Pilot Team: Teresa Russell, Rebecca Miller & Tonyha Sumners

1. Implementation of Quality & Safety Competencies in ADN CurriculumSt. John’s College of Nursing of Southwest Baptist UniversitySpringfield, 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 SystemsSt. 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 & SafetyFundamentals 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 50th percentile • Website: 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 EducationFundamentals 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 • Qualitative comments were primarily paraphrased from presentation information • Post-clinical findings: • Loss of understanding of 1 major concept-Retouch • 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. TheImplementation of Quality & Safety Competencies in ADN Curriculumat 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