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Incorporate the New 2010 NLN Framework!
Sue Field DNP, RN
http://fieldsue.com
Objectives: Attendees will
• Analyze methods to – implement core values, integrating concepts,
and program learner outcomes
of the 2010 NLN Educational Competencies Model into a nursing program.
• Formulate a plan to – facilitate faculty group involvement in the
implementation of the
2010 NLN Educational Competencies Model.
Journey to the Templates
1. NLNAC Initial Accreditation Less than desirable Framework
2. Consultants– June Larson: Chair of the NLN Outcomes and
Competencies Committee– Denise Hirst: Project Manager for QSEN
3. Presentation at the NLN National Conference 2011
4. 6 hour workshop in North Carolina in March 2012
5. Article written for publication
National Standards
• IOM (Institute of Medicine) report in 2003• IOM report in 2011• QSEN (Quality Safety Education in
Nursing) 2005– 5 outcomes of IOM + Safety
National Standards
• Carnegie Study: – Educating Nurses a Call for Radical
Transformation: Benner, Sutphen, Leonard & Day (2010)
• NLN Outcomes and Competencies (2010)• Benner’s article last month
– Knowledge– Practice (Skills)– Ethical Component (Attitude)
NLN Framework
Purchase
• National League for Nursing. (2010). Outcomes and competencies for graduates of practical/vocational, associate degree, baccalaureate, master’s, practice doctorate, and research doctorate programs in nursing. NLN.
• http://www.nln.org/facultydevelopment/competencies/index.htm
Student Learner Outcomes
1. Human Flourishing
2. Nursing Judgment
3. Professional Identify
4. Spirit of Inquiry
Professional IdentityStudent Learner Outcomes PN to PhD
PN/VOC ADN/DIP
BS MASTER PRACTICE DOC
RESEARCH DOC
Assess how one’s personal strengths
and values…
Implement one’s role as a nurse in ways…
Express one’s
identity as a
nurse …
Implement one’s
advanced practice
role…
As a nurse-scholar, seek
ways to translate research
findings into practice…
Implement one’s role
as a research scholar
committed…
Human Flourishing
Program Learner
Outcomes
Practical Nursing ProgramsLearner
Outcomes
Associate Degree Nursing ProgramsLearner Outcomes
Human
Flourishing
Promote the human dignity, integrity, self determination, and personal growth of patients, oneself, and members of the health care team.
Advocate for patients and families in ways that promote their self-determination, integrity, and ongoing growth as human beings.
Program Learner
Outcomes
Practical Nursing Programs
Learner Outcomes
Associate Degree Nursing ProgramsLearner Outcomes
Nursing
Judgment
Provide a rationale for judgments used in the provision of safe, quality care and for decisions that promote the health of patients within a family context.
Make judgments in practice, substantiated with evidence, that integrate nursing science in the provision of safe, quality care and that promote the health of patients within a family and community context.
Nursing Judgment
Professional Identity
Program Learner
Outcomes
Practical Nursing
Programs
Learner Outcomes
Associate Degree Nursing ProgramsLearner Outcomes
Professional
Identity
Assess how one’s personal strengths and values affect one’s identity as a nurse and one’s contributions as a member of the health care team.
Implement one's role as a nurse in ways that reflect integrity, responsibility, ethical practices, and an evolving identity as a nurse committed to evidence-based practice, caring, advocacy, and safe, quality care for diverse patients within a family and community context.
Spirit of Inquiry
Program Learner
Outcomes
Practical Nursing ProgramsLearner
Outcomes
Associate Degree Nursing ProgramsLearner Outcomes
Spirit
of
Inquiry
Question the basis for nursing actions, considering research, evidence, tradition, and patient preferences.
Examine the evidence that underlies clinical nursing practice to challenge the status quo, question underlying assumptions, and offer new insights to improve the quality of care for patients, families, and communities.
QSEN Outcomes (2005)
• 1. QSEN: Patient Centered Care Student will recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and need
• 2. QSEN: Safety Student will minimize risk of harm to patients and providers through both system effectiveness and individual performance.
QSEN Outcomes…
• 3. QSEN: Informatics The student will use information and technology to communicate, manage knowledge, mitigate error, and support decision making.
• 4. QSEN: Teamwork and Collaboration Student will function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.
QSEN Outcomes…
• 5. QSEN: Quality Improvement • Student will use data to monitor the outcomes of
care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.
• 6. QSEN: Evidence Based Practice • Student will integrate best current evidence with
clinical expertise and patient/family preferences and values for delivery of optimal health care.
QSEN and NLN Competencies and Outcomes
• NLN: Human Flourishing– QSEN: Patient Centered Care
• NLN Nursing Judgment– QSEN: Safety– QSEN: Informatics
• NLN Personal/Professional identity– QSEN: Teamwork and Collaboration
• NLN Spirit of Inquiry– QSEN: Quality Improvement – QSEN: Evidence Based Practice
NAPNES PN Student Learner Outcomes
• From NAPNES– May 6, 2007– 5 years old
• Need to be up to date with latest standards including
–QSEN–NLN Outcomes and Competencies
NAPNES PN Outcomes (2007)
1. Demonstrate professional behaviors of accountability and professionalism according to the legal and ethical standards for a competent licensed practical/vocational nurse.
2. Effectively communicate with patients, significant support person(s), and members of the interdisciplinary health care team incorporating interpersonal and therapeutic communication skills.
NAPNES…
3. Collect holistic assessment data from multiple sources, communicate the data to appropriate health care providers, and evaluate client responses to interventions.
4. Collaborate with the registered nurse or other members' of the health care team to organize and incorporate assessment data to plan/ revise patient care and actions based on established nursing diagnoses, nursing protocols, and assessment and evaluation data.
NAPNES…
5. Demonstrate a caring and empathic approach to the safe, therapeutic, and individualized care of each client
6. Implement patient care, at the direction of a registered nurse, licensed physician or dentist through performance of nursing interventions or directing aspects of care, as appropriate, to unlicensed assistive personnel (UAP).
Missing from NAPNES
• 1. Patient Centered Care and Human Flourishing
• 2. Quality Improvement and Spirit of Inquiry• 3. Informatics• 4. Evidence Based Practice/Research• 5. Safety: Mitigate errors • 6. Nursing Judgment
NLN 2000 AD Learner Outcomes
• 1. Practice within the ethical, legal and regulatory framework of nursing and standards of nursing practice.
• 2. Demonstrate caring behaviors toward the patient, significant support persons and members of the health care team
• 3. Demonstrate accountability for nursing care given by self and or delegated to others.
NLN 2000 AD Learner Outcomes
• 4. Utilize therapeutic communication skills in professional relationships.
• 5. Utilize the nursing process to provide individualized nursing care in diverse settings.
• 6. Utilize critical thinking to make clinical judgments and management decisions to provide safe, appropriate and individualized care.
NLN 2000 AD Learner Outcomes
• 7. Develop individualized teaching plans based on assessed patient needs.
• 8. Collaborate with the patient, support persons, as well as members of the healthcare team to assist the patient to achieve optimal outcomes.
• 9. Develop personal goals for professional development and participate in lifelong learning.
Missing from 2010 NLN
• 1. Patient Centered Care and Human Flourishing
• 2. Quality Improvement and Spirit of Inquiry
• 3. Informatics• 4. Evidence Based Practice/Research• 5. Safety: Mitigate errors • 6. Nursing Judgment
1st Step Course Outcomes
• 1. List the Course Outcomes– A. Identify the learning activities– B. Identify the measurements – C. Identify the student learner outcomes are
related to the course outcomes.
Course Outcomes
• Example of Outcomes to Assignments
1. The Core Values
1. Present in your Philosophy Statement
2. Flow through your Curriculum
Core Values Template Example
2. Integrating Concepts
• NLN outcomes and competencies book (2010)
• Suggested statements are listed – for EACH of the 6 integrating concepts
1. Context and Environment
2. Knowledge and Science
3. Personal/Professional Development
4. Quality and Safety
5. Relationship Centered Care
6. Teamwork
Three Apprenticeships
• Knowledge• Practice Know How• Ethical Comportment
– Benner: Do away with curricular threads and implement 3 apprenticeships
Integrating Concepts Three Apprenticeships
1. Context and Environment– Knowledge– Practice Know How– Ethical Comportment
2. Knowledge and Science– Knowledge– Practice Know How– Ethical Comportment
3. Personal/Professional
Development– Knowledge– Practice Know How– Ethical Comportment
4. Quality and Safety– Knowledge– Practice Know How– Ethical Comportment
5. Relationship Centered Care– Knowledge– Practice Know How– Ethical Comportment
6. Teamwork– Knowledge– Practice Know How– Ethical Comportment
Integrating Concepts Template Example
Program Learner Outcomes
• Needs to meet National Standards• NAPNES from 2007 does not include
national standards• QSEN and NLN Framework
QSEN and NLN Competencies and Outcomes
QSEN• Patient Centered Care• Safety• Informatics• Teamwork and
Collaboration• Quality Improvement • Evidence Based Practice
• Human Flourishing• Nursing Judgment
• Personal/Professional identity
• Spirit of Inquiry
NLN
Student Learner Outcomes
• Need to demonstrate that EVERY student that graduates has fulfilled the student learner outcomes.
• Clinical/Program Portfolio is a great way to prove this.
Student Learner Outcomes Template 1
Student Learner Outcomes Template 2
“How To’s”Steps that might work for you and your
nursing program
How to: Part I
• PAIR faculty members – Who teach the same courses
• Determine for each course outcome– How the course outcome relates to the program
outcomes– Determine the learning activities for the outcome and – Determine the measurements used for the outcome
• See template next slide
How to: Part I
Course Template
How to: Part II Round Robin
• Arrange tables by integrating concepts– Attach template to tables by integrating concepts
• Faculty pairs rotate through the stations. – Faculty identify the course outcomes that fulfill
competencies listed
Context and Environment
Knowledge and Science
PersonalProfessional
GrowthQuality and
Safety
Teamwork
Relationship Centered
Care3
Apprenticeshipsfor each:Knowledge
PracticeEthical Comportment
Part III: Compilation
• Compile all information on one document
Part IV: Program Learner Outcomes
• Complete the Program Learner Outcomes Template – in a round robin – similar to the Integrating Concepts Round Robin
Human Flourishing
Professional Identify
Nursing Judgment
Spirit of Inquiry Nursing
Practice
Part V: Identify ApprenticeshipsMissing Course Outcomes
• Identify apprenticeships that lack course outcomes.– Develop new course outcomes as needed
• Identify the new outcomes needed – Evaluate BOTH the Apprenticeships AND the Learner
Outcomes Templates– Be careful of Additive curriculum
» (May need to take something out of your curriculum)
• Develop learning activities for each• Develop outcome measures for each
Templates
• Template A: Course Templates• Template 1. Core Competencies • Template 2. Integrating Concepts • Template 3. Learner Outcomes• Template B: Program Portfolio
References• Benner, P., Sutphen, M, Leonard-Kahn, V., Day, L. (2008, September).
Formation and everyday ethical comportment. American Journal of Critical Care,17(5473), 473-476.
• Benner, P., Sutphen, M, Leonard-Kahn, V., Day, L. (2010). Educating nurses a call for radical transformation. San Francisco, CA: Jossey-Bass.
• Benner, P., Tanner, C., Chesla, C. (2009). Expertise in nursing practice. (2nd ed.). NY: Springer Publishing.
• Caputi, L. (2010). Teaching nursing: The art and science. (2nd ed.).Glen Ellyn, IL: College of DuPage Press.
• Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P, & Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55(3), 122-131.
• Hirst, D. & Foster, B. (2009). Undergraduate curriculum mapping: Faculty interactive approach using QSEN competencies. Poster presentation. (Template modeled after Hirst & Foster’s work).
• National League for Nursing. (2010). Outcomes and competencies for graduates of practical/vocational, associate degree, baccalaureate, master’s, practice doctorate, and research doctorate programs in nursing. NLN. http://www.nln.org/facultydevelopment/competencies/index.htm
• QSEN Quality and Safety Education for Nurses. http://www.qsen.org
