Take Home Implementation Tools for Safety Evaluation Teri M. Chenot, Ed.D., MS, M.Ed., MSN, RN, CCE Associate Professor – Keigwin School of Nursing, Co-Director of the QSEN Institute Regional Center at Jacksonville University May 31, 2017 2017 QSEN International Forum

Healthcare Professionals Patient Safety Assessment Curriculum Survey (HPPSACS) was developed in 2006 for an exploratory study to examine patient safety education for nursing students and investigate nursing student awareness, skills, and attitudes about patient safety.

The overall goal was to provide recommendations for the needed knowledge base for nursing competence for nurses to function as safe practitioners in the health care workforce.

The HPPSACS is a 34-item instrument for pre-licensure nursing students and is an adapted version of the Patient Safety/Medical Fallibility Assessment Pre and Post Curriculum Survey created by Madigosky et al. (2006) for use with medical students.

Phase I of the study used exploratory factor analysis and alpha reliability to test the HPPSACS scores for validity and reliability. Phase II used exploratory factor analysis and alpha reliability analysis to explore validity and reliability of scores on the HPPSACS and to test two research questions.

Research questions: Will interpretable constructs be identified when responses to the HPPSACS are intercorrelated and factor analyzed using R-technique exploratory factor analysis? The results from the exploratory factor analysis for Phases I and II provided evidence in support of the research question. Four identifiable factor constructs were based on the data from Phase II of the study, with themes of comfort, error reporting, denial, and culture.

Research questions: Will responses to items on the HPPSACS yield scores that are internally consistent as indicated by alpha reliability coefficients? The alpha reliability coefficients obtained yielded evidence in support of the question.

Limitations: The HPPSACS was adapted from an instrument developed for use with medical residents. To address this limitation, the adapted instrument was pilot tested with a group of registered nurses who volunteered to participate for the purposes of establishing reliability and validity of the data.

Limitations: The survey is a self-report instrument subject to weaknesses of all such instruments in that participants’ answers are subjective and could have been influenced by social desirability. The HPPSACS was administered at only a few (seven) universities and colleges.

This study is the first known study conducted on nursing students’ perceptions about their awareness, skills, and attitudes regarding patient safety. The sample size was relatively large (N=318) and encompassed a diverse group of respondents from associate, accelerated, and traditional nursing degree programs.

Findings from this study support the evidence from the nursing research conducted by Smith, Cronenwett, and Sherwood (2007) that there are opportunities for improvement for patient safety curriculum in schools of nursing.

International interprofessional inquiries to utilize the HPPSACS instrument include: U.S. DNP students Australia (Pharmacy) Pakistan (Medical Education) Saudi Arabia South Korea (Nursing) United Kingdom (Nursing)

HPPSACS 2 (Nursing version – 4-12-13): Chenot and Christopher developed a 45-item instrument based on the HPPSACS and two focus-groups from practicing nurses at two academic medical campus sites. Confirmatory factor analysis.

Other: Armstrong, Dietrich, Norman, Barnsteiner, and Mion (2017) developed the Nurses’ Attitudes and Skills around Updated Safety Concepts (NASUS) which included adapted items from the HPPSACS. Mansour (2014) developed an adapted HPPSACS for the United Kingdom.

Acknowledgments: Roberta Christopher, EdD, MSN, ARNP, NE-BC, CHTS-CP, Program Director and Assistant Professor – Health Informatics and Nursing, Co-Director of the QSEN Institute Regional Center at Jacksonville University for collaboration on the HPPSACS 2.

Acknowledgments: Wendy Madigosky, MD, MSPH, IHI Open School Faculty Network Advisor, Director, Foundations of Doctoring Curriculum and Interprofessional Education and Development, University of Colorado Anschutz Medical Center for collaboration on the HPPSACS instrument.

References Armstrong, G. E., Dietrich, M., Norman, L., Barnsteiner, J., & Mion, L. (2017). Development and psychometric analysis of a nurses’ attitudes and skills safety scale. Journal of Nursing Care Quality, 32(2), E3-E10. Chenot, T. M., & Daniel, L. G. (2010). Frameworks for patient safety in the nursing curriculum. Journal of Nursing Education, 49(10), 559-568. Madigosky, W. S., Headrick, L. A., Nelson, K., Cox, K. R., & Anderson, T. (2006). Changing and sustaining medical students’ knowledge, skills, and attitudes about patient safety and medical fallibility. Academic Medicine, 81, 94-101. Mansour, M. (2014). Factor analysis of nursing students’ perception of patient safety. Nurse Education Today, 35(2015), 32-37. Smith, E. L., Cronenwett, L., & Sherwood, G. (2007). Current assessments of quality and safety education in nursing. Nursing Outlook, 55(3), 132-137.

Questions? Contact Information: Teri M. Chenot, Ed.D., MS, M.Ed., MSN, RN, CCE Phone: (904) 256-7284 tchenot@ju.edu