Incorporate the New 2010
NLN Framework!
Sue Field DNP, RN
http://fieldsue.com
Objectives: Attendees will
• Analyze methods to
– implement core values, integrating concepts,
and program learner outcomes
of the 2010 NLN Educational Competencies
Model into a nursing program.
• Formulate a plan to
– facilitate faculty group involvement in the
implementation of the
2010 NLN Educational Competencies Model.
Journey to the Templates
1. NLNAC Initial Accreditation
Less than desirable Framework
2. Consultants
– June Larson: Chair of the NLN Outcomes and
Competencies Committee
– Denise Hirst: Project Manager for QSEN
3. Presentation at the NLN National Conference
2011
4. 6 hour workshop in North Carolina in March 2012
5. Article written for publication
National Standards
• IOM (Institute of Medicine) report in 2003
• IOM report in 2011
• QSEN (Quality Safety Education in
Nursing) 2005
– 5 outcomes of IOM + Safety
National Standards
• Carnegie Study:
– Educating Nurses a Call for Radical
Transformation: Benner, Sutphen, Leonard &
Day (2010)
• NLN Outcomes and Competencies (2010)
• Benner’s article last month
– Knowledge
– Practice (Skills)
– Ethical Component (Attitude)
NLN Framework
Purchase
• National League for Nursing.
(2010). Outcomes and
competencies for graduates of
practical/vocational, associate
degree, baccalaureate, master’s,
practice doctorate, and research
doctorate programs in nursing.
NLN.
• http://www.nln.org/facultydevelopmen
t/competencies/index.htm
Student Learner Outcomes
1.
2.
3.
4.
Human Flourishing
Nursing Judgment
Professional Identify
Spirit of Inquiry
Professional Identity
Student Learner Outcomes PN to PhD
PN/VOC
Assess
how one’s
personal
strengths
and
values…
ADN/
DIP
BS
MASTER
PRACTICE RESEARCH
DOC
DOC
Implement Express Implement As a nurseone’s role one’s
one’s
scholar, seek
as a nurse identity advanced
ways to
in ways…
as a
practice
translate
nurse …
role…
research
findings into
practice…
Implement
one’s role
as a
research
scholar
committed
…
Human Flourishing
Practical Nursing
Program
Programs
Learner
Learner
Outcomes
Outcomes
Promote the
human dignity,
integrity, self
determination,
Human
and
personal
Flourishing
growth of patients,
oneself, and
members of the
health care team.
Associate Degree
Nursing Programs
Learner Outcomes
Advocate for patients
and families in ways
that promote their selfdetermination,
integrity, and ongoing
growth as human
beings.
Nursing Judgment
Practical Nursing
Program
Programs
Learner
Outcomes Learner Outcomes
Associate Degree
Nursing Programs
Learner Outcomes
Provide a rationale
for judgments used
in the provision of
safe, quality care and
Nursing for decisions that
Judgment promote the health
of patients within a
family context.
Make judgments in
practice, substantiated
with evidence, that
integrate nursing
science in the provision
of safe, quality care and
that promote the health
of patients within a
family and community
Professional Identity
Program
Learner
Outcomes
Practical
Nursing
Programs
Associate Degree
Nursing Programs
Learner Outcomes
Learner
Outcomes
Assess how one’s
personal strengths
and values affect
one’s identity as a
Professional nurse and one’s
contributions as a
Identity
member of the
health care team.
Implement one's role as a
nurse in ways that reflect
integrity, responsibility,
ethical practices, and an
evolving identity as a nurse
committed to evidence-based
practice, caring, advocacy,
and safe, quality care for
Spirit of Inquiry
Practical Nursing
Program
Programs
Learner
Learner
Outcomes
Outcomes
Question the
basis for nursing
actions,
Spirit
considering
research,
of
evidence,
tradition, and
Inquiry patient
preferences.
Associate Degree
Nursing Programs
Learner Outcomes
Examine the evidence that
underlies clinical nursing
practice to challenge the
status quo, question
underlying assumptions,
and offer new insights to
improve the quality of care
for patients, families, and
communities.
QSEN Outcomes (2005)
• 1. QSEN: Patient Centered Care Student will
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
need
• 2. QSEN: Safety Student will minimize risk of
harm to patients and providers through both
system effectiveness and individual
performance.
QSEN Outcomes…
• 3. QSEN: Informatics The student will use
information and technology to communicate,
manage knowledge, mitigate error, and support
decision making.
• 4. QSEN: Teamwork and Collaboration
Student will function effectively within nursing
and inter-professional teams, fostering open
communication, mutual respect, and shared
decision-making to achieve quality patient care.
QSEN Outcomes…
• 5. QSEN: Quality Improvement
• Student will use data to monitor the outcomes of
care processes and use improvement methods
to design and test changes to continuously
improve the quality and safety of health care
systems.
• 6. QSEN: Evidence Based Practice
• Student will integrate best current evidence with
clinical expertise and patient/family preferences
and values for delivery of optimal health care.
QSEN and NLN
Competencies and Outcomes
• NLN: Human Flourishing
– QSEN: Patient Centered Care
• NLN Nursing Judgment
– QSEN: Safety
– QSEN: Informatics
• NLN Personal/Professional identity
– QSEN: Teamwork and Collaboration
• NLN Spirit of Inquiry
– QSEN: Quality Improvement
– QSEN: Evidence Based Practice
NAPNES PN
Student Learner Outcomes
• From NAPNES
– May 6, 2007
– 5 years old
• Need to be up to date with latest
standards including
–QSEN
–NLN Outcomes and Competencies
NAPNES PN Outcomes (2007)
1. Demonstrate professional behaviors of
accountability and professionalism according
to the legal and ethical standards for a
competent licensed practical/vocational nurse.
2. Effectively communicate with patients,
significant support person(s), and members of
the interdisciplinary health care team
incorporating interpersonal and therapeutic
communication skills.
NAPNES…
3. Collect holistic assessment data from
multiple sources, communicate the data to
appropriate health care providers, and evaluate
client responses to interventions.
4. Collaborate with the registered nurse or other
members' of the health care team to organize
and incorporate assessment data to plan/ revise
patient care and actions based on established
nursing diagnoses, nursing protocols, and
assessment and evaluation data.
NAPNES…
5. Demonstrate a caring and empathic
approach to the safe, therapeutic, and
individualized care of each client
6. Implement patient care, at the direction
of a registered nurse, licensed physician or
dentist through performance of nursing
interventions or directing aspects of care,
as appropriate, to unlicensed assistive
personnel (UAP).
Missing from NAPNES
• 1. Patient Centered Care and Human
Flourishing
• 2. Quality Improvement and Spirit of Inquiry
• 3. Informatics
• 4. Evidence Based Practice/Research
• 5. Safety: Mitigate errors
• 6. Nursing Judgment
NLN 2000 AD Learner Outcomes
• 1. Practice within the ethical, legal and
regulatory framework of nursing and
standards of nursing practice.
• 2. Demonstrate caring behaviors toward
the patient, significant support persons
and members of the health care team
• 3. Demonstrate accountability for nursing
care given by self and or delegated to
others.
NLN 2000 AD Learner Outcomes
• 4. Utilize therapeutic communication skills
in professional relationships.
• 5. Utilize the nursing process to provide
individualized nursing care in diverse
settings.
• 6. Utilize critical thinking to make clinical
judgments and management decisions to
provide safe, appropriate and
individualized care.
NLN 2000 AD Learner Outcomes
• 7. Develop individualized teaching plans
based on assessed patient needs.
• 8. Collaborate with the patient, support
persons, as well as members of the
healthcare team to assist the patient to
achieve optimal outcomes.
• 9. Develop personal goals for professional
development and participate in lifelong
learning.
Missing from 2010 NLN
• 1. Patient Centered Care and Human
Flourishing
• 2. Quality Improvement and Spirit of
Inquiry
• 3. Informatics
• 4. Evidence Based Practice/Research
• 5. Safety: Mitigate errors
• 6. Nursing Judgment
Course Templates
• http://fieldsue.com
• Templates at website above.
1st Step Course Outcomes
• 1. List the Course Outcomes
– A. Identify the learning activities
– B. Identify the measurements
– C. Identify the student learner outcomes are
related to the course outcomes.
Course Outcomes
• Example of Outcomes to Assignments
1. The Core Values
1. Present in your Philosophy Statement
2. Flow through your Curriculum
Core Values Template Example
2. Integrating Concepts
• NLN outcomes and competencies book
(2010)
• Suggested statements are listed
– for EACH of the 6 integrating concepts
1. Context and Environment
2. Knowledge and Science
3. Personal/Professional Development
4. Quality and Safety
5. Relationship Centered Care
6. Teamwork
Three Apprenticeships
• Knowledge
• Practice Know How
• Ethical Comportment
– Benner: Do away with curricular threads and
implement 3 apprenticeships
Integrating Concepts
Three Apprenticeships
1. Context and Environment
–
–
–
Knowledge
Practice Know How
Ethical Comportment
2. Knowledge and Science
–
–
–
Knowledge
Practice Know How
Ethical Comportment
3. Personal/Professional
Development
–
–
–
Knowledge
Practice Know How
Ethical Comportment
4. Quality and Safety
–
–
–
Knowledge
Practice Know How
Ethical Comportment
5. Relationship Centered Care
–
–
–
Knowledge
Practice Know How
Ethical Comportment
6. Teamwork
–
–
–
Knowledge
Practice Know How
Ethical Comportment
Integrating Concepts Template Example
Program Learner Outcomes
• Needs to meet National Standards
• NAPNES from 2007 does not include
national standards
• QSEN and NLN Framework
QSEN and NLN
Competencies and Outcomes
•
•
•
•
•
•
QSEN
Patient Centered Care
Safety
Informatics
Teamwork and
Collaboration
Quality Improvement
Evidence Based Practice
NLN
• Human Flourishing
• Nursing Judgment
• Personal/Professional
identity
• Spirit of Inquiry
Student Learner Outcomes
• Need to demonstrate that EVERY student
that graduates has fulfilled the student
learner outcomes.
• Clinical/Program Portfolio is a great way to
prove this.
Student Learner Outcomes
Template 1
Student Learner Outcomes
Template 2
“How To’s”
Steps that might work for you and your
nursing program
How to: Part I
• PAIR faculty members
– Who teach the same courses
• Determine for each course outcome
– How the course outcome relates to the program
outcomes
– Determine the learning activities for the outcome and
– Determine the measurements used for the outcome
• See template next slide
How to: Part I
Course Template
How to: Part II Round Robin
• Arrange tables by integrating concepts
– Attach template to tables by integrating concepts
• Faculty pairs rotate through the stations.
– Faculty identify the course outcomes that fulfill
competencies listed
Context and
Environment
Relationship
Centered
Care
Teamwork
3
Apprenticeships
for each:
Knowledge
and Science
Knowledge
Practice
Ethical Comportment
Personal
Professional
Growth
Quality and
Safety
Part III: Compilation
• Compile all information on one document
Part IV: Program Learner
Outcomes
• Complete the Program Learner Outcomes
Template
– in a round robin
– similar to the Integrating Concepts Round Robin
Human
Flourishing
Spirit of
Inquiry
Nursing
Practice
Nursing
Judgment
Professional
Identify
Part V: Identify Apprenticeships
Missing Course Outcomes
• Identify apprenticeships that lack course
outcomes.
– Develop new course outcomes as needed
• Identify the new outcomes needed
– Evaluate BOTH the Apprenticeships AND the Learner
Outcomes Templates
– Be careful of Additive curriculum
» (May need to take something out of your curriculum)
• Develop learning activities for each
• Develop outcome measures for each
Templates
•
•
•
•
•
Template A:
Template 1.
Template 2.
Template 3.
Template B:
Course Templates
Core Competencies
Integrating Concepts
Learner Outcomes
Program Portfolio
References
•
•
•
•
•
•
•
•
Benner, P., Sutphen, M, Leonard-Kahn, V., Day, L. (2008, September).
Formation and everyday ethical comportment. American Journal of Critical
Care,17(5473), 473-476.
Benner, P., Sutphen, M, Leonard-Kahn, V., Day, L. (2010). Educating nurses
a call for radical transformation. San Francisco, CA: Jossey-Bass.
Benner, P., Tanner, C., Chesla, C. (2009). Expertise in nursing practice. (2nd
ed.). NY: Springer Publishing.
Caputi, L. (2010). Teaching nursing: The art and science. (2nd ed.).Glen
Ellyn, IL: College of DuPage Press.
Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J.,
Mitchell, P, & Warren, J. (2007). Quality and safety education for nurses.
Nursing Outlook, 55(3), 122-131.
Hirst, D. & Foster, B. (2009). Undergraduate curriculum mapping: Faculty
interactive approach using QSEN competencies. Poster presentation.
(Template modeled after Hirst & Foster’s work).
National League for Nursing. (2010). Outcomes and competencies for
graduates of practical/vocational, associate degree, baccalaureate,
master’s, practice doctorate, and research doctorate programs in nursing.
NLN. http://www.nln.org/facultydevelopment/competencies/index.htm
QSEN Quality and Safety Education for Nurses. http://www.qsen.org
• Questions???
• http://fieldsue.com/