A Multisite Study of a Quality Improvement Teaching Strategy to Build Competency.

BACKGROUND: Quality improvement (QI) is an essential part of nursing education. Although there are robust examples of teaching strategies for QI, there is a distinct lack of research on effective strategies for teaching QI in nursing education. METHOD: This multisite study included students from six nursing programs. A treatment fidelity plan was developed and followed to ensure consistency for implementation of the study and data collection. A quasiexperimental, nonpaired, pre- and posttest study design was used to examine changes in student perspectives of QI after participating in a QI teaching strategy. Pre- and posttest questions were mapped to the American Association of Colleges of Nursing's Essentials subcompetency statements for QI. RESULTS: A total of 254 pre- and 116 posttest responses were included for analysis. Significance (p = .05) was found at the beginning level within three questions. CONCLUSION: Findings from this study indicate beginning-level students can benefit from a competency-based QI learning activity. [J Nurs Educ. 2024;63(1):38-42.].

Creating a Just Culture in the Perioperative Setting.

There has been an increased perioperative focus on avoiding adverse events and providing safe patient care since To Err Is Human: Building a Safer Health System published in 2000. Adverse events continue to occur in perioperative areas and are likely underreported. The interdisciplinary nature and high cost of perioperative care may discourage personnel from speaking up for fear of retribution and punishment when reporting. Organization leaders can implement a just culture that focuses on improving patient care processes and safety rather than placing blame after an adverse event. A tenet of just culture is achieving balanced accountability between systems and individuals. Strategies for just culture implementation include leader support, policies and procedures for reporting, accessibility of reporting systems, provision of information for staff members, identification of support champions, and creation of a good catch program. Leaders also should measure and track progress associated with the just culture in their facility.

Creating a Community of Nurse Educator Scholars: The QSEN Academic Task Force Success.

BACKGROUND: Engaging in scholarship is a critical component of being an effective nurse educator and can have a significant impact on the nursing profession as a whole. PROBLEM: Nurse educators are expected to teach and simultaneously engage in scholarship. Barriers include heavy workloads and lack of resources including faculty mentors. Evidence supports that organized work groups support success. APPROACH: Members of the Quality and Safety Education for Nurses (QSEN) Academic Task force were queried about scholarly activity as a result of engagement with fellow task force members. OUTCOMES: Scholarly outcomes included numerous peer-reviewed publications, teaching tips, presentations, and grants. CONCLUSION: Participating in national work groups can serve as a platform for fostering a community of scholars to make meaningful contributions to the profession.

National Study of Quality, Safety, and Just Culture in Prelicensure Nursing Education.

AIM: The study's aim was to evaluate the integration and application of quality and safety competencies and concepts of fair and just culture in prelicensure nursing education. BACKGROUND: Health care 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. In prelicensure nursing education, the response to errors is often punitive and threatens dismissal. METHOD: Members of the National Student Nurses' Association were recruited to participate in an electronic assessment through the organization's mailing system. RESULTS: Students representing all prelicensure program types (BSN, ADN, diploma, accelerated) and 46 states ( N = 268) completed the survey. CONCLUSION: Nurse educators were found to have a positive impact on student quality and safety competency. Improvement is possible in developing and supporting just culture within nursing programs to bridge the gap between academia and practice.

Screen-Based Patient Simulation: An Exemplar for Developing and Assessing Competency.

BACKGROUND: Nursing education is moving toward competency-based education and assessment. Nurse educators will need to adopt strategies to develop and measure competence. PURPOSE: The purpose of this study was to determine if screen-based virtual patient simulation is an effective strategy to assist learners in developing competencies and subcompetencies required in nursing practice. METHODS: Thirteen questions (6 assessment and clinical reasoning focused, 4 clinical judgment focused, 3 attitude and socialization to nursing focused), aligned with the competencies of the American Association of Colleges of Nursing Essentials, were developed for a pre-/posttest design to evaluate student competency development. RESULTS: Senior nursing students (n = 52) participated; 1-tailed paired t test identified 12 of 13 items as statistically significant. Posttest scores were greater than pretest scores. CONCLUSIONS: The change in mean scores from pre- to posttest suggests screen-based virtual patient simulation scenarios improve learners' competence in addressing the patient's physical and psychological comfort and decreased caregiver biases.

AACN Essentials and nurse practitioner education: Competency-based case studies grounded in authentic practice.

The 2021 American Association of Colleges of Nursing (AACN) Essentials: Core Competencies for Professional Nursing Practice articulate the standards for baccalaureate and graduate level nursing education in the 21st century. Integral to these expectations is the call for nurse educators to implement a competency-based education format. For nurse practitioner education programs, the curriculum must not only align with core competencies described by the National Organization of Nurse Practitioner Faculties (NONPF) and with the standards of the National Task Force (NTF), but will now also be framed in the Essentials. This article demonstrates a template for how nurse practitioner faculty can develop learning opportunities for students to demonstrate competency as they integrate and apply knowledge in the context of authentic practice situations. The impact of this innovation and standardization of nursing education sets the stage for a dynamic learning environment where all students can expect the same education and every employer can expect the same competence from their new hires.

Impact of a Virtual Patient Simulation on Nursing Students' Attitudes of Transgender Care.

BACKGROUND: Transgender individuals experience considerable prejudice and bias, creating barriers to health care. PURPOSE: The purpose of this study was to determine the effect of a virtual patient simulation scenario of caring for a transgender adult on nursing students' attitudes and beliefs about transgender people. METHODS: A validated 29-item instrument developed to assess an individual's view of transgender identity was administered in a pre-/posttest nonequivalent-groups design to junior- and senior-level nursing students. RESULTS: Statistically significant differences were found between the control and treatment groups for the subscale human value. CONCLUSIONS: Findings support experiential learning in nursing as an effective tool in teaching cultural competence and sensitivity when caring for transgender patients. Attitudes and beliefs of senior nursing students and junior nursing students toward transgender individuals differed, with senior students being more receptive.

Influence of Technology in Supporting Quality and Safety in Nursing Education.

Despite the unprecedented obstacles created by the COVID-19 pandemic, nursing professional development practitioners and nurse educators successfully harnessed educational technology to disseminate an extraordinary amount of vital information needed to provide care to a society in crisis. The agile adoption of educational technology allowed rapid access and dissemination of information that carried institutions through the uncharted waters of the pandemic and created a roadmap for mass education techniques to guide not only future disaster preparedness and crisis intervention but also application of nursing education in all arenas.

Systematic Curriculum Mapping of Virtual Patient Assignments to End-of-Program Outcomes.

BACKGROUND: During the COVID-19 pandemic, virtual clinical learning assignments replaced onsite clinical instruction in many prelicensure nursing programs, but the alignment of those learning experiences to end-of-program outcomes was unknown. PURPOSE: This article describes the process and results of mapping student competencies gained via virtual patient simulation experiences to a program's end-of-program outcomes and accrediting standards. METHODS: A faculty team followed the process of curriculum mapping as described in the literature to evaluate the effectiveness of the program's virtual clinical learning product in addressing end-of-program outcomes. RESULTS: The mapping process identified where competencies were being met, which needed enhancing or were redundant, and where gaps existed. CONCLUSIONS: Curriculum mapping is an effective strategy in evaluating whether virtual patient simulation learning experiences support end-of-program outcomes. Mapping learning activities to outcomes will be fundamental to curriculum development and evaluation as schools of nursing integrate accrediting standards.

Content Validation for an Emergency Department Fall Risk Assessment Instrument.

PURPOSE: There are many falls risk assessment tools available for inpatient use; however, few have been validated for the emergency department population. The purpose of this study was to develop a valid instrument to capture fall risk specific to that population. DESIGN: Using clinical expertise and evidence from the literature, the Hurwitz Fall Risk Assessment Instrument was developed. Seven clinicians with expertise in the area of fall prevention were then recruited to serve as expert content reviewers. METHODS: The content validity index was used to determine consensus of relevance for specific items and the overall scale. RESULTS: Two rounds of rigorous review yielded a scale content validity index universal agreement calculation of 1, indicating that all items were evaluated as relevant and appropriate for inclusion in an instrument designed to address the unique attributes of emergency department patients. CONCLUSIONS: This study establishes scale content validation for the Hurwitz Fall Risk Assessment Instrument for use in the emergency department population.

Leadership, Teamwork, and Collaboration: The Lived Experience of Conducting Multisite Research Focused on Quality and Safety Education for Nurses Competencies in Academia.

AIM: The aim of this study was to explore facilitators and barriers to conducting a multisite national study in nursing academia unsupported by grant funding. BACKGROUND: Scholarship focused on the Quality and Safety Education for Nurses (QSEN) competencies stimulates opportunities for research and collaboration among nurse educators and clinicians. Twelve members of the QSEN Academic Task Force collaborated on a multisite study of the effectiveness of a QSEN teaching strategy and published the findings. METHOD: A descriptive phenomenological reflective approach using Kim's critical reflective inquiry model was used to explore the lived experiences of the original study investigators. Data were analyzed using Colaizzi's phenomenological reduction. RESULTS: Findings revealed seven facilitators and one overarching barrier to conducting academic research projects of this scope. CONCLUSION: Participants found that strong leadership, a commitment to teamwork and collaboration, and a shared interest were critical to conducting a successful national study across academic settings.

Exploratory factor analysis of the Just Culture Assessment Tool for nursing education.

BACKGROUND: Just culture has been identified as a vital component of safety culture by national and international organisations. In a just culture, emphasis is not placed on blaming individuals for errors but rather on examining personal and system processes that can best support safety and prevent reoccurrence. Although those in the practice arena have worked to implement the concepts of just culture, the same is not true in nursing education, leaving nursing students lacking the pre-requisite knowledge, skills and attitudes to implement just culture in practice on graduation. AIMS: Assessment of this phenomena is the essential first step to align nursing education with practice in promoting just culture as a mechanism for patient safety. The purpose of this paper is to further refine the Just Culture Assessment Tool-Nursing Education through exploratory factor analysis. METHODS: The Just Culture Assessment Tool-Nursing Education was adapted from the Just Culture Assessment Tool, an instrument created for the practice setting. Validity and reliability were established for the Just Culture Assessment Tool-Nursing Education in a study of 800 nursing students to assess their perceptions and understanding of just culture with their nursing programmes. Using the previously conducted data, an exploratory factor analysis was conducted. RESULTS: Factor analysis supports six subscales, similar to that of the Just Culture Assessment Tool. However, individual items were loaded into different subscales. All subscales demonstrated good reliability. Factor analysis supported further refinement of two items to improve the instrument's ability to capture data. CONCLUSIONS: Perceptions of just culture differ between experienced providers and nursing students; nursing students have less experience with reporting errors. Factor analysis of Just Culture Assessment Tool-Nursing Education items demonstrated these differences, supporting modification of items by the instrument developers. An 'if' statement for students to consider their possible actions rather than experience was added to two items to better capture data from nursing students when completing the assessment.

Content Validation of the Quality and Safety Framed Clinical Evaluation for Nurse Practitioner Students.

BACKGROUND: Clinical performance evaluation is a high-stakes assessment that requires a valid and reliable instrument. There appear to be no identified clinical evaluation instruments developed for nurse practitioner (NP) students that have undergone content validation. PURPOSE: This study describes the process to develop, validate, and pilot a clinical evaluation instrument for NP students framed in the Quality and Safety Education of Nurses Competencies for advanced practice. METHODS: Six expert nurse educators were recruited for the purpose of rating items for relevance for inclusion in the Quality and Safety Framed Clinical Evaluation Instrument for NP Students using the content validity index. The instrument was pilot tested in a primary care clinical course. RESULTS: Two rounds of review yielded a 34-item content validated instrument. CONCLUSIONS: Evidence suggests that the Quality and Safety Framed Clinical Evaluation for NP Students is a valid and reliable instrument to evaluate the clinical performance of NP students.

"Perioperative Unfolding Case Study"-A Lesson in Quality and Safety.

Unfolding case studies present the opportunity for learners to develop and improve their critical thinking and problem-solving skills to deliver safe patient care. The structure of an unfolding case study actively engages learners to determine and customize nursing care based on the patient's changing situation. In addition, this type of case study supports development of knowledge, skills, and attitudes consistent with the Quality and Safety Education for Nurses (QSEN) competencies. During the student session at the AORN Global Surgical Conference & Expo 2019, the author gave attendees the opportunity to participate in the "Perioperative unfolding case study" that was framed in the QSEN competencies. Session evaluations indicated that participants found the process provided a thorough overview of perioperative nursing and emphasized safety-focused initiatives that protect patients undergoing operative and other invasive procedures. This article offers an in-depth discussion of the "Perioperative unfolding case study" and its implementation.

Nursing Students' Perceptions of Just Culture in Nursing Programs: A Multisite Study.

BACKGROUND: While just culture is embraced in the clinical setting, just culture has not been systematically incorporated into nursing education. PURPOSE: The purpose of this study was to assess prelicensure nursing student perceptions of just culture in academia. METHODS: Following a quantitative, descriptive design, the Just Culture Assessment Tool for Nursing Education (JCAT-NE) was used to measure just culture across multiple (N = 15) nursing programs. RESULTS: The majority of JCAT-NE respondents (78%) reported their program has a safety reporting system, 15.4% had involvement in a safety-related event, and 12% submitted an error report. The JCAT-NE mean total score was 127.4 (SD, 23.6), with a statistically significant total score decline as students progressed from the beginning (133.6 [SD, 20.52]) to the middle (129.77 [SD, 23.6]) and end (122.2 [SD, 25.43]) of their programs (χ[2] = 25.09, P < .001). CONCLUSIONS: The results from this study are a call to action for nursing education to emphasize the tenets of just culture, error reporting, and quality improvement.

QSEN Transcends Cultures: Teaching Quality and Safety Education in China.

There has been increasing focus on improving the quality and safety of health care globally. Understanding that the health of one nation impacts others worldwide drives initiatives for collaboration to improve the health of all. In this, the Year of the Nurse and Midwife as designated by the World Health Organization, The Quality and Safety Education for Nurses (QSEN) Competencies provide structure that transcends culture for framing the nursing role to contribute to improving patient safety and the quality of care delivery internationally. This article describes initiatives to share resources and strategies to support quality and safety education and practice with nurses across countries. [J Contin Educ Nurs. 2020;51(3):106-108.].

QSEN Transcends Cultures: Leadership Lessons Learned From a Global Experience.

Quality and Safety Education for Nurses (QSEN) has global appeal, acknowledging the important role of nursing in care delivery. This article complements the Teaching Tips column, shifting from content covered to the leadership lessons that presenters must consider when preparing for and presenting to a global audience. Four critical lessons are addressed: humility and acceptance, time for translation, job role assumptions, and conceptual clarification. [J Contin Educ Nurs. 2010;51(1):9-11.].