Learning Concepts of Quality Improvement and Safety in Nursing Using a Personal Quality Improvement Project

Learning Concepts of Quality and Safety using a Personal Quality Improvement ProjectNurse educators need to be keenly aware of the ever-changing needs of the workforce, our communities and our accreditors. It is well known that nurses play a unique and critical role in improving healthcare quality and safety. The expectation for nursing leaders to have knowledge, skills and attributes associated with Quality and Safety in healthcare are clearly outlined in the American Academy of Colleges of Nurses (AACN) Masters Essentials (AACN, 2008) and in Progress to Date: Revision of The AACN Essentials (Case-Wirth, McCurren, McFadden and Higgins, February 1st 2020). In a recent quality cycle review of a graduate level curriculum a notable gap in quality and safety was identified. To address this gap, a course needed to be developed. Potential barriers to the development of this course included its necessary online format, a limited time frame (one semester) and needing to meet the expected student learner outcomes for a diverse set of programming. Resources used to develop the course were vast, however one source greatly influenced the final course. This source, a massive open online course (MOOC) offered by Case Western University in collaboration with Coursera titled Take the Lead on Healthcare Quality Improvement was taken by the author during spring/summer of 2017 (Dolansky, Moore and Singh, n.d.). The completion of a quality improvement proposal and/or project through this MOOC using a step wise process mirrored the project processes used in other courses within the graduate program and embraced the active learning strategies that resonate so well with students. However; the reality of the time limitations given the length of a semester required thinking about how this type of learning could be implemented in a shorter and more concentrated period of time without losing the depth or meaningfulness. Using Fink’s Backwards Design framework (2013), Quality and Safety for the Advanced Practice Nurse was developed using a project-based approach. Content was front loaded in the first half of the 15-week term and a 60 hour practicum occurred during the second half of the term. During the didactic front loading, students were engaged participated in the development of their “Personal Quality Improvement Project (PQIP)” using a six-step process. These formative assessments gave students the opportunity to use the knowledge, skills and tools acquired during the didactic content, and plan for implementation of their projects, their summative assessment, in the second half of the term during the practical application. Topics ranged from increasing activity levels, eating healthier, financial health to reduction of procrastination habits. Students used quality improvement tools identified in the didactic portion of the course to implement, track, evaluate and then present their outcomes. Informal feedback from students suggests that using this process to force student self-care was a novel way to both gain the skills necessary for implementing QI in practice and to provide students an opportunity to engage in self care that they had long been neglecting. Continued evaluation of the course using both formal and informal student feedback will provide opportunities to continue to improve this course. References: Case-Wirth, J.; McCurren, C.; McFadden, J. and Wiggins, M. (2020, February). Progress to Date: Revision of The AACN Essentials. Presentation presented at the American Association of Colleges of Nursing Doctoral Education Conference, Naples, Florida. https://www.aacnnursing.org/Portals/42/Downloads/Essentials/doc-conf-essentials-pp.pdfFink, D. (2013). Creating Significant Learning Experiences: An integrated approach to designing college courses. San Francisco, CA: Jossey-Bass. Dolansky, M., Moore, S. & Singh, M. (n.d.) Take the Lead on Healthcare Quality Improvement. [MOOC]. Coursera. https://www.coursera.org/learn/hcqualityimprovementOgrinc, G., Headrick, L., Moore, S., Barton, A., Dolansky, M., Madigosky, W. (2018). Fundamentals of Health Care Improvement: A Guide to Improving Your Patients’ Care (3rd ed.). Oakbrook Terrace, IL: Joint Commission Resources