QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Session Title: What Regulatory Mechanisms Reinforce Accountability for Quality & Safety Education Presentation Title: Baccalaureate Education Prepares Nurses for Team Play in Quality & Safety Initiatives by Patricia. Martin, PhD, RN Chair, AACN Taskforce for Revision of Essentials of Baccalaureate Nursing education Dean & Professor, Wright State University College of Nursing & Health Martin-QSEN-June2008 Martin-QSEN-June2008 1

QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Purpose Consider the knowledge skills & attitudes associated with the six QSEN competencies Would a school of nursing be held accountable for student learning related to these competencies? Would a school have a choice whether to address learning in these content domains? Martin-QSEN-June2008 Martin-QSEN-June2008 2

Timeline July 2008 – AACN Board reviews October 2008 – AACN Membership votes CCNE (autonomous arm of AACN) will have a process to decide about adopting the new Essentials of Baccalaureate Nursing Education Martin-QSEN-June2008

Thank you to all regional meeting QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon AACN Taskforce Chair - Patricia A. Martin, RN, PhD Carol Ashton – Idaho State U. Chip Bailey – Duke U. Derryl Block – U. of Wisconsin, Green Bay Daisy Cruz-Richman – SUNY Downstate Karen Drenkard – INOVA Health Systems Jean Lange – Fairfield U. Teri Murray – St. Louis U. Roxanne Moutafis – U. of Arizona Linda Niedringhaus – Elmhurst College Judith Sands – U. of Virginia Polly Bednash – Executive Director AACN Kathy McGuinn – Staff Liaison Joan Stanley – Staff Liaison Horacio Oliveira – Staff Liaison Thank you to all regional meeting participants Martin-QSEN-June2008 Martin-QSEN-June2008 4

Putting the puzzle together QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Framework Putting the puzzle together Martin-QSEN-June2008 Martin-QSEN-June2008 5

QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 1 Liberal Education for Baccalaureate Generalist Nursing Practice Recognizes that a solid base in liberal education (sciences & the arts) provides the cornerstone for the practice & education of nurses. Sciences Physical Sciences (e.g., physics) Life Sciences (e.g., biology) Social Sciences (e.g., psychology) The Arts Fine Arts (e.g., painting) Performing Arts (e.g., dance) Humanities Arts (e.g., theology) Martin-QSEN-June2008 Martin-QSEN-June2008 6

Essential 1 Liberal Education QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 1 Liberal Education Develop intellectual & innovative capacity Question dominant assumptions Solve complex problems Understand the relevance of culture Understand reasons for policies & standards Accept responsibility for lifelong learning Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 7

QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 2 Basic Organizational and Systems Leadership for Quality Care Recognizes that in order to provide high quality health care, knowledge & skills in leadership, communication, quality improvement, & patient safety systems are necessary. Martin-QSEN-June2008 Martin-QSEN-June2008 8

Essential 2 Leadership/Quality Care QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 2 Leadership/Quality Care Understand complex organizational systems Develop leadership KSA Develop collaboration KSA Participate in quality & patient safety initiatives Employ principles of QI, policy, & cost effectiveness for practice improvements Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 9

Essential 3 Scholarship for Evidence-Based Practice QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 3 Scholarship for Evidence-Based Practice Recognizes that professional nursing practice is grounded in the analysis & application of evidence for practice. Martin-QSEN-June2008 Martin-QSEN-June2008 10

Essential 3 EBP Patient Centered Care Teamwork & Collaboration EBP QI QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 3 EBP Advocate for protection of research subjects Evaluate the credibility of information sources Collaborate in the collection, documentation, & dissemination of evidence Understand the process for developing, validating, & endorsing quality standards & safety measures Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 11

Essential 4 Information Mgmt. & Application of Patient Care Technology QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 4 Information Mgmt. & Application of Patient Care Technology Recognizes that knowledge & skills in information & patient care technology are critical in the delivery of quality patient care. Martin-QSEN-June2008 Martin-QSEN-June2008 12

Essential 4 Information/Patient Care Technology QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 4 Information/Patient Care Technology Employ a range of technologies to facilitate patient care, e.g., pt. ed., pt. safety, etc. Use databases to retrieve pertinent literature Use information technologies in clinical decision making Demonstrate knowledge of regulations that impact ethical & safe use of technologies Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 13

Essential 5 Health Care Policy, Finance, & Regulatory Environments QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 5 Health Care Policy, Finance, & Regulatory Environments Recognizes that healthcare policies, including financial & regulatory, directly & indirectly influence the nature & functioning of the healthcare system. Martin-QSEN-June2008 Martin-QSEN-June2008 14

Essential 5 Policy/Finance/Regulations QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 5 Policy/Finance/Regulations Demonstrate basic knowledge of healthcare policy, finance, & regulatory environments (local, state, national, global). Explore impact of socio-cultural, economic, legal, & political factors influencing healthcare delivery & practice. Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 15

QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 6 Interprofessional Communication & Collaboration for Improving Patient Health Outcomes Recognizes that collaboration among healthcare professionals is critical to delivering high quality & safe patient care. Martin-QSEN-June2008 Martin-QSEN-June2008 16

Essential 6 Communication & Collaboration QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 6 Communication & Collaboration Compare/contrast roles & perspectives of the nursing profession with other professionals on the team Incorporate effective communication techniques to produce positive professional working relationships Advocate for high quality & safe patient care Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 17

Essential 7 Clinical Prevention & Population Health QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 7 Clinical Prevention & Population Health Recognizes that health promotion & disease prevention at the individual & population level are necessary to improve population health. Martin-QSEN-June2008 Martin-QSEN-June2008 18

Essential 7 Clinical Prevention & Population Health QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 7 Clinical Prevention & Population Health Assess protective & predictive factors which influence the health of individuals, families, … Assess health/illness beliefs, values, attitudes, & practices of … groups, communities, populations Collaborate to provide spiritually & culturally appropriate health promotion plus disease & injury preventions & interventions Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 19

Essential 8 Professionalism & Professional Values QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 8 Professionalism & Professional Values Recognizes that professionalism is fundamental to the discipline of nursing. Professionalism is the consistent demonstration of core values of: Altruism Autonomy Human Dignity Integrity Social Justice Martin-QSEN-June2008 Martin-QSEN-June2008 20

Essential 8 Professionalism & Values QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 8 Professionalism & Values Demonstrate professional standards of moral, ethical, & legal conduct Recognize the impact of attitudes, values & expectations on vulnerable population care Recognize the relationship between personal health, self renewal, & the ability to deliver sustained quality care Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 21

Essential 9 Baccalaureate Generalist Nursing Practice QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 9 Baccalaureate Generalist Nursing Practice This essential is the culmination/integration of the preceding 8 essentials Recognizes that the integration of knowledge & skills is critical to practice. Practice occurs across the lifespan & in the continuum of healthcare environments. The baccalaureate graduate demonstrates clinical reasoning within the context of patient-centered care to form the basis for nursing practice that reflects ethical values. Martin-QSEN-June2008 Martin-QSEN-June2008 22

Essential 9 Nursing Practice QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Essential 9 Nursing Practice Implement holistic evidenced-based patient-centered care Communicate effectively with all of the healthcare team, including patent & family Facilitate patent-centered transitions of care Create a safe environment that results in high quality patient outcomes Patient Centered Care Teamwork & Collaboration EBP QI Safety Informatics Martin-QSEN-June2008 Martin-QSEN-June2008 23

QSEN 1 Patient-centered Care QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 1 Patient-centered Care Definition: Recognize the patient or designee as the source of control & full partner in providing compassionate & coordinated care based on respect for patient’s preferences, values, & needs. Martin-QSEN-June2008 Martin-QSEN-June2008 24

QSEN 1 Patient-centered Care QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 1 Patient-centered Care 1 LibEd 2 Lead 3 EBP 4 Tech- nology 5 Policy Financ Regs 6 Comm & Collab 7 Pop Health 8 Values 9 Pract ice X Martin-QSEN-June2008 Martin-QSEN-June2008 25

QSEN 2 Teamwork & Collaboration QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 2 Teamwork & Collaboration Definition: Function effectively within nursing & inter-professional teams, fostering open communication, mutual respect, & shared decision-making to achieve quality patient care. Martin-QSEN-June2008 Martin-QSEN-June2008 26

QSEN 2 Teamwork & Collaboration QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 2 Teamwork & Collaboration 1 LibEd 2 Lead 3 EBP 4 Tech- nology 5 Policy Financ Regs 6 Comm & Collab 7 Pop Health 8 Values 9 Pract ice X Martin-QSEN-June2008 Martin-QSEN-June2008 27

QSEN 3 Evidence-based Practice (EBP) QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 3 Evidence-based Practice (EBP) Definition: Integrate best current evidence with clinical expertise & patient/family preferences & values for delivery of optimal health care. Martin-QSEN-June2008 Martin-QSEN-June2008 28

QSEN 3 EBP 1 LibEd 2 3 4 5 6 7 8 9 X Pract ice Lead EBP Tech- nology QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 3 EBP 1 LibEd 2 Lead 3 EBP 4 Tech- nology 5 Policy Financ Regs 6 Comm & Collab 7 Pop Health 8 Values 9 Pract ice X Martin-QSEN-June2008 Martin-QSEN-June2008 29

QSEN 4 Quality Improvement (QI) QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 4 Quality Improvement (QI) Definition: Use data to monitor the outcomes of care processes & use improvement methods to design & test changes to continuously improve the quality & safety of health care systems. Martin-QSEN-June2008 Martin-QSEN-June2008 30

QSEN 4 QI 1 LibEd 2 3 4 5 6 7 8 9 X Pract ice Lead EBP Tech- nology QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 4 QI 1 LibEd 2 Lead 3 EBP 4 Tech- nology 5 Policy Financ Regs 6 Comm & Collab 7 Pop Health 8 Values 9 Pract ice X Martin-QSEN-June2008 Martin-QSEN-June2008 31

QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 5 Safety Definition: Minimize risk of harm to patients & providers through both system effectiveness & individual performance. Martin-QSEN-June2008 Martin-QSEN-June2008 32

QSEN 5 Safety 1 LibEd 2 3 4 5 6 7 8 9 X Pract ice Lead EBP Tech- QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 5 Safety 1 LibEd 2 Lead 3 EBP 4 Tech- nology 5 Policy Financ Regs 6 Comm & Collab 7 Pop Health 8 Values 9 Pract ice X Martin-QSEN-June2008 Martin-QSEN-June2008 33

QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 6 Informatics Definition: Use information & technology to communicate, manage knowledge, mitigate error, & support decision-making. Martin-QSEN-June2008 Martin-QSEN-June2008 34

QSEN 6 Informatics 1 LibEd 2 3 4 5 6 7 8 9 X Pract ice Lead EBP Tech- QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon QSEN 6 Informatics 1 LibEd 2 Lead 3 EBP 4 Tech- nology 5 Policy Financ Regs 6 Comm & Collab 7 Pop Health 8 Values 9 Pract ice X Martin-QSEN-June2008 Martin-QSEN-June2008 35

QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Implications If CCNE adopts the new Essentials, baccalaureate programs would find the QSEN work very helpful in the curriculum Safety & quality are purposively integrated into the rationale & outcomes of the Essentials Martin-QSEN-June2008 Martin-QSEN-June2008 36

Timeline July 2008 – AACN Board reviews October 2008 – AACN Membership votes CCNE (autonomous arm of AACN) will have a process to decide about adopting the new Essentials of Baccalaureate Nursing Education Martin-QSEN-June2008

The Challenge Leaders in education & practice must collaborate to assure life-long learning regarding the knowledge, shills, & attitudes essential to safe high quality health care. Better Patient Outcomes Martin-QSEN-June2008 Martin-QSEN-June2008 38

QSEN Meeting in Charlotte NC June 2008 Martin slides for Monday June23 afternoon Dayton THE END Martin-QSEN-June2008 Martin-QSEN-June2008 39