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WSU COLLEGE OF NURSING
SENIOR 1: PRE-LICENSURE CURRICULAR NEEDS ASSESSMENT AND GAPS ANALYSIS SUMMARY
NURS523: EDUCATION ISSUES AND CURRICULUM ANALYSIS
TEAM SPLENDID SCHOLARS:
Margaret Baldridge
Ruth Bryant Elaine Clement
Ira Kantrowitz-Gordon Mariana Sheldon Marian Wilson
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March 4, 2012 WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Table of Contents
Introduction ..........................................................................................................................................................................................................................2
Evaluation of Senior 1 Nursing Courses based upon CON Program Outcomes .................................................................................................................4
Evaluation of Senior 1 Nursing Courses based upon AACN Baccalaureate Essentials ....................................................................................................15
Evaluation of Senior 1 Nursing Courses based upon WSU Big 7 Goals...........................................................................................................................24
Evaluation of Senior 1 Nursing Courses based upon Nursing Commission Requirements ..............................................................................................28
Evaluation of Senior 1 Nursing Courses to NCLEX .........................................................................................................................................................32
Evaluation of Senior 1 Nursing Courses upon QSEN .......................................................................................................................................................39
Evaluative summary of gaps and recommendations based upon WSU Big 7, Nursing Commission, NCLEX, CON, QSEN and AACN Baccalaureate Essentials criteria…...……………………………………………………………………………………………………44
Conclusion………………………………………………………………………………………………………………………………………….……56
List of Works Cited………………………………………………………………………………………………………………………………………58
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WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Introduction
The student members of “Team Splendid Scholars” conducted a review of an assigned group of courses in the school of Nursing at Washington State
University to determine if there were any gaps between the curriculum intent and the criteria used by external evaluating agencies. This type of
review requires having adequate knowledge of the subject matter and a sufficient understanding of the individual course content to make a decision
(Whittington, 2004). Decisions about curriculum analysis depend upon a clear understanding of the standards against which the curriculum is being
judged, and the criteria used to determine if the standards are being attained (Iwasiw, 2009). For the purposes of this particular review, the criteria
used for evaluating the nursing courses included:
WSU Big 7 (Office of Assessment of Teaching and Learning, 2011)
Nursing Commission (Commission on Collegiate Nursing, 2009)
NCLEX (National Council of State Boards of Nursing, 2009)
CON Program Outcomes
QSEN (QSEN Phase III Steering Committee, 2012)
AACN Baccalaureate Essentials (American Association of Colleges of Nursing, 2008)
The objective of this review was to provide a basis for communicating whether any material modifications should be made to any of the courses to
conform to these specified criteria. This report does not conclude any representation as to the quality nor student outcomes of the WSU nursing
curriculum or program. We specifically reviewed the pre-licensure curricular needs assessment and gaps analysis submitted by the faculty for the
following courses in the WSU College of Nursing:
N408 Professional Development: III Leadership and Management
N412 Family and Community as a Context of Care
N414 Child and Family Health Theory
N415 Children and Families as the Focus of Nursing Care
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N416 Childbearing Health of the Family
N417 Nursing Care of Childbearing Families
These courses are all from the first semester of the senior year of the baccalaureate nursing program. As a result, courses that form part of a series,
for example, the Leadership and Management courses, were each reviewed individually, separate and apart from each other. In the future, it may be
preferable to review course series as a group. This is because every course does not need to meet every criterion. The curriculum needs to be
evaluated as a whole.
Based upon our review, we present the following recommendations. In the first section, courses are evaluated based upon each group of standards in
a tabular format followed by a list of recommendations. This section is followed by an evaluative summary of gaps and a list of recommendations
for each course based upon all of the standards. We conclude this project with some closing statements about the WSU nursing curriculum overall.
This compilation and review was limited to the form prescribed by WSU and presented in accordance with the requirements of the academic
assignment, which differ substantially from generally accepted auditing standards, the objective of which is the expression of an opinion regarding
the curriculum taken as a whole.
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WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Evaluation of Senior 1 Nursing Courses based upon CON Program Outcomes
UCC is conducting a 4 year review of the pre-licensure nursing curriculum. This year, the Committee is conducting a needs assessment and gap
analysis of our curriculum when compared to college, university, regulatory, professional and community outcome expectations. Each course will be
evaluated utilizing the ‘Pre-licensure curricular needs assessment and gaps analysis forms 1 and 2.’ Gap Forms 1 & 2 completed by faculty teaching
each Senior1 course will be made available to you. Please complete this form as a summary of the individual course forms provided to you. Provide
a summary of gaps based for each of the factors impacting curricular development listed below.
CON PROGRAM OUTCOMES:
N408 N412 N414 N415 N416 N417
Competence in Provision
of Care
1. Provide competent nursing
care to individuals, families, groups and
communities through promotion, maintenance and
restoration of health; prevention of illness,
and physical, emotional, and spiritual support
throughout life the span.
I,R
R
R, I
Gap: Need
more time for class
discussion and case studies with
more individual
written work. Difficult to do small
groups over AMS, and
workload of correcting
R
Gap:
Discrepancy among clinical
groups in their opportunities for equal
experiences for the students
(Pediatric opportunities vary from site to
site and community to
community.
M
Gap: Lack
of practical exposure to
diverse groups due to
population encountering
and student population.
M Gaps:
Consider woman’s
health issues including menopause.
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case studies is huge.
The biggest strength of this course is the
ability to provide a
variety of experiences for students.
2. Formulate nursing
practice decisions using evolving
knowledge and research from nursing science, the
biological and behavioral
sciences, and the humanities.
I,R
N/A R
Gap: Need more active
use of EBP by students.
R
R
Gap: Access to
new knowledge curtailed as
budget cuts in library
have begun to be a challenge in
terms of obtaining
some articles.
R
3. Use developmentally
appropriate teaching- learning
principles to assist clients to achieve their health goals
and to assist colleagues to
improve the quality of their nursing care.
I
R
R
R
Gap:
Challenge is that students’
prerequisite development courses vary
considerably so everyone comes
with a different base knowledge in human
development.
R
Gap: More
likely to see in clinical
portion -or leadership for assisting
colleagues.
R Gap:
Consider specific
teaching project.
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Professional
Values
1. Provide
compassionate, ethical care to individuals of
diverse cultures, values, beliefs, and
lifestyles.
I,R Gap: Faculty
report a need to invite more of
the CON affiliate community
nurse leaders.
R
R
Gap: Faculty
report a possible gap
may be the lack of evaluation of
competencies in this
category. Faculty report there
is no opportunity
for actual observation or practice,
but extra credit
assignment often brings these out.
R
Gap: Lack of
consistency of content among
various clinical groups, as often topics come up
as a result of the experiences they
have in clinical.
R
R
2. Demonstrate the
values central to nursing practice
including: altruism, autonomy, human dignity, integrity,
and social justice.
I,R
R
R
Gap: Faculty
report there is a lack of direct
practice experience in
advocacy for underserved or vulnerable
populations.
R
R
.
Not specifically
addressed.
I,R R R R R
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3. Protect the rights of people to receive optimum care and
make informed decisions affecting
their health welfare.
Gap: Faculty report difficultly
to get students freely talking in
large lecture classes of 125-135 students.
Not specifically addressed.
Role
Development
1. Uphold the
standards and values of the profession
including accepting responsibility for learning and
personal growth.
I,R
R
R
R
R
R
Gap:
Faculty ask that consideration
be given to more
independent opportunities for role
exploration in the
childbearing family area.
2. Interpret professional nursing
using perspectives gained from past,
present and future trends in nursing and society.
I,R
N/A
N/A
N/A
Not
addressed.
Not
addressed.
3. Advocate for responsible, humane
health care policies.
I,R
I
R
Gap: Faculty note possible
R
Not
addressed.
Not
addressed.
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gap may be this standard is difficult to
measure.
4. Partner with clients, families,
communities and interdisciplinary health care teams to
design and provide quality health care.
I
Gap: Faculty report on inconsistency in
reception of topic: “Politics
is sometimes a hot button with some cold and
boring button for others.”
N/A R
Gap:
Standard could be met
by having more
opportunity for other disciplines to
interact with students.
R
Gap:
Inconsistent opportunities for
all students to experience
much interdisciplinary interactions.
Not
addressed.
Not
addressed.
5. Participate in
revision of health care policy and practice within a
rapidly changing global environment.
I
N/A N/A
Gap: Lack of
opportunity to participate
in policy revision.
N/A
Not addressed.
Not addressed.
Designer,
Manager, Coordinator of Care
1. Demonstrate
leadership skills and knowledge of the management process
in designing, managing and
coordinating care.
I,R
N/A N/A R
Not addressed.
R
Gap: Consider formal
leadership training
activity or seminar.
2. Use evolving information
technology to
I
N/A R
R
Gap: Clinical
Not
addressed.
Not
addressed.
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Summary of Gap Analysis and Recommendations:
CON Program Outcomes
N408 Professional Development III: Leadership & Management
Overall, this series of four courses in Leadership & Management should be updated to reflect the recommendations from the Institute of Medicine’s
The Future of Nursing (RWJ/IOM, 2011) and recent changes in the healthcare industry, such as “Pay-for-Performance” (U.S. Department of Health
& Human Services, 2006). Important topics such as quality improvement, cost-benefit analyses, employee hiring/firing, staff development, and
principles of nursing workload need to be incorporated (American Nurses Association, 2008). We refer faculty to the excellent discussion on pages
251-256, “Skills for the Managed Care Environment: Leadership and Management” in Nursing Education in the Clinical Setting (Emerson, 2007).
The following is a list of the faculty- identified gaps grouped by course with the associated criteria followed by a recommendation:
monitor and improve the health care of clients.
experiences for students vary from agency to
agency so there is a disparity of
IT experience when on site.
3. Demonstrate
knowledge of fiscal
dimensions within a
variety of current
and evolving health
care systems.
I,R
Gap: Faculty report: “It is
difficult in a 3 hour class of over 130 young
adult learners to capture their
attention and interest. Several teaching tools
are used, i.e. YouTube, PPT,
group exercises, guest speakers and websites.”
N/A
N/A
N/A
Not
addressed.
Gap:
Consider
fiscal presentation
in post-conference to meet the
variety of current
evolving health care systems.
Consider discussion
board to meet this objective.
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N408 Gap: Faculty report a need to invite more of the CON affiliate community nurse leaders.
Criteria: Provide compassionate, ethical care to individuals of diverse cultures, values, beliefs, and lifestyles.
Recommendation: Invitations could be extended to CON-affiliated nurses who are leaders of healthcare organizations that specifically provide care
to people of diverse cultures, values, beliefs, and lifestyles in the community.
N408 Gap: Faculty report difficultly to get students freely talking in large lecture classes of 125-135 students. Criteria: Protect the rights of people to receive optimum care and make informed decisions affecting their health welfare. Recommendation: Discussion of such a sensitive topic might be more effective if the students are divided into small groups for case study reviews
and role-playing. Classroom Response Systems (“clickers”) might also be useful to aggregate data from such a large group: “Faculty can pose case studies or clinical problems and ask students for their opinions. Differences in answers can be discussed (O'Neil, 2009, p. 172).
N408 Gap: Faculty report on inconsistency in reception of topic: “Politics is sometimes a hot button with some cold and boring button for others.” Criteria: Partner with clients, families, communities and interdisciplinary health care teams to design and provide quality health care
Recommendation: Specific case studies that describe and report on the sometimes dramatic consequences of political decisions on healthcare could be reviewed by students in an online discussion board as part of a hybrid learning environment. Students could also submit reflections online.
N408 Gap: Faculty report: “It is difficult in a 3 hour class of over 130 young adult learners to capture their attention and interest. Several teaching tools are used, i.e. YouTube, PPT, group exercises, guest speakers and websites.”
Criteria: Demonstrate knowledge of fiscal dimensions within a variety of current and evolving health care systems. Recommendation: Fiscal responsibility is a vitally important topic. After graduation, baccalaureate-prepared nurses are often required to be “in
charge”. Those RN’s who do not manage within the constraints of the budget can lose their job. As a class project, different student groups could be assigned to an area of responsibility within a variety of health care systems. Real life scenarios that impact the budget could be presented, and the students would have to problem-solve based upon their knowledge of fiscal dimensions. Examples could include community health clinics, or an
inpatient medical/surgical unit. “A student who expects the world to correspond with the ideal will inevitably be disappointed. If students are able to work only under ideal circumstances, they have been sadly unprepared for reality” (Emerson, 2007, p. 252).
N414 Child & Family Health: Theory N414 Gap: Faculty report a need for more time for class discussion and case studies with more individual written work. Difficult to do small groups
over AMS, and workload of correcting case studies is huge. Criteria: Provide competent nursing care to individuals, families, groups and communities through promotion, maintenance and restoration of health;
prevention of illness, and physical, emotional, and spiritual support throughout life the span. Recommendation: Students can review the case study and formulate responses online prior to class. During class, faculty can pose a question and ask for responses using a Classroom Response System (“clickers”). This information provides faculty with an assessment of understanding the
material and with discussion material. If the students understand the material, the faculty can move to the next topic. If students do not, the faculty can ask students to confer and respond a second time. Discussions can be based on student answers (O'Neil, 2009, p. 172).
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N414 Gap: Faculty report “More active use of EBP by students would be beneficial”.
Criteria: Formulate nursing practice decisions using evolving knowledge and research from nursing science, the biological and behavioral sciences, and the humanities. Recommendation: “It is incumbent upon nurse educators to provide the theoretical foundations for evidence-based practice. To accomplish this,
nurse educators must refurbish curricula to incorporate both the pertinent new and expanded theory in the classroom and relevant practice in the most applicable clinical settings” (Emerson, 2007, p. 252). Therefore, it is recommended that case studies be presented that would require the
students to research evidence-based practice. For example, what would be best practice for management of a child with recurrent episodes of asthma, or uncontrolled diabetes? See above recommendation for evaluation of learning.
N414 Gap: Faculty report a possible gap may be the lack of evaluation of competencies in this category. Faculty report there is no opportunity for
actual observation or practice, but extra credit assignment often brings these out.
Criteria: Provide compassionate, ethical care to individuals of diverse cultures, values, beliefs, and lifestyles.
Recommendation: This would, in fact, be difficult to measure during a theory class. However, “One single learning environment cannot encompass
all of the knowledge and skills opportunities, but the clinical education experiences of the curriculum taken as a whole should” (Emerson, 2007, p.
254). A self-assessment tool may also be beneficial. “Self-assessment is critical to the process: It is the students, not the instructors, who are the
ultimate arbitrators of the learning experience. The learning environment is one of mutual respect, collaboration, cooperation, and support”
(Candela, 2006).
N414 Gap: Faculty report there is a lack of direct practice experience in advocacy for underserved or vulnerable populations.
Criteria: Demonstrate the values central to nursing practice including: altruism, autonomy, human dignity, integrity, and social justice. Recommendation: Same as above, “One single learning environment cannot encompass all of the knowledge and skills opportunities, but the
clinical education experiences of the curriculum taken as a whole should” (Emerson, 2007, p. 254). In class role-playing and case study exercises
could also be evaluated to bring out any possible problem areas.
N414 Possible Gap: Faculty note a possible gap may be that this standard is difficult to measure. Criteria: Advocate for responsible, humane health care policies.
Recommendation: Self-assessment is critical to the process. It is the students, not the instructors, who are the ultimate arbitrators of the learning
experience. The learning environment is one of mutual respect, collaboration, cooperation, and support (Candela, 2006). However, also recall that:
Nurses are already committed to delivering high-quality care under current regulatory, business, and organizational conditions. But the power to
change those conditions to deliver better care does not rest primarily with nurses, regardless of how ably led or educated they are; it also lies with
governments, businesses, health care institutions, professional organizations and other health professionals, and the insurance industry (RWJ/IOM,
2011).
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N414 Possible Gap: Faculty report “More time for other disciplines to interact with students in classroom format would be great-however they do
have that opportunity in their associated clinical course.” Criteria: Partner with clients, families, communities and interdisciplinary health care teams to design and provide quality health care. More interdisciplinary interactions may be provided by increasing on campus interdisciplinary educational opportunities. In class communication,
conflict resolution, and role-playing skills could also be utilized. Students could also be involved in developing interdisciplinary clinical pathways and quality improvement activities.
N414 Gap: Faculty report a lack of opportunity to actually participate in policy revision. Criteria: Participate in revision of health care policy and practice within a rapidly changing global environment.
Recommendation: It may not be realistic for students to actually participate in policy revision, however, students could be engaged in class discussions about this topic.
N415 Children & Families as the Focus of Nursing Care
N415 Gap: Discrepancy among clinical groups in their opportunities for equal experiences for the students (Pediatric opportunities vary from site to
site and community to community). Criteria: Provide competent nursing care to individuals, families, groups and communities through promotion, maintenance and restoration of health;
prevention of illness, and physical, emotional, and spiritual support throughout life the span. Recommendation: This is not specifically a curricula-related issue. It is a challenge faced by many schools of nursing due to a shortage of available clinical sites. Some schools have made attempts for students to identify their preference of clinical site based upon their long term professional
goals. For example, a student interested in pursuing a career in community health nursing may indicate a preference for an outpatient setting.
N415 Gap: Challenge is that students’ prerequisite development courses vary considerably so everyone comes with a different base knowledge in human development. Criteria: Use developmentally appropriate teaching- learning principles to assist clients to achieve their health goals and to assist colleagues to
improve the quality of their nursing care. Recommendation: Encourage SON to review course sequencing and to mandate appropriate course prerequisites.
N415 Gap: Lack of consistency of content among various clinical groups, as often topics come up as a result of the experiences they have in clinical.
Criteria: Provide compassionate, ethical care to individuals of diverse cultures, values, beliefs, and lifestyles.
Recommendations: Not every clinical learning opportunity will be available to every student, but concepts related to this criterion should be
addressed during group discussions.
N415 Gap: Inconsistent opportunities for all students to experience much interdisciplinary interactions. Criteria: Partner with clients, families, communities and interdisciplinary health care teams to design and provide quality health care.
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Recommendation: Again, since clinical learning experiences are variable, more interdisciplinary interactions may be provided by increasing on campus interdisciplinary educational opportunities. In class communication, conflict resolution, and role-playing skills could also be utilized.
N415 Gap: Faculty report clinical experiences for students vary from agency to agency so there is a disparity of IT experience when on site. Criteria: Use evolving information technology to monitor and improve the health care of clients.
Recommendation: If the school can provide the student with basic technology skills, on-the-job training will provide the specific skills needed once hired by an agency.
N416 Childbearing Health of the Family
N416 Gap: Lack of practical exposure to diverse groups due to population encountering and student population.
Criteria: Provide competent nursing care to individuals, families, groups and communities through promotion, maintenance and restoration of health; prevention of illness, and physical, emotional, and spiritual support throughout life the span.
Recommendation: “One single learning environment cannot encompass all of the knowledge and skills opportunities, but the clinical education experiences of the curriculum taken as a whole should” (Emerson, 2007, p. 254).
N416 Gap: Access to new knowledge is curtailed as budget cuts in library have begun to be a challenge in terms of obtaining some articles. Criteria: Formulate nursing practice decisions using evolving knowledge and research from nursing science, the biological and behavioral sciences,
and the humanities. Recommendation: This is not specifically a curricula-related issue. It is more of an administrative challenge faced by many schools of nursing due to a shortage of resources. In the interim, there may be a need to revert to alternative methods to obtain articles until the problem is resolved. This is an
area in which Dr. Doutrich is particularly skilled.
N416 Gap: Faculty report “More likely to see in clinical portion – or leadership for assisting colleagues.” Criteria: Use developmentally appropriate teaching- learning principles to assist clients to achieve their health goals and to assist colleagues to improve the quality of their nursing care.
Recommendation: Assure that appropriate patient education teaching principles are incorporated into the course so that students are prepared to help clients achieve their health goals and assist colleagues to improve the quality of their nursing care when they are in the clinical setting.
N417 Nursing Care of Childbearing Families
N417 Gap: Consider woman’s health issues including menopause.
Criteria: Provide competent nursing care to individuals, families, groups and communities through promotion, maintenance and restoration of health; prevention of illness, and physical, emotional, and spiritual support throughout life the span.
Recommendation: This would be an appropriate consideration. N417 Gap: Consider specific teaching project.
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Criteria: Use developmentally appropriate teaching- learning principles to assist clients to achieve their health goals and to assist colleagues to improve the quality of their nursing care.
Recommendation: There are already many effective evaluation strategies already in use for this course, N417 Gap: Faculty ask that consideration be given to more independent opportunities for role exploration in the childbearing family area, such as
opportunities for shadowing nurse practitioners, certified nurse midwives and CRNA’s. Criteria: Uphold the standards and values of the profession including accepting responsibility for learning and personal growth.
Recommendation: What is essential must be winnowed from what would be nice (Emerson, 2007). N417 Gap: Consider fiscal presentation in post-conference to meet the variety of current evolving health care systems. Consider discussion board to
meet this objective. Criteria: Demonstrate knowledge of fiscal dimensions within a variety of current and evolving health care systems.
Recommendation: This content should be adequately covered in N408.
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WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Evaluation of Senior 1 Nursing Courses based upon AACN Baccalaureate Essentials
AACN Baccalaureate Essentials
Does current course
support, address, or link to:
N408 N412 N414 N415 N416 N417
1.Liberal education:
provides the cornerstone for the practice and education of nurses
I
Possible Gap: The analysis provided is not
specific in how the course addresses
critical thinking and reasoning skills. Are their opportunities to
increase broad knowledge base of
various populations? Can politics include exposure to other
health systems? For instance including
discussion on other countries and/or military, Native
American health systems, etc. would
meet needs to discuss cultural diversity, population health.
N/A
1 & 2. These are both identified as
“Not Applicable.” It seems the course
content does offer opportunities to address these
standards. A course on family
centered health care might incorporate
aspects from social sciences,
anthropology, genetics, etc. to increase student
exposure to varied “ways of
knowing.” Quality & safety can be addressed in
R
This analysis is not descriptive. There
may be opportunities to
expand liberal knowledge base such as
incorporating theories from
sociology, anthropology, psychology.
R
This standard is assessed as
sufficiently addressed.
Not addressed
This standard is not assessed
in the analysis.
R
These standards
were not separately
addressed in the analysis, but could be
gleaned from some of the
analysis in the CON evaluation
that this is adequately
addressed.
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context of problem-solving, improving access
to care, etc.
2. Basic organizational and systems leadership for
quality care and patient safety: Knowledge and skills in leadership, quality
improvement, and patient safety are necessary to
provide high quality health care.
I,R
Possible Gap:
The gap analysis does not specify whether
content is provided regarding the BSN role
in leadership of safety and quality initiatives. Addition of these
elements in discussion of leadership could be
beneficial.
N/A
(see above comments)
N/A (skills not a primary goal of
course)
It is stated that leadership skills are not a goal of this
course. It could be that the definition of
leadership and in fact, many opportunities exist
for nurses lead patient care quality
and safety.
R
This standard is assessed as
sufficiently addressed.
Not addressed
This standard is not assessed
in the analysis.
R
Gap:
Instruction on safety and
quality may be lacking.
3. Scholarship for evidence-based practice:
Professional nursing practice is grounded in the translation of current
evidence into one’s practice
I,R
Possible Gap: That PowerPoints provide references seems like
weak evidence of the incorporation of EBP
in this course. When articles are listed in the assignment, are these
highlighted as best practices? Are students
asked to find best practices in nursing leadership or examples
of nurses leading quality and safety
R
Evidence provided that this item is sufficiently
addressed.
R
Faculty state that more active use of EBP would be
preferred under the CON analysis, but
do not address this standard as deficient under the AACN
analysis. There are likely opportunities
to build more EBP usage into the normal course work
R
How EBP is incorporated is not well-
defined in the analysis.
R
This standard is assessed as sufficiently
addressed.
R
EBP is assessed as sufficiently
addressed.
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initiatives? If so, this could address and help meet AACN standards
under item #4 that is regarded as “Not
Applicable” in this gap analysis.
4. Information management and application of patient
care technology: Knowledge and skills in
information management and patient care technology are critical in the delivery
of quality patient care.
N/A
(see above comments)
N/A
Possible Gap: The gap analysis
states item 4 is “Not Applicable.” There may be
opportunities to include addressing
the organizing, retrieving, acquiring and
maintaining of information within
this course. It is also possible this is already
occurring and just not identified as
“information management.” In addition,
familiarity with data management
might be added to this course by asking students to
retrieve data on the topic of
N/A
Gap: The gap analysis states item
4 is “Not Applicable.” There may be
opportunities to include information
gathering on family health trends, for example morbidity
and mortality.
R
Assessed as meeting this
standard.
R
This is assessed as
sufficient, however only mentioned
patient care technology,
not information management.
R
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interest from sites such as CDC, World Health
Organization, etc.
5. Healthcare policy, finance, and regulatory
environments: Healthcare policies, including financial and regulatory, directly and
indirectly influence the nature and functioning of
the healthcare system and thereby are important considerations in
professional nursing practice.
I,R
Evidence seems sufficient that this standard is covered.
N/A
Possible Gap: These items are listed as “Not
Applicable.” It seems the course
content does address topics that may have related
policies and examples of
communication collaboration, such as those
surrounding pregnancy,
divorce, poverty, etc.
R (loosely)
Gap: Faculty identified gap; may be opportunities to
incorporate content.
R (loosely)
Gap: Standard is difficult to
address uniformly due
to varied student experiences.
Not
addressed.
Not assessed.
R
Gap: Policy is not specifically
addressed.
6. Inter-professional communication and
collaboration for improving patient health outcomes:
Communication and collaboration among healthcare professionals are
critical to delivering high quality and safe patient
care.
I,R
Evidence seems sufficient that this
standard is covered.
N/A
Possible Gap: These items are
listed as “Not Applicable.” It seems the course
content does address topics that
may have related policies and examples of
communication
R
Gap: Faculty identify this as a gap
and there is no evidence it is specifically
addressed. A course focused on child
health in the community should involve other adults,
perhaps in regard to
R
Evidence seems
sufficient that this standard is covered.
R
Assessed as sufficiently
addressed using SBAR techniiques.
R
Communication
opportunities seem sufficient.
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collaboration, such as those surrounding
pregnancy, divorce, poverty,
etc.
social services, teachers, etc
7. Clinical prevention and population health: Health promotion and disease
prevention at the individual and population level are
necessary to improve population health and are important components of
baccalaureate generalist nursing practice.
I
Possible Gap: It is not
clear from the gap analysis whether this
standard addresses disease prevention and health promotion.
Incorporating safety or quality stories in this
segment could address nurses’ role in promoting health in
healthcare settings.
R (introduced at family level)
Evidence seems sufficient that this
standard is covered.
R
Evidence seems
sufficient that this standard is covered.
R
Evidence
seems sufficient that
this standard is covered.
Not
addressed.
Not addressed in analysis.
R
Examples of
learning opportunities
across the healthcare continuum
appear to be addressed.
8. Professionalism and
professional values: Professionalism and the inherent values of altruism,
autonomy, human dignity, integrity, and social justice
are fundamental to the discipline of nursing.
I,R
Possible Gap: It is not clear from the gap analysis how social
justice and autonomy are incorporated into
the course.
R
Evidence seems sufficient that this standard is
covered.
R
Gap: Faculty identify that little actual practice is
allowed for these standards;
simulation may provide some opportunities.
R
Gap:
Inconsistent experiences for
students.
R
Addressed sufficient.
R
Professional values are addressed.
3/4/12 10:15 AM
20
9. Baccalaureate generalist nursing practice:
The baccalaureate
graduate nurse is prepared to practice
with patients, including individuals, families,
groups, communities, and populations across the lifespan and across
the continuum of healthcare
environments. The baccalaureate graduate
understands and respects the variations of care, the increased complexity, and
the increased use of healthcare resources
inherent in caring for patients.
Learning opportunities, including direct clinical
experiences, must be sufficient in breadth and
depth to ensure the baccalaureate graduate attains these practice
focused outcomes and integrates the delineated
knowledge and skills into the graduate’s professional nursing
I,R
Possible Gap: It is
unclear how diversity and variation of
populations served are addressed in this course.
It is unclear why
managing care as part of an inter-professional team is listed as “Not
Applicable” in the gap analysis. Course
content includes conflict management, professional etiquette,
communication skills; all of these could be
provided in context of the inter-professional team.
It is unclear why
simulation experiences are listed as “Not Applicable” when
learning activities cite case studies, clinical
scenarios, and communication exercises. These all
could provide opportunities to for
simulation exercises.
R
Evidence seems
sufficient that most of this
standard is covered.
It is listed as “Not Applicable” for many of the items
under this standard; there
may be a misperception of what can be
classified as simulation and
learning opportunities. The use of invited
guests could be one way of
incorporating more “clinical learning
opportunities.”
R
Gap: Opportunities
to demonstrate mastery through
clinical practice are needed.
R
N/A although clinical and theory instructors
collaborate to connect theory and
practice through clinical opportunities lab,
case studies, clinical conference and
simulation.
R
This standard
seems to be well-described
and addressed.
R
R
R
Some evidence
this standard is addressed.
Most bulleted points not specifically
addressed.
R
R
R
Clinical
scenarios and learning
opportunities appear to be sufficient.
R
R
3/4/12 10:15 AM
21
Summary of Gap Analysis and Recommendations:
AACN Baccalaureate Essentials
408. Overall, this course seems to cover many standards desired by the AACN Baccalaureate Essentials. It is possible that the gaps are not actual
gaps, but just not reflected in the limited information provided about this course for the analysis. Based on the information received, it appears there
are opportunities to strengthen the course alignment with the Essentials, with very little adjustment. Recommendations include:
1. Highlighting evidence-based leadership practices throughout the course so the concept of EBP and research is apparent throughout the course
content.
practice.
Clinical learning is
focused on developing and refining the knowledge and skills
necessary to manage care as part of an inter-
professional team.
Simulation experiences augment clinical
learning and are complementary to direct
care opportunities essential to assuming the role of the
professional nurse.
A clinical immersion
experience provides opportunities for
building clinical reasoning, management, and evaluation skills.
N/A
N/A
N/A
N/A
N/A However,
role playing becomes part of the seminar
process.
N/A
N/A
N/A
N/A
R
R
R
R
R
R
R
R
R
3/4/12 10:15 AM
22
2. Ask students to search for examples of best practices of leadership and nurse-led safety or quality initiatives in the literature, thereby
increasing the opportunities to increase information management skills.
3. Consider that each assignment can “multi-task” to meet many layers of learning; for instance communication lessons can be within the
context of inter-professional teams, varied populations, and on topics of safety.
4. Increase opportunities to use simulation in group activities.
412. This course covers many standards desired by the AACN Baccalaureate Essentials. Based on the information available, it appears that there are
opportunities to strengthen alignment by incorporating the following adjustments:
1. Incorporate aspects from social sciences, anthropology, genetics, etc. to increase student exposure to varied “ways of knowing.”
2. Quality and safety examples can be woven into course content.
3. Look for opportunities to include “information management” or “data management,” such as asking students to retrieve data on the course-related
topics from sites such as CDC, World Health Organization, etc. 4. Increase use of simulations that are imbedded in classroom settings and guest lecturers to facilitate clinically-relevant learning.
414. This course covers many standards desired by the AACN Baccalaureate Essentials. Based on the information available, it appears that there are
opportunities to strengthen alignment by incorporating the following adjustments:
1. Incorporate theories from social sciences, anthropology, psychology to increase student exposure to broad theoretical base and question
ethnocentric assumptions. 2. Incorporate more opportunities for promoting and identifying evidence-based practice. 3. Increase identifying leadership roles, using child-family health setting to find opportunities for nurses to lead in quality and safety improvements.
4. Question definitions of information management and include opportunities to seek data and new knowledge related to course content. 5. Weave inter-professional communication and policy lessons into course content.
415. This course covers most standards desired by the AACN Baccalaureate Essentials. Based on the information available, it appears that there are
opportunities to strengthen alignment by incorporating the following adjustments:
1. Find opportunities to Incorporate evidence-based practice and awareness of policy into course content.
2. Use class time to share knowledge from diverse student clinical settings so there is equality of exposure to new knowledge.
416. Several standards of AACN Baccalaureate Essentials were not addressed in the analysis. It is possible the standards are not understood, or the
faculty do not see evidence of them being present in the course. Based on the information available, it appears that there are opportunities to
strengthen alignment by incorporating the following adjustments:
1. Find opportunities to increase addressing missing standards including broad liberal education knowledge, information management, and health
policies.
3/4/12 10:15 AM
23
2. Expand opportunities for clinical and simulation learning.
417. Standards of AACN Baccalaureate Essentials were not specifically addressed in the analysis, however, could be gleaned from the College of
Nursing analysis provided. More detail is needed to adequately assess the standards. Based on the information availab le, it appears that there are
opportunities to strengthen alignment by incorporating the following adjustments:
1. Find opportunities to increase directly addressing standards of safety, quality, and health policies.
Overall combined recommendations:
Across many courses there are opportunities to increase alignment with AACN Essentials of Baccalaureate standards. Specific attention could be
paid to incorporating lessons that demonstrate how leadership in both direct care and managerial positions may improve safety, quality, and
therefore, patient outcomes. Greater appreciation of the meaning of a “liberal education” might be needed in order to assure the incorporation of
non-nursing points of view into lessons. Faculty might look for opportunities to present health topics from the perspective of genetics,
physiology, anthropology, sociology, or other arts and sciences. Information management seems to be an area identified as a “gap” in many
courses. It is possible faculty do not understand the definition of this standard, or they do not see its relevance in their courses. There may be
opportunities to include greater appreciation for information management by addressing how nurses in all settings organize, retrieve, acquire and
maintain of information. In addition, faculty might include data management in their lesson plans by asking students to retrieve data on the topic
of interest from sites such as Centers for Disease Control, World Health Organization, or other collections of health data. To help meet multiple
standards that are desired by AACN and other agencies, faculty might consider how each assignment can “multi-task” to meet several learning
objectives; for instance communication lessons can be within the context of inter-professional teams, varied populations, and on topics of safety
or quality. All courses might increase opportunities to use simulation, particularly if there are insufficient or inconsistent clinical settings.
Evidence-based practice seems to be inconsistently addressed. All courses should be challenged to assure their content is evidence-based and
reinforce that students consider research, clinical experience, and patient preferences to provide care that aligns with current triad models of an
evidence-based practice.
3/4/12 10:15 AM
24
WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Evaluation of Senior 1 Nursing Courses based upon WSU Big 7 Goals
WSU Big 7 Goals:
Factors impacting
curricular
development
N408 N412 N414 N415 N416 N417
1. Critical and
creative thinking. Use reason, evidence and
context to increase knowledge, to reason ethically and to
innovate in imaginative ways.
I, R
R
R
R
See summa
ry below.
R
R
See summar
y below.
2. Quantitative
reasoning. Solve quantitative problems from a wide variety of
authentic contexts and everyday life
situations.
I
Standard not directly addressed in the faculty comments; however
course objective 4 is to examine fiscal resource
allocation and implication for health care. Working with budgets and resource
allocation is a quantitative issue.
N/A
Possible Gap: The faculty states this is N/A, however,
reinforcing the basics of statistics will aid
students in their review of research for EBP.
N/A
Possible Gap: May be opportunities to
stress the importance of
statistics when understanding research. This is
part of quantitative reasoning.
R R
R
3. Scientific literacy.
Have a basic understanding of major scientific
concepts and processes required for
I, R
R
R
R R
R
3/4/12 10:15 AM
25
personal decision making, participation in civic affairs,
economic productivity and
global stewardship.
4. Information literacy. Effectively identify, locate,
evaluate, use responsibly and share
information for the problem at hand.
I
R
R
R N/A
Possible Gap: Faculty state N/A,
however one must have information and
science literacy to effectively obtain and evaluate relevant data
to maintain an EBP. The faculty does state
this may be related to clinical documentation and
retrieval.
R
5. Communication. Write, speak and
listen to achieve intended meaning and understanding among
all participants.
I, R
R
R
R N/A
Gap: Faculty identify
this standard as a clinical goal. This can be added to the
curriculum because the students must
effectively communicate with each other and their
patients to perform safe, evidence-based
patient care.
R
6. Diversity. Understand, respect
and interact
I, R
Gap: Opportunities in this
class for the
R
R
R R
Gap: Opportunities
may exists for faculty
R
3/4/12 10:15 AM
26
Summary of gaps and recommendations:
N408: It is likely the Big Seven goals are covered in the N408 curriculum; this is just not emphasized in the faculty comments. For example, there
was not a connection between learning fiscal resource allocation and the use of quantitative reasoning.
Recommendation: Assure faculty understand how their coursework is linked to Big Seven goals.
N412: How the curriculum encompasses the Big Seven goals is well described in the faculty comments. The use of quantitative reasoning within the
class can be achieved by ensuring that students understand statistical analyses within the research.
constructively with others of similar and diverse cultures,
values, and perspectives.
communication techniques introduced in this class to teach students how to
respect and interact constructively with others.
to address diversity in the population of laboring mothers.
Not just ethnic or cultural, but the
students will have to work with babies born to drug addicted
mothers, teen mothers, and various
other “non-traditional” families.
7. Depth, breadth and integration of learning
for the benefit of themselves, their
communities, their employers and for society at large.
I, R
R
R
R R
Not addresse
d.
3/4/12 10:15 AM
27
N414: Again, the curriculum descriptions explain how it covers the Big Seven goals, the only issue being the lack of quantitative reasoning which
can be taught by reviewing the statistics of research.
N415: The faculty comments for this class and how it covers the Big Seven goals were extensive.
N416: Faculty notes give a brief description of how the curriculum covers the goals. The proposed curriculum may cover the goals better than is
explained by faculty comments.
Recommendation: Faculty will understand how “diversity” can included socioeconomics, non-traditional families, and differences other than
ethnicity. Use all opportunities to recognize and point out diversity to students.
N417: The faculty comments for this class and how it covers the Big Seven goals were extensive.
3/4/12 10:15 AM
28
WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Evaluation of Senior 1 Nursing Courses based upon Nursing Commission Requirements
Nsg Commission requirements: theory & practice in following areas:
N408 N412 N414 N415 N416 N417
Medical
nursing
I
? I/R/M
R (peds)
Addressed
N/A
R
Surgical nursing
I
? I/R/M
R (peds)
Addressed
N/A
R
Obstetric
nursing
I
? I/R/M
N/A N/A I
Addressed
Nursing of children
I
? I/R/M
R
Addressed
I
I
Community
and public health nursing
I
Possible gap: Unclear if this is addressed; Are concepts of power,
leadership styles/theories, teamwork
etc discussed in context of public health scenarios? Impact of
politics on community health resources
discussed?
? I/R/M
R
Addressed
I
R
History and health trends
I
Possible gap: Unclear if
addressed. Could be presented in context of
? I/R/M
Insufficient evidence to
assess this criteria.
R ? I/R/M
Does not appear to be
addressed.
R
3/4/12 10:15 AM
29
shifting sources of power in patient care delivery (MD, providers,
government, etc) and trends is leadership
related to patient care delivery models.
Legal and
ethical issues
I
Possible Gap: Unclear if addressed. May want to
include L/E issues examples in discussions about delegation, power,
collaboration, politics, leadership observations.
? I/R/M
R
Addressed
R
Does not appear to be addressed.
R
Assessment
and analysis of client and family
I
Not addressed
? I/R/M
R
Addressed
R
R
Implementation of care
I
Possible Gap: Might be addressed within
collaboration & delegation but unclear
from evidence provided.
? I/R/M
R
Addressed
R
Evaluation of care
I
Unclear if addressed.
Could be component of collaboration, delegation
& leadership styles
? I/R/M
Evidence unclear if this is
addressed; no reference to outcome assessment.
R
Addressed
R
No response
Delegation of nursing care
IR
? I/R/M
Appears to not be addressed ? I/R/M Appears to not be
? I/R/M
R
3/4/12 10:15 AM
30
Summary of gaps and recommendations:
N 408: Overview for this course indicates focus is on impact of leadership, management, and resource allocation on patient outcomes. Concepts of leadership presented through assignments, projects, discussion and simulated case studies. The connection of these with patient outcomes is not clear
from evidence provided. Assignments could incorporate impact of certain negotiated or delegated decisions on the delivery of care to specific patient population (minority, medical, OB, etc.) (may already be in place) which would satisfy additional criteria for the Nursing Commission standard.
addressed
Provide care for diverse groups
I
Not addressed
? I/R/M
R R
No response Appears to not
be addressed.
Safe, effective
care environment
I, R
? I/R/M
R
R
No response
Health
promotion Leadership and
management
I, R
? I/R/M R
N/A
R
N/A
No response
Parenteral therapies
N/A ? I/R/M
Unclear that this is
addressed.
R
Addressed
R
? I/R/M
Pain management
I
Not addressed
? I/R/M
Possible Gap: Unable to determine.
Pain management could be incorporated into one of the
clinical examples to satisfy this criterion.
R
Addressed
R
R
Working in a health care team
I, R, M
? I/R/M
Not addressed based on
available information.
R
Addressed
R
R
3/4/12 10:15 AM
31
Evolution of nurse’s political involvement to create change (advanced practice status, IV sedation, ANA, unions versus non-union) and historical trends in patient care delivery models could be incorporated into assignments.
N412: Course objectives suggest these topics are addressed but may need to be more clearly specified in a project or assignment: History and health trends; evaluation of care; delegation of nursing care; parenteral therapy; pain management; working in a health care team
N414: Delegation of nursing care may need to be emphasized via discussion, project etc. Leadership and management considered N/A by course
reviewer however these could be introduced in discussions about teaching parents how’s/why’s of child proofing their home (for example), or discharge planning implications for returning to school with conditions such as obesity or special needs such as asthma, diabetes, short bowel
syndrome, etc.
N415: Health history /trends and legal/ethical issues not clearly portrayed
N416: These areas are not clearly illustrated in course reviewers comments yet are undoubtedly incorporated into the care of the newborn, outpatient
care and in-home care of the family: Evaluation of care, Provide care for diverse groups
N417: History and health trends not clearly exemplified. Otherwise extensive documentation of coursework, projects, discussions as documented
within the CON Program Objectives section suggests these Nursing Commission criteria met.
3/4/12 10:15 AM
32
WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Evaluation of Senior 1 Nursing Courses based upon NCLEX
NCLEX test content/blueprint (effective April 2010) Processes integrated throughout curriculum: nursing process, caring, communication and documentation, teaching/learning 4 Client Needs categories (2 of the 4 divided into subcategories)
1. Safe and effective Care environment: Management of Care, Safety and infection Control 2. Health promotion and maintenance
3. Psychosocial integrity 4. Physiological integrity: Basic care and comfort, pharmacological and parenteral therapies reduction of risk potential, physiological
adaptation.
N408 N412 N414 N415 N416 N417
Safe and effective care
environment
The concept of safe
& effective care is
taught & practiced
in this course
Gap: Does not appear to be
addressed
Gap: Does not appear to be
addressed
Gap: Does not appear to
be addressed
Gap: Does not appear to be addressed
Recommendations: introduction to
clinical environment
Management of care
Gap: Not addressed
Recommendation:
define leadership & give examples of
professional responsibilities,
professional values,professional growth, define
resource allocation & factors involved
in present day budgetary limitations related to
legislation
Gap: Not addressed
Recommendation: Discuss & review client rights for
access of optimum health care,
Confidentiality related to pt. records, technology
for enhancing pt. health care ed.,
consultation services to provide holistic health care
Gap: Does not
appear to be addressed
Recommendation:
should be based on child growth
and development and generational stages of
development
Gap: Does
not appear to be addressed
Recommend
ations: safety practices in
the home, preventative care
practices, protective
measures to ensure safety from abuse
or neglect
Gap:
Recommendations proper car seats,
safety with regards to
products and formula
Gap: Does not appear to be addressed
Recommendation: Policy and procedures for organization where student is in practicum
3/4/12 10:15 AM
33
Safety Gap: Does not appear to be addressed
Recommendations: Regulatory
mandates and scope of practice
Gap: Does not appear to be addressed
Recommendations: preventative
measures and statistical evidence of illness and
trauma across the generations, safety
of chemical sand medications in the home
Gap: Does not appear to be addressed
Recommendation: development of
national safety measures and policy related to
immunizations, food and drug
safety measures
Gap: Does not appear to be addressed
Recommendations :
proper hygiene practices,
immunizations, primary
care established
Gap: Does not appear to be addressed
Recommendation: Introduction to organizational codes and policy
related to safety at practicum site
Infection
control
Gap: Does not
appear to be addressed
Recommendation: CDC recommendations
and standards of care.
Gap: Does not
appear to be addressed
Recommendation: immunization and present day risk of
communicable disease. CDC
recommendations and school requirements for
students
Gap: Does not
appear to be addressed
Recommendation: Exposure to bacterial and viral
agents and preventative
measures, childhood illness, family illness
Gap: Does
not appear to be addressed
Recommendations : disease
prevention, wellness
practices,
Gap: Does not appear to be addressed
Recommendation: Policy related to infection control and standards of care
within the clinical environment at practicum site
Health promotion
and maintenance
Gap: Not addressed Recommendation:
Promotion of client centered health care goals & quality
control measures for practicing nurses,
design quality care initiatives, political activism in change
of health care policy
Gap: Does not appear to be
addressed
Recommendations: explore family
resources for holistic health care
investigate socioeconomic constraints to health
care access
Gap: Does not appear to be
addressed
Gap: Does not appear to
be addressed Recommendations:
therapeutic communicati
on, family dynamics
Gap: Signs and
symptoms of PP depression;
bonding
Recommenda
tions: support resources for family
Gap: Does not appear to be addressed
Recommendation: Health care
practices for families (acute care setting) or females along the continuum from premenstrual to post
menopause
3/4/12 10:15 AM
34
Psychosocial integrity
Gap: Does not appear to be addressed
Recommendations: Patient’s right
advocacy, cultural sensitivity, social justice issues,
conflict resolution issues and decision
making
Gap: Does not appear to be addressed
Recommendations: continuum of health
from prevention to holistic health maintenance.
Explore the impact of illness of family
lifestyle explore role of each family member when there
is chronic illness in family.
Gap: Does not appear to be addressed
Recommendation: Content related to
nursing theory
Physiological
integrity
Gap: Does not
appear to be addressed Recommendation:
Health habits, Health maintenance
and preventative care
Gap: Does not
appear to be addressed
Gap: Does
not appear to be addressed Recommend
ations :
nutrition and
oral hydration, personal
hygiene, sleep habits
Gap: Does not appear to be addressed
Recommendation: Assessment of clients psychosocial needs during clinical practicum with therapeutic
interventions and evaluations of interventions
Basic care
and comfort
Gap: Does not
appear to be
addressed
Recommendation:
Concepts of health care promotion and
preventative care
Gap: Does not
appear to be
addressed
Recommendations :
Gap: Does not
appear to be
addressed Recommendation:
nutrition, personal hygiene, rest and
sleep, comfort, mobility, elimination
Gap: Not
addressed Recommendations :
medication administratio
n, supplements, the 6 rights
Standard met. Gap: Does not appear to be
addressed Recommendation: documentation and report by student nurse reflects knowledge when
interpreting patient care plans, laboratory test results, diagnostic tests
and treatment plans for clients’
3/4/12 10:15 AM
35
Pharmacological and
parenteral therapies
Gap: Does not
appear to be
addressed
Recommendation: Scope of practice
Gap: Does not
appear to be
addressed
Recommendation: Explore non-
pharmaceutical interventions for fever control and
common cold symptom, explore
pain perception and physical symptoms , explore palliative
care , controlled substance use and
dependency
Gap: Does not
appear to be
addressed
Recommendation: medication
administration, medication safety, 6 rights
Gap: Does
not appear
to be
addressed Recommend
ations : normal vitals,
diagnostic tests,
laboratory values, therapeutic
procedures, potentials for
alteration in body systems and
complications related to
diagnostic tests and surgical
interventions
Standard met. Gap: Does not appear to be
addressed Recommendation: Care of patient antepartum, during labor and
delivery and postpartum client and neonate or care of families-all
generations
Reduction of risk potential
Gap: Not ddressed
Recommendation:
Utilization of new technology to improve patient care
outcomes, EMR, knowledge of
healthcare policy, practices grounded in evidence based
research
Gap: Does not
appear to be
addressed
Recommendation: education of patient
concerning treatments and
procedures, diagnostic testing, explore trends with
lab results
Gap: Does not
appear to be
addressed Recommendation: Parental
responsibilities laws that protect
and regulate care of minors
R Standard met. Gap: Does not appear to be
addressed Recommendation:
Antepartum supplements. Medications common to the postpartum population
3/4/12 10:15 AM
36
Physiological adaptation
Gap: Does not
appear to be
addressed
Recommendation:
Gap: Does not
appear to be
addressed
Recommendations: identify chronic
illness and underlying pathophysiology
and treatment protocols
Gap: Does not
appear to be
addressed
Recommendation: illness and
management of care
R Standard met. Gap: Does not appear to be
addressed Recommendation:
Nursing
process
Gap: Does not
appear to be
addressed
Recommendation:
integration throughout course,
evaluation formative an summative
Standard met. Gap: Does not
appear to be
addressed Recommendation:
Case studies exploring nursing
process for children and family members
R Gap: Does
not appear
to be
addressed
Recommendation: explore
nurse caring
behaviors
during
interventions
with client
population
Gap: Does not appear to be
addressed Recommendation:
Caring Standard met. Gap: Does not
appear to be
addressed
Recommendations: diversity of client
population review of cultural sensitivity and
generational considerations
Gap: Does not
appear to be
addressed
Recommendation: Caring practice
within the family unit referrals for parenting classes
R Gap: Does
not appear
to be
addressed
Recommenda
tion: communication and
documentation integrated
in client need categories. Introduction
to electronic
Gap: Does not appear to be
addressed Recommendation: Client care assessments and assignment that
assist in evaluating the student’s knowledge of the nursing process
3/4/12 10:15 AM
37
Summary of gaps and recommendations:
N408: It appears that the only concept addressed in the faculty comment is that of safe and effective care.
Recommendations: Strategies could include assignments which focus on guiding and evaluating client care, evidence based research skills, client’s rights, conflict management, confidentiality, documentation, workload management, ethical dilemmas, informed consent, information technology,
medical records, written
assignments reflect
standards of care.
Communication and
documentation
Standard met. Gap: Does not
appear to be
addressed
Recommendation:
Gap: Does not
appear to be
addressed Recommendation:
communication appropriate for developmental
stage evidenced by documentation
in assigments
R Gap: Does
not appear
to be
addressed
Recommend
ation: Recommenda
tion: Strategies
could involve case studies, concept
mapping, discussion
forums
Gap: Does not appear to be
addressed Recommendation: Caring
practice based on theories of caring Watson or Leininger
Teaching/learning
Standard met. Standard met. Standard met. R Standard met. Gap: Does not appear to be
addressed Recommendation: Documentation on client care records
and communication evaluated with interactive process
( students’ communication with allied health team and clients)
3/4/12 10:15 AM
38
electronic medical records, skills assessment and evaluation, state and federal regulations, legal scope of practice, medical referrals, supervision, performance evaluation and the reporting of unsafe practice.
And, how is “resource allocation on patient outcomes” (which includes people, materials, plant and equipment, money, and information) addressed?
N412: Faculty Comment: The value in the seminar is to encourage students to translate knowledge into applicable nursing process that may be
“outside the box”. All reinforce areas are incorporated into creative case studies and class content for interactive learning.
Recommendations: above
N414: The faculty comments do not define curriculum other than to state that content is adapted to child and family health, and that exam questions are written in NCLEX style. There is a brief comment regarding teaching and learning.
Recommendations: Above
N415: Single faculty comment: “as above, content adapted to emphasize pediatric/family care”.
Recommendations: See above; written based on NCLEX test plan.
N416: Summary: Although caring, communication and documentation, and teaching and learning are processes that should be integrated throughout the client needs categories and subcategories, nursing process is the only one of 4 mentioned in this course.
Recommendations: Above
N417 The faculty comment section was empty.
Recommendations: above
3/4/12 10:15 AM
39
WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Review of Senior 1 Nursing Courses to QSEN
Other professional standards – QSEN
N408 N412 N414 N415 N416 N417
Patient Centered Care -
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
needs
I, R
No evidence
provided.
X
R
M
R
Note evaluated, but implied in other evaluations as care focuses on the
family and cultural contexts
Teamwork and
Collaboration - Function effectively within nursing
and inter-professional teams, fostering open
communication, mutual respect, and shared decision-making to
achieve quality patient care
This competency was missing from the evaluation form. Evidence
obtained from CON “Role
Not rated.
“Describe the techniques for
conflict management,
active listening, negotiations,
and delegation that are usable
and transferable in nursing
practice and
Not rated.
Considered “N/A” in
relevant CON and AACN
criteria.
Not rated.
“discuss case management
and community
resources, collaboration with other
pros such as child life,
PT/OT etc” “more time for other
disciplines to
Not rated.
“roles of other professionals
in health care” but “Gap may
be opportunities for all students
to experience much
interdisciplinary interactions.”
Not rated.
“SBAR communicati
on and exam/case
studies”
Not rated.
Opportunities to shadow other professionals, although this is not
truly inter-disciplinary. Gap identified “consider more independent
opportunities for role exploration”
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Development” and AACN #6
personal interactions. Describe the
concept of servant
leadership and how that bridges into
nursing practice. The
servant leadership project will
give the students the
opportunity to practice teamwork
skills and volunteering
process”
interact with students in classroom
format would be great—
however they do have that opportunity
in the associated
clinical course.” value of other
professional collaboration
threaded in content when applicable
Consider adding an
objective to course relative to
Interprof. collaboration
incorporating info into case studies. The
students do get this
emphasized in their clinical
course related to N414
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Summary of gaps and recommendations:
408. Professional Development III: Leadership and Management. This course covered several of the QSEN competencies. The evaluator listed
general evidence from course objectives or activities but did not make specific linkages between objectives and QSEN competencies. For example,
“Identify positive and negative communication styles in the student’s personal and professional lives” was offered as an example of QSEN, but it
Evidence-based Practice
(EBP)-Integrate best
current evidence with
clinical expertise and
patient/family
preferences and values
for delivery of optimal
health care
I, R.
Standard met. R
R.
R.
Standard met.
Quality Improvement
(QI)-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
I. No
evidence provided
N/A N/A.
Gap:
“Students do
not have the opportunity to practice
quality improvement.
”
N/A.
Possible Gap: Little
opportunity exists for continuous
improvement monitoring.
N/A Possible gap: Not indicated in
evaluations. Could be addressed through focused group activities
examining QI data from the setting.
Safety-Minimizes risk of
harm to patients and
providers through both
system effectiveness and
individual performance
I Standard met. R
R
R
Possible gap: Safety not mentioned in evaluation. Could be modeled through drills for emergency response,
proper medication safety, procedures for infant identification, etc.
Informatics-Use
information and
technology to
communicate, manage
knowledge, mitigate
error, and support
decision-making
I. No evidence
provided
N/A N/A R
N/A Standard met.
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does not align with a specific QSEN competency. Evidence for QSEN competencies was found in this course’s evaluation within other frameworks.
It is possible that since QSEN was the last framework on the evaluation tool, evaluation fatigue had overtaken the instructor.
Recommendation: strengthen the linkage between existing course content and QSEN competencies, focusing on informatics and quality
improvement.
412. Family and Community as Context of Care. This course was strongly aligned with three QSEN competencies (evidence-based care, patient-
centered, and safety). Teamwork and Collaboration was considered not applicable, although it is difficult to support this position.
Recommendation: identify existing content or incorporate new content that supports Teamwork and Collaboration.
414. Child and Family Health Theory. This course was strong in incorporating patient-centered care, evidence-based practice, and safety.
Interprofessional collaboration was identified as a gap, although there are opportunities in the associated practice course, N 415.
Recommendation: Add a course objective for Teamwork and collaboration.
415. Children and Families as the Focus of Nursing Care. This is the practice course to accompany N 414. As a practicum it has inherent strengths
in incorporating evidence-based practice, informatics (EHR), safety, and patient-centered care. Teamwork and Collaboration, and Quality
Improvement were identified gaps.
Recommendation. Add course objectives for Teamwork and collaboration and identify ways to incorporate interprofessional education into
the clinical rotation systematically, for example with interdisciplinary rounds.
416. Childbearing Health of the Family. This didactic course had strengths in evidence-based practice, and patient-centered care. Teamwork and
Collaboration and Safety had limited evidence of incorporation. Informatics and QI were considered N/A.
Recommendation. Strengthen interprofessional and safety components in course.
417. QSEN ratings missing from the faculty evaluation. Inferences were made from other frameworks and from personal knowledge of content area.
Teamwork and collaboration, QI and Safety were evident as gaps.
Recommendation. Increase teamwork and collaboration with inter-professional patient rounds; develop QI project that examines site-
specific data on a relevant clinical measure; and safety could be practiced with emergency drills or simulation.
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One of the 6 QSEN competencies, Teamwork and Collaboration, was not included in the course assessments. Given the increasing emphasis on
inter-professional education and practice and other forms of collaboration, this is an important area to address within the undergraduate curriculum.
Recommendation: revise needs assessment form to include Teamwork and Collaboration.
There is overlap between QSEN competencies and other frameworks used in this evaluation. It may be more efficient to combine categories across
frameworks. For example, CON program outcomes, Role Development includes “Partner with clients, families, communities and interdisciplinary
health care teams to design and provide quality health care” which aligns with QSEN’s Teamwork and Collaboration. Similarly, CON program
outcomes, Designer and Manager of Care includes “Use evolving information technology to monitor and improve the health care of clients” which
aligns with QSEN’s Informatics.
Table of QSEN competencies overlapping in other frameworks:
QSEN Competency Other Frameworks
Patient Centered Care
Teamwork and Collaboration CON (Role Development) AACN (#6)
Evidenced Based Practice AACN (#3)
Quality Improvement AACN (#2)
Safety AACN (#2)
Informatics CON (Designer and Manager of Care)
AACN (#4)
Recommendation: Integrate QSEN competencies into other frameworks in order to reduce the work of conducting this evaluation.
There is limited opportunity for inter-professional collaboration in education or practice.
Recommendation: incorporate more opportunities for inter-professional education and practice throughout the semester’s courses.
Quality Improvement and Informatics content were virtually nonexistent throughout the semester’s courses
Recommendation: systematically identify ways to increase QI and informatics throughout the curriculum.
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WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Evaluative summary of gaps and recommendations based upon WSU Big 7, Nursing Commission,
NCLEX, CON, QSEN and AACN Baccalaureate Essentials criteria
N408 Professional Development: III Leadership and Management
Nursing Commission (Commission on Collegiate Nursing, 2009)
Overview for this course indicates focus is on impact of leadership, management, and resource allocation on patient outcomes. Concepts of leadership presented through assignments, projects, discussion and simulated case studies. The connection of these with patient outcomes is not clear
from evidence provided. Assignments could incorporate impact of certain negotiated or delegated decisions on the delivery of care to specific patient population (minority, medical, OB, etc.) (may already be in place) which would satisfy additional criteria for the Nursing Commission standard.
Evolution of nurse’s political involvement to create change (advanced practice status, IV sedation, ANA, unions versus non-union) and historical trends in patient care delivery models could be incorporated into assignments.
NCLEX (National Council of State Boards of Nursing)
It appears that the only concept addressed in the faculty comment is that of safe and effective care.
Recommendations: Strategies could include assignments which focus on guiding and evaluating client care, evidence based research skills, client’s rights, conflict management, confidentiality, documentation, workload management, ethical dilemmas, informed consent, information technology, electronic medical records, skills assessment and evaluation, state and federal regulations, legal scope of practice, medical referrals, supervision,
performance evaluation and the reporting of unsafe practice.
How is “resource allocation on patient outcomes” (which includes people, materials, plant and equipment, money, and information) addressed?
CON Program Outcomes
Overall, this series of four courses in Leadership & Management should be updated to reflect the recommendations from the Institute of Medicine’s
The Future of Nursing (RWJ/IOM, 2011) and recent changes in the healthcare industry, such as “Pay-for-Performance” (U.S. Department of Health
& Human Services, 2006). Important topics such as quality improvement, cost-benefit analyses, employee hiring/firing, staff development, and
principles of nursing workload need to be incorporated (American Nurses Association, 2008). We refer faculty to the excellent discussion on pages
251-256, “Skills for the Managed Care Environment: Leadership and Management” in Nursing Education in the Clinical Setting (Emerson, 2007).
The following is a list of the faculty- identified gaps with the associated criteria followed by a recommendation:
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Faculty report a need to invite more of the CON affiliate community nurse leaders. Criteria: Provide compassionate, ethical care to individuals of diverse cultures, values, beliefs, and lifestyles.
Recommendation: Invitations could be extended to CON-affiliated nurses who are leaders of healthcare organizations that specifically provide care
to people of diverse cultures, values, beliefs, and lifestyles in the community.
Faculty report difficultly to get students freely talking in large lecture classes of 125-135 students.
Criteria: Protect the rights of people to receive optimum care and make informed decisions affecting their health welfare.
Recommendation: Discussion of such a sensitive topic might be more effective if the students are divided into small groups for case study reviews and role-playing. Classroom Response Systems (“clickers”) might also be useful to aggregate data from such a large group: “Faculty can pose
case studies or clinical problems and ask students for their opinions. Differences in answers can be discussed (O'Neil, 2009, p. 172).
Faculty report on inconsistency in reception of topic: “Politics is sometimes a hot button with some cold and boring button for others.”
Criteria: Partner with clients, families, communities and interdisciplinary health care teams to design and provide quality health care Recommendation: Specific case studies that describe and report on the sometimes dramatic consequences of political decisions on healthcare could be reviewed by students in an online discussion board as part of a hybrid learning environment. Students could also submit reflections online.
Faculty report: “It is difficult in a 3 hour class of over 130 young adult learners to capture their attention and interest. Several teaching tools are used, i.e. YouTube, PPT, group exercises, guest speakers and websites.”
Criteria: Demonstrate knowledge of fiscal dimensions within a variety of current and evolving health care systems. Recommendation: Fiscal responsibility is a vitally important topic. After graduation, baccalaureate-prepared nurses are often required to be “in
charge”. Those RN’s who do not manage within the constraints of the budget can lose their job. As a class project, different student groups could be assigned to an area of responsibility within a variety of health care systems. Real life scenarios that impact the budget could be presented, and the students would have to problem-solve based upon their knowledge of fiscal dimensions. Examples could include community health clinics, or an
inpatient medical/surgical unit. “A student who expects the world to correspond with the ideal will inevitably be disappointed. If students are able to work only under ideal circumstances, they have been sadly unprepared for reality” (Emerson, 2007, p. 252).
QSEN (QSEN Phase III Steering Committee, 2012)
This course covered several of the QSEN competencies. The evaluator listed general evidence from course objectives or activities but did not make
specific linkages between objectives and QSEN competencies. For example, “Identify positive and negative communication styles in the student’s
personal and professional lives” was offered as an example of QSEN, but it does not align with a specific QSEN competency. Evidence for QSEN
competencies was found in this course’s evaluation within other frameworks. It is possible that since QSEN was the last framework on the
evaluation tool, evaluation fatigue had overtaken the instructor.
Recommendation: strengthen the linkage between existing course content and QSEN competencies, focusing on informatics and quality
improvement.
AACN Baccalaureate Essentials (American Colleges of Nursing, 2008)
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Overall, this course seems to cover many standards desired by the AACN Baccalaureate Essentials. It is possible that the gaps are not actual gaps, but just not reflected in the limited information provided about this course for the analysis. Based on the information received, it appears there are
opportunities to strengthen the course alignment with the Essentials, with very little adjustment. Recommendations include: 1. Highlighting evidence-based leadership practices throughout the course so the concept of EBP and research is apparent throughout the course content.
2. Ask students to search for examples of best practices of leadership and nurse-led safety or quality initiatives in the literature, thereby increasing the opportunities to increase information management skills.
3. Consider that each assignment can “multi-task” to meet many layers of learning; for instance communication lessons can be within the context of inter-professional teams, varied populations, and on topics of safety. 4. Increase opportunities to use simulation in group activities.
N412: Family and Community as a Context of Care
WSU Big 7 (Office of Assessment of Teaching & Learning, 2011)
How the curriculum encompasses the Big Seven goals is well described in the faculty comments. The use of quantitative reasoning within the class
can be achieved by ensuring that students understand statistical analyses within the research.
Nursing Commission (Commission on Collegiate Nursing, 2009)
Course objectives suggest these topics are addressed but may need to be more clearly specified in a project or assignment: History and health trends; evaluation of care; delegation of nursing care; parenteral therapy; pain management; working in a health care team
NCLEX (National Council of State Boards of Nursing)
Faculty Comment: The value in the seminar is to encourage students to translate knowledge into applicable nursing process that may be “outside the box”. All reinforce areas are incorporated into creative case studies and class content for interactive learning.
Discuss & review client rights for access of optimum health care, Confidentiality related to pt. records, technology for enhancing pt. health
care ed., consultation services to provide holistic health care
Preventative measures and statistical evidence of illness and trauma across the generations, safety of chemical sand medications in the home
Immunization and present day risk of communicable disease. CDC recommendations and school requirements for students
Explore family resources for holistic health care investigate socioeconomic constraints to health care access
Continuum of health from prevention to holistic health maintenance. Explore the impact of illness of family lifestyle explore role of each
family member when there is chronic illness in family.
Explore non-pharmaceutical interventions for fever control and common cold symptom, explore pain perception and physical symptoms ,
explore palliative care , controlled substance use and dependency
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Education of patient concerning treatments and procedures, diagnostic testing, explore trends with lab results
Identify chronic illness and underlying pathophysiology and treatment protocols
Diversity of client population review of cultural sensitivity and generational considerations
QSEN (QSEN Phase III Steering Committee, 2012)
This course was strongly aligned with three QSEN competencies (evidence-based care, patient-centered, and safety). Teamwork and Collaboration
was considered not applicable, although it is difficult to support this position.
Recommendation: identify existing content or incorporate new content that supports Teamwork and Collaboration.
AACN Baccalaureate Essentials (American Colleges of Nursing, 2008)
This course covers many standards desired by the AACN Baccalaureate Essentials. Based on the information available, it appears that there are opportunities to strengthen alignment by incorporating the following adjustments: 1. Incorporate aspects from social sciences, anthropology, genetics, etc. to increase student exposure to varied “ways of knowing.”
2. Quality and safety examples can be woven into course content. 3. Look for opportunities to include “information management” or “data management,” such as asking students to retrieve data on the course-related
topics from sites such as CDC, World Health Organization, etc. 4. Increase use of simulations that are imbedded in classroom settings and guest lecturers to facilitate clinically-relevant learning.
N414 Child and Family Health Theory
WSU Big 7 (Office of Assessment of Teaching & Learning, 2011)
The curriculum descriptions explain how it covers the Big Seven goals, the only issue being the lack of quantitative reasoning which can be taught by
reviewing the statistics of research.
Nursing Commission (Commission on Collegiate Nursing, 2009)
Delegation of nursing care may need to be emphasized via discussion, project etc. Leadership and management considered N/A by course reviewer however these could be introduced in discussions about teaching parents how’s/why’s of child proofing their home (for example), or discharge planning implications for returning to school with conditions such as obesity or special needs such as asthma, diabetes, short bowel syndrome, etc.
NCLEX (National Council of State Boards of Nursing)
The faculty comments do not define curriculum other than to state that content is adapted to child and family health, and that exam questions are written in NCLEX style. There is a brief comment regarding teaching and learning.
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CON Program Outcomes
Faculty report a need for more time for class discussion and case studies with more individual written work. Difficult to do small groups over AMS, and workload of correcting case studies is huge.
Criteria: Provide competent nursing care to individuals, families, groups and communities through promotion, maintenance and restoration of health; prevention of illness, and physical, emotional, and spiritual support throughout life the span.
Recommendation: Students can review the case study and formulate responses online prior to class. During class, faculty can pose a question and ask for responses using a Classroom Response System (“clickers”). This information provides faculty with an assessment of understanding the material and with discussion material. If the students understand the material, the faculty can move to the next topic. If students do not, the faculty
can ask students to confer and respond a second time. Discussions can be based on student answers (O'Neil, 2009, p. 172).
Faculty report “More active use of EBP by students would be beneficial”.
Criteria: Formulate nursing practice decisions using evolving knowledge and research from nursing science, the biological and behavioral sciences, and the humanities.
Recommendation: “It is incumbent upon nurse educators to provide the theoretical foundations for evidence-based practice. To accomplish this, nurse educators must refurbish curricula to incorporate both the pertinent new and expanded theory in the classroom and relevant practice in the most applicable clinical settings” (Emerson, 2007, p. 252). Therefore, it is recommended that case studies be presented that would require the students to
research evidence-based practice. For example, what would be best practice for management of a child with recurrent episodes of asthma, or uncontrolled diabetes? See above recommendation for evaluation of learning.
Faculty report a possible gap may be the lack of evaluation of competencies in this category. Faculty report there is no opportunity for actual observation or practice, but extra credit assignment often brings these out.
Criteria: Provide compassionate, ethical care to individuals of diverse cultures, values, beliefs, and lifestyles. Recommendation: This would, in fact, be difficult to measure during a theory class. However, “One single learning environment cannot encompass all of the knowledge and skills opportunities, but the clinical education experiences of the curriculum taken as a whole should” (Emerson, 2007, p.
254). A self-assessment tool may also be beneficial. “Self-assessment is critical to the process: It is the students, not the instructors, who are the ultimate arbitrators of the learning experience. The learning environment is one of mutual respect, collaboration, cooperation, and support” (Candela,
2006).
Faculty report there is a lack of direct practice experience in advocacy for underserved or vulnerable populations. Criteria: Demonstrate the values central to nursing practice including: altruism, autonomy, human dignity, integrity, and social justice.
Recommendation: Same as above, “One single learning environment cannot encompass all of the knowledge and skills opportunities, but the clinical education experiences of the curriculum taken as a whole should” (Emerson, 2007, p. 254). In class role-playing and case study exercises could also
be evaluated to bring out any possible problem areas.
Faculty note a possible gap may be that this standard is difficult to measure.
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Criteria: Advocate for responsible, humane health care policies. Recommendation: Self-assessment is critical to the process. It is the students, not the instructors, who are the ultimate arbitrators of the learning
experience. The learning environment is one of mutual respect, collaboration, cooperation, and support (Candela, 2006). However, also recall that: Nurses are already committed to delivering high-quality care under current regulatory, business, and organizational conditions. But the power to change those conditions to deliver better care does not rest primarily with nurses, regardless of how ably led or educated they are; it also lies with
governments, businesses, health care institutions, professional organizations and other health professionals, and the insurance industry (RWJ Foundation/Institute of Medicine, 2010).
Faculty report “More time for other disciplines to interact with students in classroom format would be great-however they do have that opportunity in their associated clinical course.”
Criteria: Partner with clients, families, communities and interdisciplinary health care teams to design and provide quality health care. More interdisciplinary interactions may be provided by increasing on campus interdisciplinary educational opportunities. In class communication, conflict resolution, and role-playing skills could also be utilized. Students could also be involved in developing interdisciplinary clinical pathways
and quality improvement activities.
Faculty report a lack of opportunity to actually participate in policy revision.
Criteria: Participate in revision of health care policy and practice within a rapidly changing global environment. Recommendation: It may not be realistic for students to actually participate in policy revision, however, students could be engaged in class
discussions about this topic.
QSEN (QSEN Phase III Steering Committee, 2012)
This course was strong in incorporating patient-centered care, evidence-based practice, and safety. Interprofessional collaboration was identified as a
gap, although there are opportunities in the associated practice course, N 415.
Recommendation: Add a course objective for Teamwork and collaboration.
AACN Baccalaureate Essentials (American Colleges of Nursing, 2008) This course covers many standards desired by the AACN Baccalaureate Essentials. Based on the information available, it appears that there are
opportunities to strengthen alignment by incorporating the following adjustments:
1. Incorporate theories from social sciences, anthropology, psychology to increase student exposure to broad theoretical base and question ethnocentric assumptions.
2. Incorporate more opportunities for promoting and identifying evidence-based practice. 3. Increase identifying leadership roles, using child-family health setting to find opportunities for nurses to lead in quality and safety improvements. 4. Question definitions of information management and include opportunities to seek data and new knowledge related to course content.
5. Weave inter-professional communication and policy lessons into course content.
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N415 Children and Families as the Focus of Nursing Care
WSU Big 7 (Office of Assessment of Teaching & Learning, 2011)
The faculty comments for this class and how it covers the Big Seven goals were extensive.
Nursing Commission (Commission on Collegiate Nursing, 2009)
Health history /trends and legal/ethical issues not clearly portrayed
NCLEX (National Council of State Boards of Nursing)
Single faculty comment: “as above, content adapted to emphasize pediatric/family care”.
CON Program Outcomes
Discrepancy among clinical groups in their opportunities for equal experiences for the students (Pediatric opportunities vary from site to site and community to community). Criteria: Provide competent nursing care to individuals, families, groups and communities through promotion, maintenance and restoration of
health; prevention of illness, and physical, emotional, and spiritual support throughout life the span. Recommendation: This is not specifically a curricula-related issue. It is a challenge faced by many schools of nursing due to a shortage of
available clinical sites. Some schools have made attempts for students to identify their preference of clinical site based upon their long term professional goals. For example, a student interested in pursuing a career in community health nursing may indicate a preference for an outpatient setting.
Challenge is that students’ prerequisite development courses vary considerably so everyone comes with a different base knowledge in human development.
Criteria: Use developmentally appropriate teaching- learning principles to assist clients to achieve their health goals and to assist colleagues to improve the quality of their nursing care.
Recommendation: Encourage SON to review course sequencing and to mandate appropriate course prerequisites.
Lack of consistency of content among various clinical groups, as often topics come up as a result of the experiences they have in clinical.
Criteria: Provide compassionate, ethical care to individuals of diverse cultures, values, beliefs, and lifestyles. Recommendations: Not every clinical learning opportunity will be available to every student, but concepts related to this criterion should be addressed during group discussions.
Inconsistent opportunities for all students to experience much interdisciplinary interactions . Criteria: Partner with clients, families, communities and interdisciplinary health care teams to design and provide quality health care.
Recommendation: Again, since clinical learning experiences are variable, more interdisciplinary interactions may be provided by increasing on campus interdisciplinary educational opportunities. In class communication, conflict resolution, and role-playing skills could also be utilized.
Faculty report clinical experiences for students vary from agency to agency so there is a disparity of IT experience when on site.
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Criteria: Use evolving information technology to monitor and improve the health care of clients. Recommendation: If the school can provide the student with basic technology skills, on-the-job training will provide the specific skills needed
once hired by an agency.
QSEN (QSEN Phase III Steering Committee, 2012)
This is the practice course to accompany N 414. As a practicum it has inherent strengths in incorporating evidence-based practice, informatics
(EHR), safety, and patient-centered care. Teamwork and Collaboration, and Quality Improvement were identified gaps.
Recommendation. Add course objectives for Teamwork and collaboration and identify ways to incorporate interprofessional education into
the clinical rotation systematically, for example with interdisciplinary rounds.
AACN Baccalaureate Essentials (American Colleges of Nursing, 2008)
This course covers most standards desired by the AACN Baccalaureate Essentials. Based on the information available, it appears that there are
opportunities to strengthen alignment by incorporating the following adjustments:
1. Find opportunities to incorporate evidence-based practice and awareness of policy into course content.
2. Use class time to share knowledge from diverse student clinical settings so there is equality of exposure to new knowledge.
N416 Childbearing Health of the Family
WSU Big 7 (Office of Assessment of Teaching & Learning, 2011)
Faculty notes give a brief description of how the curriculum covers the goals. The proposed curriculum may cover the goals better than is explained
by faculty comments.
Nursing Commission (Commission on Collegiate Nursing, 2009)
These areas are not clearly illustrated in course reviewers comments yet are undoubtedly incorporated into the care of the newborn, outpatient care and inhome care of the family: Evaluation of care, Provide care for diverse groups
NCLEX (National Council of State Boards of Nursing)
Summary: Although caring, communication and documentation, and teaching and learning are processes that should be integrated throughout the
client needs categories and subcategories, nursing process is the only one of 4 mentioned in this course.
Proper car seats, safety with regards to products and formula
Signs and symptoms of PP depression; bonding Recommendations: support resources for family
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Explore nurse caring behaviors during interventions with client population
Signs and symptoms of PP depression; bonding
Support resources for family
Communication and documentation integrated in client need categories. Introduction to electronic medical records, written assignments reflect standards of care.
Strategies could involve case studies, concept mapping, discussion forums
CON Program Outcomes
Lack of practical exposure to diverse groups due to population encountering and student population. Criteria: Provide competent nursing care to individuals, families, groups and communities through promotion, maintenance and restoration of health;
prevention of illness, and physical, emotional, and spiritual support throughout life the span. Recommendation: “One single learning environment cannot encompass all of the knowledge and skills opportunities, but the clinical education
experiences of the curriculum taken as a whole should” (Emerson, 2007, p. 254).
Access to new knowledge is curtailed as budget cuts in library have begun to be a challenge in terms of obtaining some articles.
Criteria: Formulate nursing practice decisions using evolving knowledge and research from nursing science, the biological and behavioral sciences, and the humanities. Recommendation: This is not specifically a curricula-related issue. It is more of an administrative challenge faced by many schools of nursing due to
a shortage of resources. In the interim, there may be a need to revert to alternative methods to obtain articles until the problem is resolved. This is an area in which Dr. Doutrich is particularly skilled.
Faculty report “More likely to see in clinical portion – or leadership for assisting colleagues.” Criteria: Use developmentally appropriate teaching- learning principles to assist clients to achieve their health goals and to assist colleagues to improve the quality of their nursing care.
Recommendation: Assure that appropriate patient education teaching principles are incorporated into the course so that students are prepared to help clients achieve their health goals and assist colleagues to improve the quality of their nursing care when they are in the clinical setting.
QSEN (QSEN Phase III Steering Committee, 2012)
This didactic course had strengths in evidence-based practice, and patient-centered care. Teamwork and Collaboration and Safety had limited
evidence of incorporation. Informatics and QI were considered N/A.
Recommendation. Strengthen interprofessional and safety components in course.
AACN Baccalaureate Essentials (American Colleges of Nursing, 2008)
Several standards of AACN Baccalaureate Essentials were not addressed in the analysis. It is possible the standards are not understood, or the faculty
do not see evidence of them being present in the course. Based on the information available, it appears that there are opportunities to strengthen
alignment by incorporating the following adjustments:
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1. Find opportunities to increase addressing missing standards including broad liberal education knowledge, information management, and health policies.
2. Expand opportunities for clinical and simulation learning.
417 Nursing Care of Childbearing Families
WSU Big 7 (Office of Assessment of Teaching & Learning, 2011)
The faculty comments for this class and how it covers the Big Seven goals were extensive.
Nursing Commission (Commission on Collegiate Nursing, 2009)
History and health trends not clearly exemplified. Otherwise extensive documentation of coursework, projects, discussions as documented within the
CON Program Objectives section suggests these Nursing Commission criteria met.
NCLEX (National Council of State Boards of Nursing)
The faculty comment section was empty,
Policy and procedures for organization where student is in practicum
Health care practices for families (acute care setting) or females along the continuum from premenstrual to post menopause
Assessment of clients psychosocial needs during clinical practicum with therapeutic interventions and evaluations of interventions
Assessment of clients psychosocial needs during clinical practicum with therapeutic interventions and evaluations of interventions
Documentation and report by student nurse reflects knowledge when interpreting patient care plans, laboratory test results, diagnostic tests
and treatment plans for clients’
Care of patient antepartum, during labor and delivery and postpartum client and neonate or care of families-all generations
Antepartum supplements. Medications common to the postpartum population
Client care assessments and assignment that assist in evaluating the student’s knowledge of the nursing process
Caring practice based on theories of caring Watson or Leininger
Documentation on client care records and communication evaluated with interactive process (students communication with allied health team
and clients)
CON Program Outcomes
Consider woman’s health issues including menopause.
Criteria: Provide competent nursing care to individuals, families, groups and communities through promotion, maintenance and restoration of health; prevention of illness, and physical, emotional, and spiritual support throughout life the span.
Recommendation: This would be an appropriate consideration.
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Consider specific teaching project. Criteria: Use developmentally appropriate teaching- learning principles to assist clients to achieve their health goals and to assist colleagues to
improve the quality of their nursing care. Recommendation: There are already many effective evaluation strategies already in use for this course,
Faculty ask that consideration be given to more independent opportunities for role exploration in the childbearing family area, such as opportunities for shadowing nurse practitioners, certified nurse midwives and CRNA’s.
Criteria: Uphold the standards and values of the profession including accepting responsibility for learning and personal growth. Recommendation: What is essential must be winnowed from what would be nice (Emerson, 2007).
Consider fiscal presentation in post-conference to meet the variety of current evolving health care systems. Consider discussion board to
meet this objective. Criteria: Demonstrate knowledge of fiscal dimensions within a variety of current and evolving health care systems.
Recommendation: This content should be adequately covered in N408.
QSEN (QSEN Phase III Steering Committee, 2012)
QSEN ratings missing from the faculty evaluation. Inferences were made from other frameworks and from personal knowledge of content area.
Teamwork and collaboration, QI and Safety were evident as gaps.
Recommendation. Increase teamwork and collaboration with interprofessional patient rounds; develop QI project that examines site specific
data on a relevant clinical measure; and safety could be practiced with emergency drills or simulation.
AACN Baccalaureate Essentials (American Colleges of Nursing, 2008)
Standards of AACN Baccalaureate Essentials were not specifically addressed in the analysis, however, could be gleaned from the College of
Nursing analysis provided. More detail is needed to adequately assess the standards. Based on the information available, it appears that there are opportunities to strengthen alignment by incorporating the following adjustments:
1. Find opportunities to increase directly addressing standards of safety, quality, and health policies.
Across many courses there are opportunities to increase alignment with AACN Essentials of Baccalaureate standards. Specific attention could be
paid to incorporating lessons that demonstrate how leadership in both direct care and managerial positions may improve safety, quality, and
therefore, patient outcomes. Greater appreciation of the meaning of a “liberal education” might be needed in order to assure the incorporation of non-
nursing points of view into lessons. Faculty might look for opportunities to present health topics from the perspective of genetics, physiology,
anthropology, sociology, or other arts and sciences. Information management seems to be an area identified as a “gap” in many courses. It is possible
faculty do not understand the definition of this standard, or they do not see its relevance in their courses. There may be opportunities to include
greater appreciation for information management by addressing how nurses in all settings organize, retrieve, acquire and maintain of information. In
addition, faculty might include data management in their lesson plans by asking students to retrieve data on the topic of interest from sites such as
Centers for Disease Control, World Health Organization, or other collections of health data. To help meet multiple standards that are desired by
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AACN and other agencies, faculty might consider how each assignment can “multi-task” to meet several learning objectives; for instance
communication lessons can be within the context of inter-professional teams, varied populations, and on topics of safety or quality. All courses might
increase opportunities to use simulation, particularly if there are insufficient or inconsistent clinical settings. Evidence-based practice seems to be
inconsistently addressed. All courses should be challenged to assure their content is evidence-based and reinforce that students consider research,
clinical experience, and patient preferences to provide care that aligns with current triad models of an evidence-based practice.
One of the 6 QSEN competencies, Teamwork and Collaboration, was not included in the course assessments. Given the increasing
emphasis on interprofessional education and practice and other forms of collaboration, this is an important area to address within the
undergraduate curriculum. Recommendation: revise needs assessment form to include Teamwork and Collaboration.
There is overlap between QSEN competencies and other frameworks used in this evaluation. It may be more efficient to combine
categories across frameworks. For example, CON program outcomes, Role Development includes “Partner with clients, families,
communities and interdisciplinary health care teams to design and provide quality health care” which aligns with QSEN’s Teamwork and
Collaboration. Similarly, CON program outcomes, Designer and Manager of Care includes “Use evolving information technology to
monitor and improve the health care of clients” which aligns with QSEN’s Informatics.
Table of QSEN competencies overlapping in other frameworks:
QSEN Competency Other Frameworks
Patient Centered Care
Teamwork and Collaboration CON (Role Development) AACN (#6)
Evidenced Based Practice AACN (#3)
Quality Improvement AACN (#2)
Safety AACN (#2)
Informatics CON (Designer and Manager of Care)
AACN (#4)
Recommendation: Integrate QSEN competencies into other frameworks in order to reduce the work of conducting this evaluation.
There is limited opportunity for interprofessional collaboration in education or practice.
Recommendation: incorporate more opportunities for interprofessional education and practice throughout the semester’s courses.
Quality Improvement and Informatics content were virtually nonexistent throughout the semester’s courses
Recommendation: systematically identify ways to increase QI and informatics throughout the curriculum.
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Conclusion
The members of Team Splendid Scholars would like to congratulate the faculty of the WSU School of Nursing for their courage to teach, and their
efforts to transform the curriculum. We recognize the enormity of the challenge, and sincerely hope that our project may facilitate the task. In a
recent publication, Tanner (1998) described the expectations set forth in the AACN Essentials as a "blueprint for the 21-year curriculum" (p. 383) but
also noted she believed none of the core knowledge and competencies identified could be eliminated (Giddens, 2007).
The author Emerson reminds us that “it is incumbent upon nursing education to provide theory and practice in the leadership, management and
managed care skills needed by the novice nurse”:
Students must develop enhanced leadership and management skills to respond to the managed care environment, practice skills that reflect
and respect the diversity of values and beliefs associated with an increasingly multicultural society, and citizenship skills of civic and social
responsibility to meet the needs of population aggregates (Emerson, 2007).
We have seen many of these elements successfully incorporated into the WSU nursing curricula. The ultimate challenge is to change the highly-
structured curricula to a focus on how to teach concepts instead of content. The members of Team Splendid Scholars agree that the WSU curriculum
is heavily laden in content. Superficial coverage of all topics in a subject area must be replaced with an in-depth coverage of fewer topics that allows
key concepts in the discipline to be understood (Tanner, 2007):
Rejecting the long-standing, content-loaded, behaviorist model of nursing education, revolutionaries called for a “caring” curriculum, creating
new pedagogies suited for a practice discipline in preparing students who could participate as leaders in health care reform, with values that
recognize the multicultural, multiracial, and growing diversity of both individual and family lifestyles in our society (Tanner, 2007).
In addition, this team suggests that a streamlined, perhaps electronic, method to gather curriculum assessments is developed. The challenge of
meeting multiple standards adequately over the course of a semester or curriculum is evident with this assignment. Faculty would benefit from an
assessment process that allows them to report what standards they are able to address in their courses, and a curriculum committee can be
responsible for assuring coordination so all standards are addressed. A survey tool at the end of each year or semester could prompt faculty to state
whether key standards were met or not. Faculty could describe how standards were met, and/or suggest ways to address any unmet standards. This
would further heighten awareness of faculty on the many standards the college is charged with addressing and engage creative solutions. Electronic
survey collection would allow for simplification of data analysis.
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Executive Summary:
An overview of the semester in its entirety suggest some priority areas where faculty might find opportunities to improve adherence to core
standards:
Diversity: All courses might increase opportunities to use simulation to address diversity, particularly if there are insufficient or inconsistent
clinical settings. Use outside speakers from diverse backgrounds for some topics.
EBP: Evidence-based practice seems to be inconsistently addressed. All courses should be challenged to assure their content is evidence-
based and reinforce that students consider research, clinical experience, and patient preferences to provide care that aligns with current triad models of an evidence-based practice.
Ethical Issues/History/Policy: These can be addressed in a project or discussion. Many policy decisions make history and derive from ethical
dilemmas. Evolution of nurse’s political involvement to create change (advanced practice status, IV sedation, ANA, unions versus non-union) and historical trends in patient care delivery models could be incorporated into assignments. Rather than try to be involved in policy
revision, provide case scenarios of examples where nurses have been involved in real life national and regional policy changing projects. One example is the work that was initiated by WOC nurses to convince HCFA to change the Medicare definition of debridement in the surgical
dressings section of the Medicare policy so that patients with chronic wounds could get reimbursement for wound dressings rather than pay out of pocket. The group then went on to recommend utilization parameters for the insurance groups that oversee implementation of Medicare (DMERC’s) and trained them on proper interpretation of required documentation. Projects that allow student nurses to learn about
political initiatives can do much to increase awareness about this professional role of the nurse.
Information Management: Information management seems to be an area identified as a “gap” in many courses. It is possible faculty do not
understand the definition of this standard, or they do not see its relevance in their courses. There may be opportunities to include greater appreciation for information management by addressing how nurses in all settings organize, retrieve, acquire and maintain information. In
addition, faculty might include data management in their lesson plans by asking students to retrieve data on the topic of interest from sites such as Centers for Disease Control, World Health Organization, or other collections of health data. To help meet multiple standards that are desired by AACN and other agencies, faculty might consider how each assignment can “multi-task” to meet several learning objectives; for
instance communication lessons can be within the context of inter-professional teams, varied populations, and on topics of safety or quality.
Evaluation of Care: This standard can be incorporated into existing lessons. Faculty can strive to incorporate patient outcomes, goals of care,
revising plan of care based on patient outcome, correlation with safety (from falls, UTI’s, SSI’s and pressure ulcers, for example) and discussion of “never events,” and use of root cause analysis.
Quality Improvement: Systematically identify ways to increase QI and informatics throughout the curriculum. These could be case scenario where student finds patient with a “never event” such as a fall, catheter associated UTI, or Stage 1 pressure ulcer and has to implement root cause analysis to identify triggering event and then make recommendations for change on the unit so potential for this to recur with another
patient is diminished.
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In addition, Team Splendid Scholars also agree that key elements nursing students need to be successful may be missing from the curriculum. Linda
Cronenwett’s The Future of Nursing Education (RWJ/IOM, 2011) provides a comprehensive list of what nursing students need to learn:
What Students Should Learn
1. Competencies necessary for continuous improvement of the quality and safety of health care systems
a. patient-centered care b. teamwork and collaboration c. evidence-based practice
d. quality improvement e. safety, and
f. informatics (Berwick, Cronenwett, Tanner) 2. Mastery of knowledge of systems
a. interpretations of variation
b. human psychology in complex systems, and c. approaches to gaining knowledge in real-world, local contexts (Berwick)
3. Skills and methods for leadership and management of continual improvement a. for nurse-teachers, and b. for nurse-executives (Berwick)
4. Competencies needed in new care delivery models 5. Population health and population-based care management (Tanner)
6. Care coordination (Tilden) 7. Knowledge based on standardized science prerequisites (Dracup, Tanner) 8. Health policy knowledge, skills, and attitudes (Tilden)
9. Competencies related to emerging health needs—e.g., geriatrics (Tanner) (RWJ/IOM, 2011)
Summary of Recommendations from "What to Teach" section:
1. Four realities driving changes in nursing education: (1) shift of care into community; (2)"evidence" not well integrated into practice or
education; (3) increased need for nurses to work in and lead teams, and (4) need additional research and new knowledge. 2. To enter practice of nursing, all students need: scientific background, practice based knowledge, clinical reasoning skills and ethical
comportment.
3. Rethink approaches to safety, patient-centered care, cultural competence and clinical judgment.
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o Motivating Themes:
1. Build in links among knowledge, practice and clinical reasoning skills 2. Think in terms of health care systems (beyond patient-nurse interactions)
o quality/safety issues
o team approaches to problem solving o need for patient education
o working across settings (seamless) o interdisciplinary team skills (able to lead effectively across settings and within groups) o collaboration and communication
3. Assess, use and "manage" knowledge so can access when needed o develop knowledge management, access and use of tools and strategies
o hardwire the ability to manage and use knowledge in real time in both education and practice 4. Care of older adults: geriatric syndromes, sleep disorders, dementia, delirium, depression, chronic care management. 5. Culturally sensitive and relationship centered care (inclusion, justice, diversity)
6. Educate for continuous improvement o competencies and skills to participate and lead CQI activities
o tools of CQI o use of informatics to enhance reliability of care o understand cultures of safety
7. Instill spirit of inquiry o examine evidence underlying practice
o access evidence o question underlying assumptions o offer new insights to improve quality of care
8. Refocus on the fundamentals to reflect expanded settings of care (may not be accomplished through subspecialties such as OB and peds).
Please accept our efforts on your behalf. We are grateful to have had this valuable learning opportunity.
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WSU College of Nursing
Senior 1: Pre-licensure Curricular Needs Assessment and Gaps Analysis Summary
NURS523: Education Issues and Curriculum Analysis
Team Splendid Scholars
Works Cited
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Candela, L. D.-L. (2006, February). A case for learning-centered curricula. Journal of Nursing Education, 45(2), 59-66.
Commission on Collegiate Nursing. (2009, April). Standards for Accreditation of Baccaluareate and Graduate Degree Nursing Programs .
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Emerson, R. (2007). Nursing Education in the Clinical Setting. St. Louis, MO: Mosby Elsevier.
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QSEN Phase III Steering Committee. (2012). Quality & Safety Competencies. Retrieved from Quality & Safety Education for Nurses:
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RWJ/IOM. (2011). The Future of Nursing: Leading Change, Advancing Health. Retrieved from Committee on the RWJ Foundation Initiative on the
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