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QSEN and Simulation: Two Great Tastes that Go Great Together

The Quality and Safety Education for Nurses (www.qsen.org) project helps ensure that the nursing curriculum is evidence based and realistic. When considering the role of simulation in the curriculum, most would agree that being evidence-based and realistic are essential characteristics.

QSEN is a collection of six competencies that are categorized by knowledge, skills and attitudes. The website is a phenomenal resource complete with learning activities for each competency.

Let's take a closer look at each of the six competencies through the lens of simulation as a means of enhancing lab-based learning across the curriculum.

Patient-centered care (PCC) addresses the need of the nurse to completely partner with the client. One attitude listed in the PCC section of the QSEN competencies states "value the patient's expertise with own health and symptoms." Ask students to ensure that PCC is demonstrated in their documentation of every simulation. For instance, in the Simulation Learning System, the students care for Annamarie Zerby, a 44-year-old female suffering from chest pain. The students would be asked to include statements by the client that demonstrate 'her' expertise with her health. Then in debriefing they will need to demonstrate/discuss how they acted on that information.

Teamwork and collaboration discusses the importance of team members empowering and appreciating other healthcare professionals to the benefit of the patient. One example in SimChart is have the students discover that the nurse's assistant entered the vitals for another patient. The student nurse then needs to discuss this with the aide and incorporate acknowledgment of their positive contributions as well as the shortcoming.

Evidence-based practice (EBP) is fully learned if the students can create habits of continuously addressing the current literature in all aspects of patient care. It is for this reason that students in every simulation should consult the evidence-base. In SimChart, as the students are completing their documentation, they should be reminded to always access the Resources section. In debriefing ask them what part of the resources were accessed and how that was connected to the care they provided for the client. By developing this habit in the EHR part of the simulation, the students are more likely to do this as professionals in practice.

Quality improvement calls for the nurse to be involved in improving processes. Students learn a great deal when allowed to assess the practice of other students. As part of all simulations, whether in group simulation or in an observer role, ask students to consider a process change/implementation in the patient care experience that could improve quality. Ask them to provide a basic outline of how the impact of the change would be measured and what would they do with the findings.

Safety involves addressing risks to the client and their desired outcomes. Allow the students to address potential or actual home safety concerns on a patient. In one SLS scenario, students will care for Ivan Emoto, a 67-year-old male admitted with congestive heart failure exacerbation. Ask the students to go into SimChart into Patient Education. They develop a teaching plan to include teaching methods and outcomes that address safety at home. Ask the students to prioritize what is taught to help minimize risk when Mr. Emoto goes home.

Informatics is the sixth competency and helps the student begin to appreciate how technology can affect patient care and subsequent outcomes. In this area, it helps for the students to be in the client's shoes. In the SLS, students care for Mr. Arthur Harris with diabetes. Ask the students to identify and download on their phone an app (application) that the client could use to help control his diabetes. Have them talk about the pros and cons of the app and ask them to spend a day 'simulating' using the app as if they were Mr. Harris.

Faculty assist students and other educators appreciate the QSEN connection by overtly listing competencies when managing/engaging the simulation. In SimChart when creating a learning activity, the very first step allows faculty to choose the QSEN competencies involved. This helps faculty and students alike remember this important connection.

By selecting a QSEN competency (or 2) for each learning experience or simulation, there is an increased assurance that evidence-based practice and realism are being included. Start today by visitng www.QSEN.org.

Tim Bristol,

PhD, RN, CNE, FAAN

For more tips and resources from Tim Bristol, click here.

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