Strategy Submission

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

**Note: Please also refer to the "Universal Template" strategy on the QSEN website for additional instructions on designing and implementing the template. References: Benner, P., Sutphen, M., Leonard, V., & Day, L. (2009). *Educating nurses: A call for radical transformation.* San Francisco: Jossey-Bass. Institute of Medicine. (2011). *The future of nursing: Leading change, advancing health. *Retrieved from the National Academies Press website: http://www.nap.edu/catalog.php?record_id=12956 Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. *Journal of Nursing Education, 45,* 204-211.