Implementation of Quality & Safety
Competencies in ADN Curriculum
St. John’s College of Nursing of
Southwest Baptist University
Springfield, Missouri
June 2008
Pilot Team: Teresa Russell, Rebecca Miller &
Tonyha Sumners
QSEN Projects: Faculty
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QSEN Fact Sheet
QSEN Reference Manual in Faculty Lounge
QSEN Pilot Team Report @ monthly faculty
meetings
Incorporated QSEN into annual faculty course
reports (Systematic Evaluation)
Established alliance with practice partner QI VP
First Touch TM
Faculty accepted QSEN competencies as
threads in new curriculum
Faculty retreat on Simulation (May 2008)
QSEN Projects: Students
 QSEN
Fact Sheet
 QSEN Terminology prior to survey
 SBAR
 First Touch TM
 Clinical Evaluation Tool (new curriculum)
 Development of Process Audit Tool
 Interdisciplinary experiences senior level
students
Primary Practice Partner:
St. John’s Health System

One of the Nation's Top 3 Integrated Health
Systems
St. John’s is a Springfield, MO - based
integrated health system, serving the residents
of southwest Missouri and northern Arkansas
since 1891.
 More than 10,000 co-workers, 460 physicians
and 1,100 volunteers work together to fulfill St.
Johns' mission of improving the health and
quality of the communities we serve, with a
particular concern for those who are
economically poor.
Introduction to Quality & Safety
Fundamentals of Nursing Students
Goal:
Incorporate components of QSEN KSA’s
into workplace orientation through
collaboration with primary practice partner.
Background
 Faculty
education regarding QSEN
activities and KSA’s
 Assessment of current compliance with
KSA’s
 Discussion with practice partner (VP
Quality and Nursing Administration)
regarding current monitoring activities
reflective of Quality and Safety initiatives
 Review of proposal for curriculum revision
Approaches
 QSEN
concepts and KSA’s introduced
within first 2 weeks of the Fundamentals of
Nursing course.
 Process and observation audits integrated
into patient care unit orientation.
References
 QSEN
articles and web site
 Healthcare agency nursing process audits
tools
 Healthcare agency quality department
audit tools
 Literature search for tools
Contents of Audit Tool
Introduction to:
 Patient Care Environment: Focus- Safety,
Teamwork, & Collaboration
 Medical Record: Focus-Quality &
Informatics
 Patient Care Focus-Patient Centered Care
& Evidence Based Practice
Patient Care Environment: FocusSafety, Teamwork & Collaboration
Examples:
 Conversations by staff in rooms, hallways, and
other areas are conducted quietly and
professionally
 Examples of Crucial Conversations heard
 Examples of conversations between disciplines
 Hallways are free of equipment and/or objects
that might impede patient/visitor movement
 All patient care equipment/supplies are located
to provide for patient privacy and safety
Medical Record: Focus-Quality &
Informatics
Examples:

Pain is assessed on admission
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Vital Signs are taken per hospital policy

I & O is documented every shift

Restraint flow sheet is completed per
hospital policy
Patient Care Focus-Patient Centered
Care & Evidence Based Practice
Examples:

IV in place less than 96 hours
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IV location promotes comfort and
safety for patient
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IV device used is appropriate for
patient’s therapy
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IV dressing is dry and intact

Hand washing foam/gel is available in
patient’s room and outside door
Patient Care Focus-Patient Centered
Care & Evidence Based Practice
Examples:

Staff going in and out of patient’s room
are using proper hand hygiene

Call lights are answered within 1-2
minutes

Patients and visitors are greeted and
assisted in ways that exemplify the
components of First Touch
First Touch TM
Patient-centered care
 Practice Partner/Press Ganey Results

Patient Satisfaction averaged at the 50th
percentile
 Website:
http://www.first-touch.org/
 Implementation with faculty/students
The Basics of First Touch TM
 How
we view others
 The first introduction
 Establishing presence
 Touch
 Retouch
 Handoffs
First Touch Education
Fundamentals of Nursing Students
 A survey
tool containing Likert scale and
qualitative comment items was developed
to measure student understanding of
major concepts of First Touch
 The tool was administered immediately
following initial education and again
immediately following students’
Fundamentals of Nursing clinical
practicum
Survey Results
 Initial

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findings:
Understanding of major concepts
Qualitative comments were primarily
paraphrased from presentation information
 Post-clinical
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findings:
Loss of understanding of 1 major conceptRetouch
Qualitative comments reflected purpose and
intent of First Touch TM Program
Student Comments Post-Clinical
How We View Others:
 “By relaying a positive message to the
next care provider it sets a positive tone
for care for the next shift”
 “It allowed me to provide unbiased care”
 “The next person taking care of my patient
wasn’t dreading going into the room”
The Implementation of Quality & Safety
Competencies in ADN Curriculum at
St. John’s College of Nursing of
Southwest Baptist University has been
influenced by participation in the Quality
& Safety Education for Nurses funded by
the Robert Wood Johnson Foundation
Pilot Schools Collaborative
Vote St. John’s College of Nursing
For
Most Effective Clinical Partnership Award
+
=
RN