED. Implementation of RED, an evidence-based discharge process targeted to reduce hospital readmissions will result in decreased rates of all-cause readmission rates, increased language assessment, patient/family involvement/attendance in SNF discharge planning, community provider handoff for continuity of care and post discharge follow-up calls.

Abstract Implications: RED targets population health with a person-centered care model that centralizes nurses as influential leaders, educators, and policy advocates in targeting optimal patient care and outcomes. Subsequently, RED will improve the geriatric populations’ health, reduce socio-economic and financial cost burden to the geriatric population, organizations, and the healthcare system by targeting reduction in rehospitalization rates.

4:45 PM – 5:00 PM
COVID-19 Visitor Restrictions in Adult ICUs Impacting Safety, Quality, and Patient-Centered Care

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 4:45 PM – 5:00 PM
Tower D
Track: Patient Centered Care
COVID-19 Visitor Restrictions in Adult ICUs Impacting Safety, Quality, and Patient-Centered Care
Co-Author: Kerry Milner, DNSc, RN, EBP-C – Sacred Heart UniversityLead Author: Suzanne Marmo – Sacred Heart University

Abstract Background: In March 2020, rising numbers of COVID-19 infections contributed to drastic changes in hospital ICU visitation policies. In a time of uncertainty and an influx of patients in need of critical care intervention, hospital visitor restriction was enacted to slow transmission of COVID-19 and keep patients and staff safe. However, many facilities continue to enforce strict visitation despite the extant research to support the return of safe visitation to ICUs and this is negatively impacting safety, quality, and patient-centered care. The purpose of the study is to describe visitation policies of Magnet and Pathway to Excellence hospitals with previous pre-pandemic open visitation in adult ICUs.

Abstract Methods: A mixed-methods study was conducted from January to March 2021. For the quantitative portion of the study, data extraction from 96 Magnet and Pathway to Excellence hospital websites was conducted to analyze adult ICU visitor policies from hospitals that had a pre-pandemic open visitation policy. For the qualitative portion of the study, a semi-structured interview was conducted with nine nursing leaders from these hospitals.

Abstract Evaluation/Results: Upwards of 1-year following the pandemic, none of the hospitals in the sample had continued open visitation and all had implemented various types of restrictive visitation policies. Visitor policies were varied with little to no evidence-based justification. Other restrictions included 83.3% of hospitals (n=80) allowing one visitor per day and 69.4% (n =50) of hospitals reporting no visitation to ICU patients diagnosed with COVID. Nursing leaders described themes of no visitation, external decision-at-system level, visiting with limits, doing harm, and changes to critical care nursing work in the qualitative analysis.

Abstract Implications: Despite the vast evidence supporting the positive impact of visitation on patients and families, the harms of restricted visitation, and the expert recommendations for returning safe visitation to hospitals, Magnet and Pathway to Excellence hospitals have continued to enforce restricted visitation on ICUs. Nurses, patients, and families are key stakeholders in establishing visitation policy. Hospitals should utilize shared decision-making to help nurses/healthcare staff, patients, and families work together as partners in creating safe and equitable patient and family-centered visitation policies in adult ICUs.


Concurrent Session 4
Workshops
Session Time: 3:30 PM – 5:00 PM

3:30 PM – 5:00 PM
Using Simulation to Advance Quality and Safe Care

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 5:00 PM
Silver
Using Simulation to Advance Quality and Safe Care
Co-Presenter: Carol F. Durham, EdD, RN, ANEF, FSSH, FAAN – UNC Chapel Hill School of Nursing
Presenter: Loretta Aller, PhD, RN

3:30 PM – 5:00 PM
Competency Implementation: A Decade in Practice

Thursday, June 2, 2022
Session Time: 3:30 PM – 5:00 PM
Presentation Time: 3:30 PM – 5:00 PM
Windows
Competency Implementation: A Decade in Practice
Presenter: Ciara Culhane, MS, RN, NPD-BC – Children’s Hospital Colorado
Co-Presenter: Laurel More, MS, RN, NPD-BC CPN – Children’s Hospital Colorado

Time: 5:15 PM – 5:30 PM – Grand Ballroom – QSEN Awards

5:30 PM – 6:30 PM – Grand Ballroom – Fireside Chat: Title QSEN: Past, Present, Future Lead Author: Rebecca S. Miltner, PhD, RN, CNL, NEA-BC – University of Alabama at Birmingham

June 3, 2022

7:00 AM – 8:00 AM South Foyer – Registration, Breakfast, and Exhibits

Time: 7:00 AM – 8:00 AM Grand Ballroom – Task Force Meetings – Transitions

Concurrent Session 5
Session Time: 8:00 AM – 9:30 AM

Session 5 A

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:00 AM – 8:30 AM
Windows
Track: Safety
Implementing a Just Culture Policy in Nursing Program Supports AACN Quality and Safety Competency
Lead Author: Michelle Cole – University of Connecticut
Co-Author: Christine Douville – Sacred Heart University
Co-Author: Angela Chlebowski – Sacred Heart University
Co-Author: Mathew Cole – Gartner
Co-Author: Kerry Milner, DNSc, RN, EBP-C – Sacred Heart University

Abstract Background: Despite the shift to a just culture (JC) in healthcare systems more than a decade ago, many nursing programs continue to lack a JC that may result in students entering the workforce being inadequately prepared. The purpose of this study was 1) to evaluate prelicensure nursing students’ perceptions of JC before and after implementing a JC policy, and (2) to identify areas for improvement.

Abstract Methods: A quasi-experimental design was used. The setting was an independent, moderate-size faith-based university with an annual enrollment of 250 freshmen and an 85% program retention rate. All students enrolled in the prelicensure program at the start of the fall semester of 2019 were recruited. The JC policy was based on the North Carolina Board of Nursing structures and processes for nursing programs to evaluate student practice events. Education, training, and post-knowledge assessment were given to faculty and students. The JC Assessment Tool for Nursing Education (JCAT-NE) was used to measure JC at baseline and 4-months after policy implementation. Student baseline and 4-month JCAT-NE responses were matched for pre/post comparisons.

Abstract Evaluation/Results: A total of 349 (45%) students completed the JCAT-NE at baseline with a mean JCAT-NE of 132.97(16.15). Seniors had significantly lower scores for the JCAT-NE dimensions of feedback and communication (p<.001), openness of communication (p<.001), and trust (p<.015) compared to freshman, sophomore, and juniors. A total 113 (32%) students (matched) had similar mean baseline (M=129.76, SD=11.02) and 4-month (M=129.27, SD=11.17) (p=.647) JCAT-NE scores. In this group, there was a statistically significant decrease in student comfort with discussing safety-related events (pre: M=5.30, SD=1.44; post: M=4.70, SD=1.72; p=.002) and JCAT-NE dimension of openness of communication (p=.026). A negative mean change in JCAT-NE dimensions of feedback and communication, openness of communication, balance, trust, quality of the event reporting, continuous improvement, and trust was observed in seniors and juniors (except trust).

Abstract Implications: Results demonstrate a need for improvement in student JC perceptions, especially in later program levels. Research to investigate why these students’ perceptions decline is needed. Strategies of faculty modeling of a JC and allowing time for error reporting in the lab and clinical can help to improve JC perceptions.

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Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:30 AM – 9:00 AM
Windows
Track: All of the above
National Study of Quality, Safety, and Just Culture in Pre-licensure Nursing Education
Lead Author: Gerry Altmiller, EdD, APRN, ACNS-BC, ANEF, FAAN – The College of New Jersey

Abstract Background: This presentation reports on a national study assessing nursing students’ understanding of the QSEN competencies and experience with concepts of fair and just culture, both of which are featured prominently in the AACN Essentials and connect nursing practice and academia. A safety culture is comprised of a just culture, a reporting culture, and a learning culture (The Joint Commission, 2017). Healthcare organizations support a safety culture by encouraging error reporting without fear of punishment and by conducting investigations to determine causes to improve quality and learn from mistakes. The same is not true of prelicensure nursing education where the response to errors is often punitive and threatens dismissal. This academic-practice gap threatens patient safety as students learn to conceal errors and near-misses, preventing processes from being modified to mitigate future errors and impeding the process of learning from mistakes.

Abstract Methods: The diverse membership of the National Student Nurse Association was recruited to participate in an electronic assessment through the organization’s mailing system. The 45-question assessment combined items from two valid and reliable assessment instruments, the Just Culture Assessment Tool-Nursing Education (Walker et al., 2019) and the Nursing Quality and Safety Self-Inventory (Piscotty et al., 2013).

Abstract Evaluation/Results: 320 nursing students representing 47 states and Guam completed the survey. All prelicensure program types (BSN, ADN, diploma, and accelerated) were represented. Individual items demonstrated significance, revealing where nurse educators are positively impacting student quality and safety competency and where improvement is possible to bridge the gap between academia and practice.

Abstract Implications: Nurse educators are in a unique position to address this critical education issue and prepare the next generation of nurses to identify with quality and safety values so that they may serve as change agents for a safer, more effective healthcare system. The findings of this study have the potential to transform nursing education by illuminating where in the program nurse educators can maximize quality and safety competency integration aligned with the AACN Essentials to adopt fair and just culture concepts that encourage 1) safety reporting, 2) identification of error prone behaviors, and 3) learning from mistakes to positively impact patient care.

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Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 9:00 AM – 9:30 AM
Windows
Track: Evidence Based Practice
Evaluating the Impact of a Novel Substance Use Disorder Protocol on Against Medical Advice Discharge
Lead Author: elizabeth brockland, RN, BSN – Rush University College of Nursing
Co-Author: Janice Phillips – Rush University
Co-Author: Hugh Vondracek, M.Sc., ΦΒΚ – Rush University College of Nursing

Abstract Background: The incidence of “Against Medical Advice” (AMA) discharge, in which patients with decisional capacity choose to leave the hospital prior to the completion of their treatment plan, is linked to poorer health outcomes, higher mortality rates, and higher readmission rates compared to standard hospital discharges. A review of the literature repeatedly finds that the presence of substance use disorders is frequently associated with against medical advice discharge. Because of the known morbidity, mortality, and readmission risks associated with AMA discharge as well as the known association between AMA discharge and substance use, we retrospectively reviewed hospital discharge data pre/post the initiation of hospital wide substance use protocol to determine if the expansion in substance use services correlated with a change in AMA discharge rates.

Abstract Methods: We reviewed hospital discharge data of all adult inpatient, non-psychiatric hospitalizations from January 1, 2015-December 31, 2019. A hospital data analyst collected inpatient discharge data from the hospital’s electronic medical records and a nurse researcher and statistician reviewed the data. Hospital discharge data included (1) all inpatient hospital discharges, (2) AMA discharges, and (3) AMA discharges in patients with a diagnosed substance use disorder on their problem list (ICD10 Codes F10-F19, excluding F17-Nicotine).

Abstract Evaluation/Results: From 2015-2019, the percentage of all inpatient hospitalizations that ended in AMA discharge at Rush University Medical Center consistently hovered around 1%. There was no statistically significant reduction in AMA discharges following the universal substance use screening and interventions developed in 2017.

Abstract Implications: Given that on average 58% of all AMA discharges were from hospitalizations where patients did not have a substance use disorder on their problem list, it’s possible the majority of patients were discharging prematurely for reasons related to a substance use disorder without their treatment team’s knowledge or for other reasons unrelated to substance use. To increase the likelihood that patients discuss their substance use, inpatient providers should build trusting relationships with patients to decrease stigma around substance use and to improve patient-centered care. Researchers should continue to explore potential interventions that may decrease against medical advice discharge rates because of the known risks they pose to a patient’s health.

Session 5 B

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:00 AM – 8:30 AM
Tower B
Track: Evidence Based Practice
IV Push Evidence-Based Practice Checklist
Lead Author: Visnja Maria Masina, DNP, APRN, AGCNS-BC – Cleveland Clinic main campus
Co-Author: Loretta Dorn – Fresenius Kabi
Co-Author: Denise Dion – Central Arizona College
Co-Author: Candy C. Cross, MSN-Ed, RN – Chandler Gilbert Community College
Co-Author: Marlene Steinheiser – Infusion Nurses Society
Co-Author: Susan Paparella – Institute for Safe Medication Practices
Co-Author: Michelle Mandrack – Institute for Safe Medication Practices
Co-Author: Heather Witek – Abbott
Co-Author: Christina M. Colvin – Cleveland Clinic main campus
Co-Author: Elizabeth Campbell – Newton-Wellesley Hospital

Abstract Background: The IV Push Evidence-Based Practice Checklist was recently published as a practice strategy. There is a lack of standardized IV Push medication preparation and administration teaching strategies in nursing programs throughout the United States. This lack of standardization creates an alarming variation in clinical practice that places patients at a higher risk of harm. The goal of this practice strategy is to provide college nursing programs, hospital nursing residency programs, and any area of practice where IV Push medication is given, an Evidence-Based Practice guide and checklist of best practice standards. Nurses that understand evidence-based practice create an environment of patient safety and a knowledgeable professional that can teach and mentor other nurses to ensure continued standardization.

Abstract Methods: In the pre-implementation phase, using the CCNE and ACEN distribution lists, the team conducted a national survey via survey monkey to assess the current educational curriculum related to the teaching of IV Push medication preparation and administration in nursing programs across the country. After researching the topic, the team noted a lack of a standardized blueprint for nursing programs that assess competency related to IV Push medication preparation and administration. The survey demonstrated there is a significant variation in what student nurses are being taught in nursing schools across the United States which creates an unsafe environment for patients The results led to the creation of a practice strategy checklist to standardize nursing training and best practices

Abstract Evaluation/Results: Following the publication of this competency assessment tool, we will send it to the CCNE and ACEN distribution list. A year from publication and dissemination, we will re-survey nursing programs using the same CCNE and ACEN distribution lists to evaluate the utilization of this practice strategy one year after implementation to give nursing schools time to incorporate the strategy into practice.

Abstract Implications: The survey results demonstrated that many nursing programs are teaching student nurses to unsafely, and unnecessarily dilute medications. Dilution and/or moving to another syringe can cause concentration errors, medication labeling errors, and potential contamination. The broad implementation and use of this practice strategy will create wide use of best practices in IV Push.

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Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:30 AM – 9:00 AM
Tower B
Track: Safety
Nursing students’ medication knowledge, personality traits, and self-efficacy beliefs related to MAE
Lead Author: Joanne Roman Jones, PhD, JD, RN – Durham VA Health Care System
Co-Author: Marie Boltz – The Pennsylvania State University, College of Nursing
Co-Author: Rachel Allen – The Pennsylvania State University, College of Nursing
Co-Author: Kimberly Van Haitsma – The Pennsylvania State University, College of Nursing
Co-Author: Douglas Leslie – The Pennsylvania State University

Abstract Background: Medication administration errors (MAEs) continue to be a significant safety concern in healthcare settings and are responsible for increased morbidity, mortality, and cost. Nursing education influences medication administration practices, which involve clinical decision making and risk perceptions. The purpose of this study was to explore the relationship between pre-licensure nursing students’ medication knowledge, personality traits (neuroticism and conscientiousness), and self-efficacy beliefs related to MAEs. The psychometric model of risk perception was selected as the primary conceptual framework to guide this study, including the model’s primary factors of knowledge and fear, along with the concepts of self-efficacy and personality.

Abstract Methods: In this mixed-methods concurrent, nested study, sixty (n=60) fourth-year, pre-licensure nursing students, recruited from three campuses of a large university, completed in-depth individual semi-structured interviews, a survey of demographics, and validated measures of self-efficacy, knowledge, and individual personality traits. Thematic analysis of qualitative data, descriptive and correlational analysis of quantitative data, and an analysis of the integrated data was conducted.

Abstract Evaluation/Results: Results indicated low knowledge (mean: 70.75 + 12.65) and neuroticism (mean: 2.44 + .68) and high self-efficacy/confidence (mean: 5.78 + .72) and conscientiousness (mean: 4.51 + .33) scores. Conscientiousness was correlated with both knowledge (r=.271, p .036) and neuroticism (r=-.313, p .015). Thematic analysis yielded four themes: (1) nature of risk perceptions, (2) more opportunities to learn, (3) experiences with MAE, and (4) intrinsic characteristics influence errors. Convergence was evident in both knowledge and personality data; self-efficacy/confidence and risk perceptions data diverged.

Abstract Implications: Findings provide a broad description of the nature of student nurse risk perceptions for future medication administration errors. Knowledge, personality traits, and self-efficacy appear to influence student nurse risk perceptions of MAE and indicate an area for future research. The findings also offer support for the critical nature of MAE education within the nursing education curriculum and reflect the QSEN competency of safety.


Concurrent Session 5
Rapid Fire Session
Session Time: 8:00 AM – 9:30 AM

8:00 AM – 8:15 AM
Patient Safety: Objective Structured Clinical Examination Use for Medication Rights in Simulation

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:00 AM – 8:15 AM
Tower C
Track: Safety
Patient Safety: Objective Structured Clinical Examination Use for Medication Rights in Simulation
Co-Author: Sara Morandini, MSN, RN, CNOR – University of Colorado Hospital AnschutzLead Author: Katherine Foss, RN, MSN – University of Colorado College of Nursing

Abstract Background: A new examination was instituted to prepare students for safe medication administration process in the practice setting. This development came in response to restrictions on small group in-person instruction imposed by the pandemic, as well as feedback from clinical partners associated with student preparation and understanding of how to apply a safe medication administration process.

Abstract Methods: Patient safety measures from the clinical practice environment were replicated in the didactic and simulation settings for students to learn and practice the medication rights process. This new method was implemented utilizing a synthesis of deliberate practice, case scenarios, low fidelity simulation, and an adaptation of Objective Structured Clinical Examination (OSCE). The purpose of the examination was to assess student knowledge and critical thinking abilities using the rights of safe medication administration process. The examination utilizes a written test of visual cues including: written orders, photos of medical vials, drawn syringes, patient identification band, and MAR. The prompting question of the examination “is it safe to administer “specific medication name” to this patient? Why or Why not?”

Abstract Evaluation/Results: The instructional method included authentic learning and the created OSCE was reviewed by didactic course faculty, pilot tested with undergraduate nursing students, and then executed with approximately 225 undergraduate BS program students. Data collected included first test success rate, test question analysis, student feedback regarding test experience, feedback from agency clinical instructors who administer medications with students in the practice environment, and the perception of student preparation in using safe medication administration process post-OSCE. Data included a greater than 90% pass rate on first attempt, 100% pass rate on second attempt. Additional data was collected focusing on the student experience. Questions included student perception of the test to prompt completion of the medication rights process, feedback on format, time allotted for testing, and an open ended question. The open ended question brought forward comments pertaining to test anxiety

Abstract Implications: Following the success, the exam has been incorporated into the curriculum as well as the implementation of an OSCE that includes psychomotor skill demonstration associated with various routes of safe medication administration.

8:15 AM – 8:30 AM
QSEN Competency Validation – Learning Management System Innovation

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:15 AM – 8:30 AM
Tower C
Track: Informatics
QSEN Competency Validation – Learning Management System Innovation
Lead Author: Kathleen Feldman, MSN, RN, NPD-BC – UCLA Health
Co-Author: Jessica Phillips, MSN, RN, NPD-BC – UCLA Health
Co-Author: Jennifer Pysz – UCLA Health

Abstract Background: The purpose of this project was to leverage the Learning Management System (LMS) at a large academic health system using the QSEN competency framework (Lyle-Edrosolo & Waxman, 2016). Paper-based competency processes have been inefficient because documents can be lost, illegible, or incomplete. Paper competency documentation also requires manual uploads into an HR Tracking/Reporting system, which has caused errors and dissatisfaction with leadership.

Abstract Methods: A Nursing Professional Development (NPD) team collaborated with Human Resources and Performance Management to gain access to the Observation Checklist feature of the LMS. QSEN-based validations were created as electronic checklists for each nursing competency. Some checklists were assigned automatically based on unit-specific patient data and other checklists selected by unit leadership. The range of checklists assigned was 1-30 with a mean of 13. Trainings and tip sheets were developed for clinical nurses and leadership.

Abstract Evaluation/Results: Reports were run monthly from March to June 2021 to track the overall completion percentages, with frequent communication updates provided to nursing leadership. Compliance data allowed the NPD team to identify units with low compliance percentages that needed additional support validating competency. Annual competency completion was 86% for RNs in 2021. Previously, we were unable to calculate completion percentages; thus, resulting in no standard comparison or evaluative measure.

Abstract Implications: Leveraging the LMS for the annual QSEN competency validation structure allowed for real time completion tracking, decreased burden on unit leadership, and improved accuracy of reporting (Lonn & Teasley, 2009). This updated process also increased our compliance with State and Federal regulatory bodies and quality and safety measures. Objective data from an automated competency process allowed the NPD Team to quantify impact and value to the organization and provided measurable information to advocate for additional resources to support the competency process. References: Lonn, S., & Teasley, S. D. (2009). Saving time or innovating practice: Investigating perceptions and uses of Learning Management Systems. Computers & Education, 53(3), 686-694. Lyle-Edrosolo, G., & Waxman, K. T. (2016). Aligning healthcare safety and quality competencies: quality and safety education for nurses (QSEN), The Joint Commission, and American Nurses Credentialing Center (ANCC) magnet® standards crosswalk. Nurse Leader, 14(1), 70-75.

8:30 AM – 8:45 AM
Bringing Bedside Informatics to the Classroom

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:30 AM – 8:45 AM
Tower C
Track: Informatics
Bringing Bedside Informatics to the Classroom
Lead Author: Mallory K. Brunel, MS – Metropolitan State University of Denver
Co-Author: Jenny Allert, DNP, RNC – Metropolitan State University of Denver

Abstract Background: Knowledge of patient-centered technology is vital to the provision of high-quality, safe, patient care. New graduate nurses need to be versed in data management, retrieval, analysis, and evaluation to guide practice decisions. While current education addresses informatics for pre-licensure students, it often focuses on theory, terminology, and an overview of systems. This leaves health partners with the burden to teach “bedside” informatics skills needed in healthcare facilities. Daily, nurses are tasked with chart audits, basic data analysis, and data trending for unit-based practice councils to inform quality improvement measures. The purpose of this proposal is to introduce a new teaching methodology that uses practical informatics as it relates to quality patient care.

Abstract Methods: Utilizing an innovative new model, the course Quality Care and Patient Safety Using Nursing Informatics was developed to bridge the gap between theory and practical application. Students are provided the opportunity to join a mock unit-based clinical practice council and perform real-time chart audits for common bundled cares. Utilizing a mock electronic health care record, students perform weekly and monthly chart audits, analyze trends and develop pathways for quality improvement and change. Students engage with the AHRQ toolkit, IHI, the Magnet Pathways, and the QSEN competencies to understand the importance that informatics plays in quality improvement.

Abstract Evaluation/Results: Final clinical practice council course presentations will be evaluated for competency in data reporting, analysis, trending, and the appropriate identification of a change process for unit improvement. Using a scaled rubric, students will be evaluated on their understanding of key course concepts. Initial results will be collected in May 2022.

Abstract Implications: By using practical bedside informatics tools and applications, students will seamlessly enter practice with the skills, knowledge, and attitude needed to use information technology in improving patient care outcomes and creating a safe care environment in alignment with AACN expectations.

8:45 AM – 9:00 AM
Innovatively Connecting the Quality Improvement Process Across Baccalaureate Courses

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:45 AM – 9:00 AM
Tower C
Track: All of the above
Innovatively Connecting the Quality Improvement Process Across Baccalaureate Courses
Lead Author: Mallory K. Brunel, MS – Metropolitan State University of Denver
Co-Author: Deborah A. Mathias, DNP, RN, CNE – MSU Denver
Co-Author: Diane A. Ream – Metropolitan State University of Denver
Co-Author: Cindy Krentz – Metropolitan State University of Denver
Co-Author: Jenny Allert, DNP, RNC – Metropolitan State University of Denver
Co-Author: Karie Poelman – Metropolitan State University of Denver

Abstract Background: QSEN Competencies, Magnet concepts, and the AACN Baccalaureate Essentials are integral to nursing education. Until now, much of this education has been siloed in various courses without obvious connections that allow for practical application. Literature shows that new graduate nurses are not adequately prepared to integrate these concepts into their practice. Utilizing an innovative teaching methodology, we have created continuity of the quality improvement process through intentionally linked assignments and practical application activities. This allows the baccalaureate prepared nurse to engage in real-world practice with confidence.

Abstract Methods: In the redesign of baccalaureate curriculum, we created a stepwise approach to integrating QSEN Competencies, Magnet concepts, and AACN Baccalaureate Essentials. Although these concepts are threaded throughout the entire program, the process starts with the first online course, in which students are introduced to the above concepts. The innovation continues as we thread a project through four courses which build on one another. In Evidence Based Practice, students join a clinical practice council and investigate the evidence behind bundle care. In Quality Improvement and Informatics, students expand on bundle care, by engaging in real-time chart audits, data analysis, and the application data in quality improvement. In Leadership and Management, using the bundle review and data collection, students develop a change proposal that affects nursing. In Culmination of the Magnet Journey, students evaluate the quality improvement process and application to future practice.

Abstract Evaluation/Results: We plan to evaluate the success of this innovative redesign of our curriculum using a mixed methods design through quantitative assessment of student performance via standardized rubrics and qualitative experience survey.

Abstract Implications: Through the integration of practical safety and quality principles, students graduate with an understanding of individual and system performance in harm reduction, patient safety, and improved patient outcomes in alignment with Domain 5 of the AACN Essentials.

9:15 AM – 9:30 AM
A Simulated Quality Improvement Teaching Strategy for RN-BSN Mobility Students

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 9:15 AM – 9:30 AM
Tower C
Track: Quality Improvement
A Simulated Quality Improvement Teaching Strategy for RN-BSN Mobility Students
Lead Author: Sarah E. Coiner, DNP, RN-BC, CNL, CNE – University of Alabama at Birmingham

Abstract Background: The new AACN Essentials include the expectation for bachelor’s prepared nurses to be competent in applying quality improvement principles to patient care and contributing to a culture of patient safety. RN-BSN Mobility students have a unique opportunity to apply their professional nursing experience to the content of their quality and safety coursework. The goal of this teaching strategy was to create a simulated quality improvement (QI) project assignment to be completed entirely online (distant accessible). Students will solve a quality or patient safety problem they are personally involved in while drawing from their experience in their current workplace.

Abstract Methods: The simulated QI project will follow the Model for Improvement (MFI) framework. This assignment can be done individually or in groups. There are three assignments, each answering one of the MFI fundamental questions and designing the first Plan, Do, Study, Act (PDSA) Cycle. Students will also provide foundational information, support from literature, and personal reflection. The final assignment is a scholarly poster presentation and critique on a virtual discussion board.

Abstract Evaluation/Results: This strategy has been altered over five semesters, involving 226 students working on 202 different project titles both individually and in groups. Student opinions are captured using the IDEA Student Rating System. The learning objectives for “Gaining a basic understanding of the subject”, “Learning to apply course material (to improve thinking, problem solving, and decisions)”, and “Developing specific skills, competencies, and points of view needed by professionals in the field most closely related to this course” have all rated above the 4.0 range every semester. In comments, the students found this assignment favorable because it provided an understanding of the QI process as well as flexibility with the online, simulated format and being able to work on a subject that they are personally passionate about.

Abstract Implications: It is important for practicing nurses to develop the QI and patient safety fundamentals outlined in the AACN Essentials. This teaching strategy provides an online, customizable approach for students to learn these concepts while applying them to their professional care delivery experience and receiving real time faculty feedback in a simulated environment.

9:00 AM – 9:30 AM
Evaluating the Impact of a Novel Substance Use Disorder Protocol on Against Medical Advice Discharge


Concurrent Session 5
Workshops
Session Time: 8:00 AM – 9:30 AM

8:00 AM – 9:30 AM
Competency Assessment: Let’s Learn and Get This Right!

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:00 AM – 9:30 AM
Grand Ballroom
Competency Assessment: Let’s Learn and Get This Right!
Presenter: Rebecca S. Miltner, PhD, RN, CNL, NEA-BC – University of Alabama at Birmingham
Co-Presenter: Mary A. Dolansky, PhD, RN, FAAN – CWRU
Co-Author: Caitlin YeagerCo-Author: Holly Buchanan, DNP, MS, RN, ANP-BC
Co-Author: Tammy Spencer

8:00 AM – 9:30 AM
Conceptualization to publication!

Friday, June 3, 2022
Session Time: 8:00 AM – 9:30 AM
Presentation Time: 8:00 AM – 9:30 AM
Silver
Conceptualization to publication!
Presenter: Yolanda M. Nelson, EdD, MSNed, RN-BC – The College of New Jersey
Co-Presenter: Bethany Robertson, DNP, CNM – Emory University Nell Hodgson Woodruff School of Nursing
Co-Author: Fay Alexander, BA – CWRU

9:30 AM – 10:00 AM South Foyer – Exhibits with refreshment

Special Session
Session Time: 10:00 AM – 11:00 AM

10:00 AM – 11:00 AM
Special Session

Friday, June 3, 2022
Session Time: 10:00 AM – 11:00 AM
Presentation Time: 10:00 AM – 11:00 AM
Grand Ballroom
Competency Assessment: An interprofessional perspective – Holmboe
Lead Author: Eric Holmboe, MD, MACP, FRCP


Keynote
Session Time: 11:00 AM – 11:45 AM

11:00 AM – 11:45 AM
Starting a Movement: The Registered Nurses of Ontario’s Journey

Friday, June 3, 2022
Session Time: 11:00 AM – 11:45 AM
Presentation Time: 11:00 AM – 11:45 AM
Grand Ballroom
Starting a Movement: The Registered Nurses of Ontario’s Journey
Keynote Speaker: Doris Grinspun, RN, MSN, PhD, LLD(hon), Dr(hc), FAAN, FCAN, O.ONT.


11:45 AM – 12:00 PM – Grand Ballroom – Closing, Evaluation

12:00 PM – 12:00 PM – Grand Ballroom – Adjourn