CONFIDENTIAL 2014 Chamberlain College of Nursing, LLC. All
rights reserved. 0713ccn Incorporating QSEN into Hospital Practices
Deb Tauber, MSN, BSN, CEN Stephanie Teets, MSN, BSN CNL Katherine
Weibel, BSN, MBA, RN-BC Chamberlain College of Nursing Adventist
Midwest Health Slide 2 Disclosure Statement Deb Tauber, Stephanie
Teets and Katherine Weibel have no financial or commercial interest
in this content. Slide 3 Objectives Learner will be able to
describe the process of using this methodology to integrate QSEN
into the hospital setting, by incorporating QSEN into the hospital
orientation process. Demonstrate how teams of healthcare
professionals can integrate the competencies of the QSEN process
into Rapid Response Mock Training. Participant will be able to
compare this opportunity to current needs in their organization or
nursing school and construct a similar opportunity to meet their
specific challenges. Slide 4 Call From Above Adventist Hospital
Leaders recognized QSEN as a potential opportunity for improving
patient safety. The first principle for designing safe systems in
health care organizations is according to the IOM report To Err is
Human to provide leadership from the top-most level of the
organization. The need to create a safe and effective nursing
environment clearly parallels, and indeed overlaps, this IOM
dictum. (The Joint Commission, 2012) Slide 5 What Exactly is a
Competency? The IOM defined competency as the habitual and
judicious use of communication, knowledge, technical skills,
clinical reasoning, emotions, values and reflection in daily
practice (Brady, 2011). 5 Slide 6 6 Quality and Safety Education
for Nurse (QSEN) QSEN Competency Categories Patient Centered Care
Teamwork and Collaboration Evidence-Based Practice Quality
Improvement Safety Informatics The purpose of the QSEN competencies
is to meet the challenge of preparing nurses to improve the
knowledge, skills and attitudes (KSAs) necessary to continuously
improve the quality and safety of healthcare systems within which
they work (Adapted from QSEN, 2009). Slide 7 Evidence Based
Practice (EBP) Implement each competency with evidence Gather best
practices Review current healthcare education, nursing and patient
safety literature 7 Slide 8 Addressing Disruptive Behaviors
Incivility in Healthcare A summary of relevant sources of
literature support the findings that the problems of incivility in
healthcare are both harmful and costly. Replacement of one nurse
can cost an organization between $46,932 - $145,000 (Kennedy,
Michols, Halamek, & Arafeh, 2012). Workplace incivility may be
subtle but it creates a heavy financial burden estimated at $24
billion dollars annually (Spence, Laschinger, Cummings, Wong, &
Grau,2014). 8 Slide 9 Summary Graph Data (Tauber, 2014) 9 Slide 10
Safety It is well documented in many initiatives leading healthcare
organizations driving improved outcomes (AACN), World Health
Organization (WHO), QSEN, The Joint Commission, that the benefit of
Interprofessionality will improve patient outcomes and decrease
sentinel events. 10 Slide 11 What is Simulation? A technique, not a
technology, to replace or amplify real experiences with guided
experiences, often immersive in nature, that evoke or replicate
substantial aspects of the real world in a fully interactive
fashion (Gaba, 2004,p 2). Gaba, D. (2004) The future vision of
simulation in health care. Quality and Safety in Health Care, 13
(Suppl 1), 2-10. 11 Slide 12 The Value of Simulation Safe
environment Learn from mistakes Repetition Enhance teamwork and
collaboration 12 Improve -Critical Thinking -Judgment -Organization
-Prioritization -Communication Controlled environment Slide 13 Mock
Codes 13 Mock rapid response Mock stroke alerts Mock cardiac alerts
Mock code blues Debriefing afterward Slide 14 Three Phases of
Debriefing (Harvard Model - CMS) Reactions - Clear the air and set
the stage for discussion -Feelings (normalize) -Facts Understanding
-Exploring - explore trainees perspectives on scenario events
-Discussion and teaching Summary - distill lessons learned for
future use -What worked well -What should be changed next time
-Major take always 14 Slide 15 15 Evaluation Tools Slide 16
Integrating QSEN into Clinical Practice 16 Socializing QSEN
Introduction to the CNOs with commitment Presentation to nursing
leadership, education team, Advanced Practice Nurses Discussions at
Patient Care Division Meetings Introduction at orientation Slide 17
17 Revised curriculum for the New Grad Residency Program
integrating QSEN competencies into each cohort meeting. Integrating
QSEN Slide 18 18 Example Curriculum Slide 19 19 Slide 20 20 Slide
21 As a Beta testing group we piloted the use of this onboarding
checklist with 16 New Graduate Nurses and their preceptors. 21
Slide 22 Feedback from Beta Testing Group Overall the feedback from
the group has been very positive. We are using process improvement
for evaluating and improving for the next groups. One of the gaps
identified has been getting the behavior portion documented for
fear of possible consequences. We hope to improve this. The hope is
as the "culture" within the organization changes and people become
more comfortable with behavioral expectations it will be easier to
hold people accountable for their behavior. 22 Slide 23 Next Steps
We will evaluate the orientation model and modify as needed from
our BETA testing group We intend to submit this information for
publication Compare HCAPHS, Press Ganey, Core Measures in one
specific unit for one year and see if any measurable differences
are noted 23 Slide 24 Gaba, D. (2004) The future vision of
simulation in health care. Quality and Safety in Health Care, 13
(Suppl 1), 2-10. INACSL,(2011). Standards of Best Practice:
Simulation. Clinical Simulation in Nursing, 7(4), S3-S7. Fero, L.,
Wesmiller, S., Witsberger, C., Zullo, T., Hoffman, L., Critical
Thinking Ability of New Graduate and Experienced Nurses, Journal of
Advanced Nursing, 65(1). 139-148. Brady, D. S. (2011). Using
Quality and Safety Education for Nurses (QSEN) as a Pedagogical
Structure for Course Redesign and Content. International Journal Of
Nursing Education Scholarship, 8(1), 1-18.
doi:10.2202/1548-923X.2147 References 24 Slide 25 References
Continued Spence Laschinger, H. K., Cummings, G. G., Wong, C. A.,
& Grau, A. L. (2014). Resonant Leadership and Workplace
Empowerment: The Value of Positive Organizational Cultures in
Reducing Workplace Incivility. Nursing Economics, 32 5-11. Tauber,
D. A. (2014). [Simulation respectful caring assertive communication
evaluation tool]. Unpublished raw data 25
