Nurse Educators' Self-Efficacy in Integrating QSEN Quality Improvement Competency into Curriculum

1. Nurse Educators’ Self-Efficacy with Integrating QSEN Quality Improvement Competency into Curriculum Leakie Bell-Wilson August 23, 2019

2. Background • Institute of Medicine (IOM) Reports (1999-2008) • The Health Professions Education: A Bridge to Quality (2003) • Quality, Safety, and Education in Nursing (QSEN) • Three-phased project began at University of North Carolina Chapel Hill School of Nursing with (RWJF) grant • Developed six competencies to address the challenges of preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems in which they work (QSEN project overview site, 2019). • Fourth of the six competencies is Quality Improvement

3. Problem Statement Quality Improvement (QI) Competency Defined as using data to monitor the outcomes of care processes and using improvement methods to design and test changes to continuously improve the quality and safety of health care systems”(QSEN, 2003). • Despite the robust efforts of QSEN project workgroup to implement the six competencies, QSEN nurse faculty studies conducted in (2009) and (2017) revealed significant gaps in faculty preparedness with integrating the QSEN quality improvement (QI) competency into the nursing curriculum(Altmiller, 2017).

4. Purpose and Significance • The purpose of this descriptive qualitative study is to explore how the cognitive, social and physiological experiences of nurse educators influence their teaching of the QSEN quality improvement (QI) competency in Bachelor of Science Nursing (BSN) programs curriculum within the United States • The experiences of this population could inform about specific resources, training, and research needed to improve the teaching and learning experience of the QSEN quality improvement (QI) competency for faculty and students, respectively

5. Literature Review • Educators Experience with QSEN QI Competency Integration • (2005) Cronenwett et. al (n=195) program Directors and Educators results contradictory and Faculty reported feeling unprepared to teach QI competency (Altmiller, 2017). • (2017) National nurse faculty survey (n=2037) educators indicate lack of literature, resources and teaching strategies related to QI competency (QSEN survey, 2017). • Students Perception of QSEN QI Competency Integration • (2009) survey by Cronenwett et.al. (n=595) pre-licensure students from the original schools rated QI as least important (Sullivan, D.T., Hirst,D., & Cronenwett, L., 2009). • (2017) students report little time spent on QI in nursing programs (Pauly-O’Neil, S., & Cooper, E., 2013).

6. Literature Review Continued • Gaps • Disconnect between Program Administrator, Educators and Students on integration success • Limited information available on QSEN • Educators perceive lack of training / resources • Less time spent teaching QI competency

7. Theoretical Framework

8. Research Questions • RQ1. How do nurse educators describe their cognitive and physiological experiences with integrating QSEN (QI) competency into current nursing curricula? • RQ2. How do nursing educators describe the influence of social factors within their institution in how they integrate QSEN (QI) competency into current nursing curricula?

9. Methodology Design Qualitative descriptive design Participants Purposive sampling of 8-10 nurse educators Selection / Recruitment Nurse educators, 4yr Institutions, Student pop > 30, 000, Holding Full/ Associate/ Assistant Professorship, One yr. experience, Adjunct excluded Measures Interview protocol (face to face) / Demographics collected online Procedure Solicit professional online nursing sites, Determine eligibility using inclusion/ exclusion criteria, Send welcome/ denial email, Assign I.D., Complete demographics ( within 14 days)

11. Impact Advance the research AND change narrative around Phenomenon Potential to identify specific factors that influence nurse educator’s self-efficacy with teaching QSEN QI competency Prepare future nurses to understand, translate, and communicate nursing care into data and identify gaps in clinical and non- clinical processes

12. References Altmiller, G., & Armstrong, G. (2017). National quality and safety education for nurse’s faculty survey results. Nurse Educator, 42 (5S), S3-S7. Bandura, A. (1977). Self-Efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2). Bandura, A. (1986). Social foundation of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall. Casey, K., Fink, R., Jaynes, C., Campbell, L., Cook, P., & Wilson, V. (2011). Readiness for practice: the senior practicum experience. Journal of Nursing Education. 50 (11), 646-652. Gavora, P. (2010). Slovak pre-service teacher self-efficacy: Theoretical and research considerations. The New Educational Review. 21(2), pp. 17-30. Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press. Padilla-Diaz, M. (2015). Phenomenology in educational qualitative research: Philosophy or philosophical science? International Journal of Educational Excellence. 1(2), 101-110. Pauly-O’Neil, S., Cooper, E. (2013). Addressing gaps in quality and safety education during pre-licensure clinical rotations. Journal of Nursing Education and Practice, 3(11), 64-70. Peterson-Graziose, V., & Breyer, J. (2017). Assessing student perception of quality and safety education for nurse’s competencies in a baccalaureate curriculum. Journal of Nursing Education. 56 (7), 435-438. QSEN Institute Frances Payne Bolton School of Nursing (2018). Quality, safety, and education in nursing. Retrieved from http://qsen.org/competencies/quality-improvement-resources-2/ Sullivan D.T., Hirst, D., Cronenwett, L. (2009). Assessing quality and safety competencies of graduating prelicensure nursing students. Nursing Outlook, 57, 323-331.