Abstract

Session presented on: Monday, July 22, 2013:

Purpose: Expectations that nurses be competent have always been a part of professional codes and standards, licensing and accreditation requirements and, are a key component of the profession's social contract. The purpose of this presentation is to describe the preliminary results of our project exploring ways to assess and document professional nursing competencies to assure safe, quality nursing practice. The QSEN (Quality Safety Education in Nursing) competencies were used as a guiding framework.

Methods: Current staff nurse competencies were assessed using two strategies: 1) a written assessment and 2) an observed standardized patient clinical scenario. Both written assessment and observed clinical scenario were developed using QSEN and assessed core knowledge, ability to analyze and synthesize information and make an appropriate clinical judgment. The written assessment consisted of 50 questions developed using the QSEN competencies with a possible score of 0-50 and the scenario assessed 63 behaviors and attitudes with a possible score of 0-63.

Results: The mean on the written assessment (37 + 4) and the observed standardized clinical scenario (mean 39 + 3)) was surprisingly low. Further analyses of the subscales show the lowest scores in quality improvement/safety (mean=24.5 + 2) with the safe medication administration performance lower than the other areas. Nurses performed better in patient-centered care (mean= 37.5 + 2) and evidence based practice (mean=40+ 3).

Conclusion: Nurse competencies were below expected level particularly in areas that impact patient safety such as medication administration. The leadership team has identified the low performers and in collaboration with the advanced practice nurses developed an on-line learning module to increase critical thinking and clinical judgment in medication administration. Reassessment is currently in progress to ensure patient safety in medication administration. Individual nurse's results were analyzed and themes related to the nursing interventions are currently being initiated for higher-level competencies.

Author Details

Stephanie Mearns, MN, BSN, RN; Anastasia Fisher, PhD, MN, BSN; Allen J. Orsi, PhD, RN

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Education, Quality, Safety

Conference Name

24th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Prague, Czech Republic

Conference Year

2013

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All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

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Advancing the culture of competency to improve patient outcomes and drive patient safety

Prague, Czech Republic

Session presented on: Monday, July 22, 2013:

Purpose: Expectations that nurses be competent have always been a part of professional codes and standards, licensing and accreditation requirements and, are a key component of the profession's social contract. The purpose of this presentation is to describe the preliminary results of our project exploring ways to assess and document professional nursing competencies to assure safe, quality nursing practice. The QSEN (Quality Safety Education in Nursing) competencies were used as a guiding framework.

Methods: Current staff nurse competencies were assessed using two strategies: 1) a written assessment and 2) an observed standardized patient clinical scenario. Both written assessment and observed clinical scenario were developed using QSEN and assessed core knowledge, ability to analyze and synthesize information and make an appropriate clinical judgment. The written assessment consisted of 50 questions developed using the QSEN competencies with a possible score of 0-50 and the scenario assessed 63 behaviors and attitudes with a possible score of 0-63.

Results: The mean on the written assessment (37 + 4) and the observed standardized clinical scenario (mean 39 + 3)) was surprisingly low. Further analyses of the subscales show the lowest scores in quality improvement/safety (mean=24.5 + 2) with the safe medication administration performance lower than the other areas. Nurses performed better in patient-centered care (mean= 37.5 + 2) and evidence based practice (mean=40+ 3).

Conclusion: Nurse competencies were below expected level particularly in areas that impact patient safety such as medication administration. The leadership team has identified the low performers and in collaboration with the advanced practice nurses developed an on-line learning module to increase critical thinking and clinical judgment in medication administration. Reassessment is currently in progress to ensure patient safety in medication administration. Individual nurse's results were analyzed and themes related to the nursing interventions are currently being initiated for higher-level competencies.