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Using Appreciative Inquiry for a QSEN Integration Project in
Using Appreciative Inquiry for a QSEN Integration Project in a Private Urban BSN Program OFFICE OF XYZ Danielle Walker PhD, RN, CNE Caitlin Dodd MSN, RN, CNE Linda Humphries DNP, RN, ACNS-BC, CCRN Gina Alexander PhD, MPH, MSN, RN Lynnette Howington DNP, RNC, WHNP-BC, CNL Barb Patten MS, RN, CNE
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Administrative Suggestion
How it all began Administrative Suggestion Charges Taskforce creation Volunteers with interest in QSEN Attendance at QSEN conference in 2016
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Appreciative Inquiry Framework
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How Appreciative Inquiry Impacted our Process
Valued our faculty’s time Knew that quality and safety was being addressed How Where Common Language Didn’t want the “just one more thing” mentality
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Creating a common language
Define What is QSEN Faculty education Creating a common language Is “Informatics” the same for everyone? Are these descriptions what you think of? Invoking a desire to work on QSEN Why do we care? Extrinsic motivation Valuing the contributions already occurring
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Current measurement methods in place
Discover Getting buy in Current measurement methods in place ATI results Organizing the discovery process 1st attempt Regroup and Restart
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Example Data Collection Grid
Safety Soph 2 Jr 1 Jr 2 Sr 1 Sr 2 Knowledge K1. Examine human factors and other basic safety design principles as well as commonly used unsafe practices (such as, work-arounds and dangerous abbreviations) 20263/ st lecture Patient safety simulation activity 30182/30263 Patient Safety concept introduced; Virtual Patient Safety Rounds Videos; Use of 5 P’s; Infection Control and prevention concept; The Shift Book patient safety assignment 30582/30563 Students discuss unsafe practices witnessed in clinical journal and through ANA standards journaling 30682/30663 Post Conference Clinical discussions on safety Seclusion/Restraint Med Consents Legal Status Guardians 40663/ Discuss ob specific workarounds, abbreviations, shortcuts witnessed Debriefing patient scenarios TeamStepps Documentation, Post Conference, Student-faculty discussions, hospital orientation 40883/40863 Safety manager role with clinical projects to manage safety Beginner Intermediate Advanced
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Identification of Gaps
Looked at data collected as a whole Identified broad areas of overall weakness The attitudinal domain across all competencies Evidence Based Practice Safety Quality Improvement
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Gap- Evidence Based Practice
Knowledge Skills Attitudes Demonstrate knowledge of basic scientific methods and processes Describe EBP to include the components of research evidence, clinical expertise and patient/family values. Participate effectively in appropriate data collection and other research activities Adhere to Institutional Review Board (IRB) guidelines Base individualized care plan on patient values, clinical expertise and evidence Appreciate strengths and weaknesses of scientific bases for practice Value the need for ethical conduct of research and quality improvement Value the concept of EBP as integral to determining best clinical practice
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Gap- Quality Improvement
Knowledge Skills Attitudes Describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice Seek information about outcomes of care for populations served in care setting Seek information about quality improvement projects in the care setting Appreciate that continuous quality improvement is an essential part of the daily work of all health professionals
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Gap- Safety Knowledge Skills Attitudes
Delineate general categories of errors and hazards in care Describe factors that create a culture of safety (such as, open communication strategies and organizational error reporting systems) Communicate observations or concerns related to hazards and errors to patients, families and the health care team Use organizational error reporting systems for near miss and error reporting Value own role in preventing errors
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Gap- Quality Improvement
Knowledge Skills Attitudes Recognize that nursing and other health professions students are parts of systems of care and care processes that affect outcomes for patients and families Give examples of the tension between professional autonomy and system functioning Use tools (such as flow charts, cause-effect diagrams) to make processes of care explicit Participate in a root cause analysis of a sentinel event Value own and others’ contributions to outcomes of care in local care settings
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What do we want moving forward
Dream What do we want moving forward Empowering people to use their big ideas Educate faculty on how to advance QSEN Taskforce started idea generation, design, and delivery Good catch and error reporting system QSEN newsletter Invited others to follow our example Created processes that valued input from others
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Taskforce reported back to faculty
Design Taskforce reported back to faculty Design is concurrent through out process Brainstorming workshop to design and deliver Each identified gap area will have a brainstorming session Signup based on interest area Held during all faculty (required) meeting
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Implementation of projects beginning in Fall 2017
Deliver Implementation of projects beginning in Fall 2017 Good Catch Error Reporting QSEN Newsletter Faculty development programs to remind about and inspire QSEN content Keeping the common language alive QSEN Monitoring
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Research We Valued and Used
Barton, A. J., Armstrong, G., Preheim, G., Gelmon, S. B., & Andrus, L. C. (2009). A national Delphi to determine developmental progression of quality and safety competencies in nursing education. Nursing Outlook, 57(6), doi: /j.outlook Beischel, K. P., & Davis, D. S. (2014). A Time for Change QSENizing the Curriculum. Nurse Educator, 39(2), doi: /nne Brady, D. S. (2011). Using Quality and Safety Education for Nurses (QSEN) as a Pedagogical Structure for Course Redesign and Content. International Journal of Nursing Education Scholarship, 8(1). doi: / X.2147
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Questions?
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