Using Simulation to teach leadership competencies in delivering safe patient care

1. Using Simulation to teach leadership competencies in delivering safe patient care Claudia Grobbel DNP RN Michelle Costlow MSN RN, Jean Ann Dean MSN RN Background Using the Quality and Safety Education in Nursing QSEN) competencies a leadership based clinical simulation has been implemented to strengthen students knowledge and practice of leadership strategies in delivering quality care in a junior level baccalaureate nursing leadership course. The Agency on Healthcare Research and Quality (AHRQ) and the Institute of Medicine (IOM) evidence clearly documents that errors are directly related to the issues in clinical practice of handoffs, interruptions, improper or poor communication and delegation and lack of teamwork. Communication, conflict, delegation and teamwork are all topics in the undergraduate Care Management course. Teaching these competencies require practice. The goal of this assignment is for students to practice knowledge and strategies learned in class as applied in clinical situations. This project was designed using the simulation process of Page, Kowlowitz & Alden (2010). The simulation represents a typical day on a nursing unit with multiple patients, family, clinical staff and a variety of communication methods. Outcome measures 1. Pretest/posttest design on AHRQ information. Multiple choice test regarding safe practice. Such as: Two patient identifiers are necessary only when administering medication. True or False. Revealed no significant improvement. 88% to 95%. 2. Quality and Safety Self Inventory (QSSI). 18 statement self rated inventory developed around the QSEN competencies ( Examples statement: “I feel I have the necessary knowledge to practice patient centered care.” Internal consistency evaluated for overall scale using Cronbach’s alpha; = .91. Theoretical Framework Bandura’s Social Cognitive Theory Bandura’s Social Cognitive Theory guided this study. Simulated practice provides a safe learning environment for students to practice skills and consequently improve their self-efficacy. Simulation Design Learner Outcomes Patient-centered Care: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs. Teamwork and Collaboration: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care. Safety: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance. NQSSI results Next Steps • Pretest will be given prior to assignment given to determine baseline knowledge. Earlier pretest was open book. • Posttest immediately after debriefing. • Set up a more structured report process. Include an HER. • Allow more time, slow simulation down to give student more time to process information, deal with interruptions and delegate. • Include standard safe practice evaluation to include hand washing, patient identifiers, room assessment for safety. • Use video recording to enhance debriefing.