Academic-clinical service partnerships are innovative strategies to advance patient safety competence and leadership in prelicensure nursing students

Research and Practice in Quality Improvement and Implementation Science: The Synergy for Change Model

BACKGROUND

Nurses play an essential role in the achievement of quality depicted by the Quintuple Aim to improve clinical outcomes, patient experience, equity, provider well-being, and reduction of costs. When quality gaps occur, practice change is required and is facilitated by quality improvement (QI) and implementation science (IS) methods. QI and IS research are required to advance our understanding of the mechanisms that explain how evidence is implemented and improvements are made.

PROBLEM

Despite past efforts of the evidence-based practice and QI movements, challenges persist in sustaining practice improvements and translating research findings to direct patient care.

APPROACH

The purpose of this article is to describe the Synergy for Change Model that proposes that both QI and IS research and practice be used to accelerate improvements in health care quality.

CONCLUSIONS

Recognizing the synergy of QI and IS practice and research will accelerate nursing's contributions to high-quality and safe care.

Partnering with healthcare organisations to teach pre-registration health professions students about quality improvement: A systematic review

AIMS AND OBJECTIVES

To describe what higher education and healthcare organisation partnerships can be identified in the published literature to teach pre-registration health professions students quality improvement and the impact of these partnerships.

BACKGROUND

Quality improvement has been gaining traction in the Western world and has been incorporated in varying degrees into the curricula for pre-registration health professions students. Providing quality improvement education in partnership with healthcare organisations has been found to be a valuable experiential learning solution, but the impacts of higher education and healthcare organisation partnerships have not been explored.

DESIGN AND METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was undertaken using the Ovid MEDLINE, Emcare, CINAHL, Scopus and Eric databases. Studies were subject to quality appraisal using the Critical Appraisal Skills Program validated tools and a thematic analysis and narrative synthesis was undertaken.

RESULTS

Eight studies were included in this review. Features of existing quality improvement partnerships included experiential learning, time pressures and barriers to successful quality improvement partnerships. The impacts of quality improvement partnerships were demonstrated by an increase in quality improvement knowledge and understanding, students leading change and the implementation of quality improvement projects.

CONCLUSION

Several key elements were identified that may act as barriers or enablers to successful implementation of quality improvement partnerships. This review advances understandings of the need for a shift in focus that pays attention to the culture of teaching quality improvement in education partnerships and how this can be achieved in a mutually beneficial way.

RELEVANCE TO CLINICAL PRACTICE

The development of quality improvement partnerships has been found to increase student knowledge and understanding, potentially improving patient outcomes, systems performance and professional development. More research is required on the establishment of quality improvement partnerships and the benefit these collaborations have on students, staff and patients.

Effectiveness of educational interventions to develop patient safety knowledge, skills, behaviours and attitudes in undergraduate nursing students: a systematic review protocol

INTRODUCTION

Patient safety is a healthcare discipline that aims to prevent and reduce patient harm, risks and errors during the provision of healthcare. Given the size of the nursing workforce in the healthcare system the inclusion of patient safety in the undergraduate nursing curriculum is necessary to enhance a safe culture in the daily work of their future careers. To this end, it is essential to apply effective teaching strategies to develop patient safety competencies. This review will aim to evaluate the effectiveness of educational interventions in developing patient safety knowledge, skills, behaviours and attitudes in undergraduate nursing students within the existing topic areas of the WHO Multi-professional Patient Safety Curriculum Guide.

METHODS AND ANALYSIS

The databases Medline, CINAHL, Scopus, Education Research Complete, The Cochrane Central Register of Controlled Trials, LILACS, Medes and Grey literature such as ClinicalTrials.gov, Google Scholar, DART-Europe, ProQuest Dissertations, CAPES thesis and dissertations, The Virginia Henderson Global e-Repository, Mednar and Thesis Canada will be searched from July 2011 to January 2022. Two independent reviewers will conduct the search, extract the data and assess the risk of bias for the included studies, using standardised critical appraisal instruments from the Joanna Briggs Institute. The quality of the evidence will be assessed using the Grading of Recommendations, Assessment Development and Evaluation methodology. Studies will be pooled in the meta-analysis. Alternatively, the findings will be presented in narrative form, including tables and figures, to aid in data presentation.

ETHICS AND DISSEMINATION

This study raises no ethical issues. The findings will be disseminated through presentations at professional conferences and publications in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42021254965.

Academic service-learning nursing partnerships in the Americas: a scoping review

Background

Academic service-learning nursing partnerships (ASLNPs) integrate instruction, reflection, and scholarship with tailored service through enriched learning experiences that teach civic responsibility and strengthen communities, while meeting academic nursing outcomes. Objective: This scoping review aimed to identify, appraise, and synthesize evidence of community focused ASLNPs that promote primary health care throughout the Americas region.

Methods

A systematic search of PubMed, CINAHL, Scopus, Google Scholar, and LILACS English-language databases was performed in accordance with PRISMA guidelines. Full-text articles published since 2010 were reviewed using an inductive thematic approach stemming from the “Advancing Healthcare Transformation: a New Era for Academic Nursing Report” and the Pan American Health Organization “Strategic Directions for Nursing.”

Results

A total of 51 articles were included with the vast majority 47 (92.1 %) representing North America. Structured, established relationships between an academic nursing institution or program and one or more community serving entities resulted in high levels of effectiveness and innovation across settings. Five themes emerged: (a) sustaining educational standards and processes - improving academic outcomes (25.5 %), (b) strengthening capacity for collaborative practice and interprofessional education (13.7 %), (c) preparing nurses of the future (11.8 %), (d) enhancing community services and outcomes (21.6 %), and (e) conceptualizing or implementing innovative academic nursing partnerships (27.4 %). A synthesis of conceptual frameworks and models revealed six focus areas: communities/populations (26.2 %), nursing (26.2 %), pedagogy (19 %), targeted outreach (14.3 %), interprofessional collaboration (11.9 %), and health determinants (9.5 %). A proliferation in US articles, triggered by nursing policy publications, was confirmed.

Conclusions

ASLNPs serve as mechanisms for nurses and faculty to develop and lead change across a wide variety of community settings and healthcare systems, develop scholarship, as well as for students to apply the knowledge and skills learned. Given the lack of geographically broad evidence, successes and challenges across U.S. partnerships should be viewed cautiously. Nevertheless, ASLNPs can play a critical role towards meeting the goal of universal health access and coverage through partnering with the education sector. Further investigation of grey literature as well as Spanish and Portuguese language literature from Latin American and Caribbean countries is highly recommended.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00698-w.

Planning and implementing quality improvement projects in clinical practice: Third-year nursing students' learning experiences

AIMS AND OBJECTIVES

To evaluate the impact of an educational design to develop nursing students' competence to work systematically with quality improvement in clinical practice.

BACKGROUND

Competence in how to improve the quality and safety of healthcare services based on new knowledge is crucial for healthcare quality. Nursing education should give students opportunities to engage in quality improvement projects to gain this competence.

DESIGN

This project qualitatively evaluated the impact of the course on students' ability to plan and implement a quality improvement project in their clinical placement.

METHODS

Data from retrospective focus group interviews and written project reports were analysed by means of qualitative content analysis. Fifty-five students participated in the study. COREQ reporting guidelines were used.

RESULTS

Three themes were derived from the analysis: (a) the importance of anchoring the quality improvement project in the clinic; (b) experiencing the steps of a quality improvement project; and (c) challenging student role.

CONCLUSIONS

Course design that facilitates student-run small-scale quality improvement projects under supervision can enhance nurse students' competence in quality improvement work, as well as raise the students' awareness of the responsibility they will undertake as future nurses.

RELEVANCE TO CLINICAL PRACTICE

Nursing students work on quality improvement project in clinical placement may enhance their awareness and competence in developing quality and safety of healthcare services as future nurses.

The interprofessional VA quality scholars program: Promoting predoctoral nursing scientists and their career trajectories

BACKGROUND

The VA Quality Scholars (VAQS) program is an interprofessional fellowship that provides a unique opportunity for predoctoral nurse scientists to embed their work in quality improvement learning "laboratories" to inform their scholarship, science, and research.

PURPOSE

To describe the VAQS program in relation to promoting nursing science and predoctoral nurse scientist (PhD) career trajectories, and to propose policy implications.

METHOD

Data were collected on all predoctoral (PhD, DNP) nurses who entered and completed the VAQS program nationally.

FINDINGS

A total of 17 predoctoral nurses (11 PhD and 6 DNP) have completed the VAQS program. Ten predoctoral PhD nurses (91%) completed their degree while in the program. Nine predoctoral PhD nurses (82%) entered a postdoctoral fellowship, and many obtained positions as faculty at research-intensive universities postfellowship.

DISCUSSION

The knowledge, skills, and experiences gained by predoctoral nurse scientists from the VAQS's program contribute to their nursing research and professional career growth.

New Graduate Nurses' Perceptions of Patient Safety: Describing and Comparing Responses With Experienced Nurses

BACKGROUND

A significant proportion of the acute health system workforce is composed of new graduate nurses, yet there is a limited understanding of patient safety perceptions among new graduate nurses and how they compare with nurses who have more experience.

METHOD

This study used a descriptive approach to complete secondary analysis on two sources of data containing new graduate nurses' (n = 1,613) and experienced nurses' (n = 64,906) responses to the Hospital Survey on Patient Safety Culture.

RESULTS

New graduate nurses had a more positive perception of safety culture than more experienced nurses. The greatest differences were observed in perceptions of how nurse managers respond to mistakes. Similarities in perceptions were observed on items associated with communication.

CONCLUSION

Educational systems and transitional programs must prepare new graduate nurses for patient care. There is an opportunity for academic and practice partners to collaborate on programs that facilitate the transition of new graduate nurses to the workforce. [J Contin Educ Nurs. 2020;51(7):309-315.].

Perceived Patient Safety Competence of Baccalaureate Nursing Students: A Descriptive Comparative Study

Introduction

Patient safety is an issue of utmost concern within health care. An interrelated approach between nursing education and practice is needed. For more than a decade, nursing education programs have responded to calls for curricular reform, integrating strategies to prepare graduates for safe nursing practice.

Objectives

The purpose of the descriptive study was to examine self-perceived safety competencies among baccalaureate (BSN) nursing students at end of program (n = 72) using the Health Professional Education in Patient Safety Survey. In addition to the objective of describing self-perceived safety competencies of BSN students, another objective was to investigate any significant differences in self-perceived competencies between traditional 4-year and accelerated 12-month program students.

Methods

A descriptive comparative design was used with a purposive sample of baccalaureate nursing students from both traditional and accelerated second-degree programs at a comprehensive university in the Northeast.

Results

Students rated self-confidence with patient safety learned in the clinical environment higher than within the classroom setting. Overall, students reported a high level of self-confidence within each of the seven patient safety dimensions with knowledge gained from the clinical setting higher than knowledge gained from the classroom setting. Paired t-test analyses revealed statistically significant differences (p < .05) between self-confidence gained in classroom and clinical environments with communicating effectively and managing safety risks. Independent t-test analyses revealed accelerated students reported lower self-confidence than traditional students, with statistically significant differences (p < .05) in dimensions of culture of safety, working in teams, managing safety risks, and disclosing adverse events/close calls.

Conclusion

In most patient safety dimensions, students felt confident with their competencies within each of the dimensions of patient safety. Results also revealed that accelerated second-degree students report lower confidence with their knowledge of patient safety gained from classroom and clinical settings. Nursing programs must continue to emphasize a culture of safety within the nursing curriculum.

Evaluation of the joint nurse scientist role across academia and practice

BACKGROUND

Mapped with the guiding principles of academic-practice partnerships (APPs) outlined by the American Association of Colleges of Nursing and the American Organization for Nursing Leadership, a joint nurse scientist role between a nursing school and acute care facility at a large academic health center was developed and characterized by a PhD-prepared nurse appointed in a research role across organizations. To date, eight faculty are now appointed across the School and four health systems.

PURPOSE

Describe outcomes, facilitators and vulnerabilities of the joint nurse scientist role.

METHODS

Review of administrative records.

DISCUSSION

Outcomes include the 1) conduct and dissemination of joint research, 2) translation of evidence into practice, 3) development of educational programs for health system nurses, 4) scholarly activities among health system nurses, and 5) improved visibility and valuation of the PhD-prepared nurse. Role facilitators include those previously reported for APPs, the joint nurse scientists' ability to broker opportunities across settings, and the evolving nature of the role. Role vulnerabilities pertain to the negotiation of workload, promotion, and institutional priorities.

CONCLUSION

The joint nurse scientist role fosters shared scholarly successes across academia and service.