1. Implementation of Quality & Safety Competencies in ADN Curriculum St. John’s College of Nursing of Southwest Baptist University Springfield, Missouri June 2008 Pilot Team: Teresa Russell, Rebecca Miller & Tonyha Sumners

2. QSEN Projects: Faculty  QSEN Fact Sheet  QSEN Reference Manual in Faculty Lounge  QSEN Pilot Team Report @ monthly faculty meetings  Incorporated QSEN into annual faculty course reports (Systematic Evaluation)  Established alliance with practice partner QI VP  First Touch TM  Faculty accepted QSEN competencies as threads in new curriculum  Faculty retreat on Simulation (May 2008)

3. QSEN Projects: Students  QSEN Fact Sheet  QSEN Terminology prior to survey  SBAR  First Touch TM  Clinical Evaluation Tool (new curriculum)  Development of Process Audit Tool  Interdisciplinary experiences senior level students

4. Primary Practice Partner: St. John’s Health System  One of the Nation's Top 3 Integrated Health Systems St. John’s is a Springfield, MO - based integrated health system, serving the residents of southwest Missouri and northern Arkansas since 1891.  More than 10,000 co-workers, 460 physicians and 1,100 volunteers work together to fulfill St. Johns' mission of improving the health and quality of the communities we serve, with a particular concern for those who are economically poor.

5. Introduction to Quality & Safety Fundamentals of Nursing Students Goal: Incorporate components of QSEN KSA’s into workplace orientation through collaboration with primary practice partner.

6. Background  Faculty education regarding QSEN activities and KSA’s  Assessment of current compliance with KSA’s  Discussion with practice partner (VP Quality and Nursing Administration) regarding current monitoring activities reflective of Quality and Safety initiatives  Review of proposal for curriculum revision

7. Approaches  QSEN concepts and KSA’s introduced within first 2 weeks of the Fundamentals of Nursing course.  Process and observation audits integrated into patient care unit orientation.

8. References  QSEN articles and web site  Healthcare agency nursing process audits tools  Healthcare agency quality department audit tools  Literature search for tools

9. Contents of Audit Tool Introduction to:  Patient Care Environment: Focus- Safety, Teamwork, & Collaboration  Medical Record: Focus-Quality & Informatics  Patient Care Focus-Patient Centered Care & Evidence Based Practice

10. Patient Care Environment: Focus- Safety, Teamwork & Collaboration Examples:  Conversations by staff in rooms, hallways, and other areas are conducted quietly and professionally  Examples of Crucial Conversations heard  Examples of conversations between disciplines  Hallways are free of equipment and/or objects that might impede patient/visitor movement  All patient care equipment/supplies are located to provide for patient privacy and safety

11. Medical Record: Focus-Quality & Informatics Examples:  Pain is assessed on admission  Vital Signs are taken per hospital policy  I & O is documented every shift  Restraint flow sheet is completed per hospital policy

12. Patient Care Focus-Patient Centered Care & Evidence Based Practice Examples:  IV in place less than 96 hours  IV location promotes comfort and safety for patient  IV device used is appropriate for patient’s therapy  IV dressing is dry and intact  Hand washing foam/gel is available in patient’s room and outside door

13. Patient Care Focus-Patient Centered Care & Evidence Based Practice Examples:  Staff going in and out of patient’s room are using proper hand hygiene  Call lights are answered within 1-2 minutes  Patients and visitors are greeted and assisted in ways that exemplify the components of First Touch

14. First Touch TM Patient-centered care  Practice Partner/Press Ganey Results Patient Satisfaction averaged at the 50 th percentile Patient Satisfaction averaged at the 50 th percentile  Website: http://www.first-touch.org/ http://www.first-touch.org/  Implementation with faculty/students

15. The Basics of First Touch TM  How we view others  The first introduction  Establishing presence  Touch  Retouch  Handoffs

16. First Touch Education Fundamentals of Nursing Students  A survey tool containing Likert scale and qualitative comment items was developed to measure student understanding of major concepts of First Touch  The tool was administered immediately following initial education and again immediately following students’ Fundamentals of Nursing clinical practicum

17. Survey Results  Initial findings: Understanding of major concepts Understanding of major concepts Qualitative comments were primarily paraphrased from presentation information Qualitative comments were primarily paraphrased from presentation information  Post-clinical findings: Loss of understanding of 1 major concept- Retouch Loss of understanding of 1 major concept- Retouch Qualitative comments reflected purpose and intent of First Touch TM Program Qualitative comments reflected purpose and intent of First Touch TM Program

18. Student Comments Post-Clinical How We View Others:  “By relaying a positive message to the next care provider it sets a positive tone for care for the next shift”  “It allowed me to provide unbiased care”  “The next person taking care of my patient wasn’t dreading going into the room”

19. The Implementation of Quality & Safety Competencies in ADN Curriculum at St. John’s College of Nursing of Southwest Baptist University has been influenced by participation in the Quality & Safety Education for Nurses funded by the Robert Wood Johnson Foundation Pilot Schools Collaborative

20. Vote St. John’s College of Nursing For Most Effective Clinical Partnership Award + = RN