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Implementing Quality and Safety at the Unit Level in an Innovative Clinical Education Model. Kathleen Williams Kafel MS,RN JoAnn Mulready-Shick EdD,RN,CNE Judith Healey Walsh MSN,RN.
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Implementing Quality and Safety at the Unit Level in an Innovative Clinical Education Model Kathleen Williams Kafel MS,RN JoAnn Mulready-Shick EdD,RN,CNE Judith Healey Walsh MSN,RN
A Partnership: University of Massachusetts Boston, Massachusetts General Hospital and Brigham and Women’s Hospital A model where nursing practice informs nursing education and nursing education influences nursing practice
Dedicated Education Unit is…. • A client unit developed into an optimal teaching/learning environment through the collaborative efforts of nurses, management, students and faculty.
Features of the DEU • Exclusive use of the DEU by University of Massachusetts Boston students • Staff nurses would serve as clinical Instructors • Orientation, faculty enrichment days provided to the CIs by the College of Nursing • University faculty expertise to support the CIs. • Continuity of students with the staff nurse/CI over length of semester • Commitment by all parties to build an optimal learning environment
Role Definement in the DEU Model • CI= Clinical Instructor. A BS prepared staff nurse who provides direct clinical instruction, supervision and evaluation of two nursing students. Challenge- the dual role of teacher and care giver. To provide instruction while providing care. CFC=Clinical Faculty Coordinator. A course professor at UMass Boston who collaborates with nursing management to support the CIs in their education and evaluation of the students. Challenge-The instruction of nurses rather than students. Continuous active collaboration to ensure a positive experience for all.
Operationalization of the DEU • MGH- a traumatic surgery unit where 6 staff nurses/CIs were assigned 12 junior level nursing students in their Adult Health rotation. • BWH- an intermediate medical unit where 3 staff nurses were assigned 6 junior level nursing student in their Adult Health rotation. • Two students worked with same CI over entire semester. • Students worked one12 hour shift per week • Student expectations in terms of clinical papers were the same as students in traditional clinical groups.
Opening Day At BWH! January 31,2008 Practice informing education……
Student Presentations • Utilizing the QSEN competencies the students in collaboration with Nursing Education chose to research and present findings specific in the following areas : • Alternatives to Restraints (at BWH) • Pressure Ulcer Prevention (at MGH) Education influencing Practice…..
Utilizing the QSEN Competencies in this DEU model to effect change • Teamwork and Collaboration • Knowledge-the strengths, limitations scope of practice of each on the unit team were described. • Skills- Team leader role was utilized, team goal was formulated and roles were clarified. • Attitudes-contributions of all members were sought and respect and value were communicated. The influence of systems in formulating change was appreciated and realized.
Patient Centered Care • Knowledge-the information communicated greatly affects the care and comfort attained. • Skills-respect, sensitivity to both physical and emotional comfort were communicated and assessed. • Attitudes-the role of the nurse in relieving and preventing all sources of pain was recognized.
Evidence-Based Practice • Knowledge-the scientific process and components of research evidence were found and utilized to educate and inform. • Skills-routine approaches were questioned, evidence was sought and experts consulted. • Attitudes-the importance of professional research was appreciated and need for continuous improvement of practice emphasized.
Quality Improvement • Knowledge-the systems of care that affect outcome were recognized and the approach for changing the process of care were explored. • Skills-information regarding quality improvement projects were sought and a tool for assessment was designed. • Attitudes-appreciation of individual and team contributions in improving care.
Informatics • Knowledge-the importance of information technology was realized. • Skills-quality electronic sources of health care information were utilized, electronic records were navigated and PDAs were introduced. • Attitudes-the necessity of health professionals to seek out continuous learning of information technology was appreciated.
Safety • Knowledge-commonly utilized unsafe practices were examined. • Skills-effective use of strategies to reduce harm were demonstrated • Attitudes-the policies implemented around safety and personal and system vigilance were valued.
Tell me and I’ll forget; show me and I may remember; involve me and I’ll understand.Chinese proverb
