Patient Safety and Improving Quality Discussion

DISCUSSION RUBRIC 50 Points PURPOSE: Discussions are designed to promote dialogue between faculty and students, and students and their peers. In the discussions, students: • Demonstrate understanding of concepts for the week • Integrate scholarly resources • Engage in meaningful dialogue with classmates • Express opinions clearly and logically, in a professional manner PARTICIPATION REQUIREMENT: You are required to post a minimum of three (3) times in each graded discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. MT on Wednesday. PARTICIPATION POINTS: It is expected that you will meet the minimum participation requirement described above.

If not: • You will receive a 10%-point deduction in a discussion if your response to the initial question is not posted by 11:59 p.m. MT on Wednesday. • You will also receive a 10%-point deduction in a discussion if you do not post at least three (3) times in each discussion on at least two (2) separate days. Discussion Criteria Answers the initial graded discussion question(s)/topic(s), demonstrating knowledge and understanding of concepts for the week. 16 points Integrates evidence to support discussion. Sources are credited. Patient Safety and Improving Quality Discussion

* (APA format not required) 12 points A (100%) Outstanding or highest level of performance Addresses all aspects of the initial discussion question(s) applying experiences, knowledge, and understanding regarding all weekly concepts. 16 points Integrates evidence to support your discussion from: • assigned readings** OR online lessons, AND • at least one outside scholarly source. *** Sources are credited. * 12 points B (87%) Very good or high level of performance Addresses most aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of most of the weekly concepts. 14 points C (76%) Competent or satisfactory level of performance Addresses some aspects of the initial discussion question(s) applying experiences, knowledge, and understanding of some of the weekly concepts. 12 points Integrates evidence to support discussion from: • assigned readings OR online lesson. Sources are credited. * 10 points Integrates evidence to support discussion only from an outside source with no mention of assigned reading or lesson. Sources are credited. * 9 points F (0) Poor or failing or unsatisfactory level of performance Minimally addresses the initial discussion question(s) or does not address the initial question(s). 0 points Does not integrate any evidence. 0 points Revised 10/19 AM, VD, KC, CM Engages in meaningful dialogue with classmates or instructor before the end of the week. 14 points Responds to a classmate and/or instructor’s post furthering the dialogue by providing more information and clarification, thereby adding much depth to the discussion. 14 points Presents information using clear and concise language in an organized manner Communicates in a professional (minimal errors in manner. English grammar, 8 points spelling, syntax, and punctuation). 8 points Responds to a classmate and/or instructor furthering the dialogue by adding some depth to the discussion. 12 points Presents information in an organized manner (few errors in English grammar, spelling, syntax, and punctuation). Patient Safety and Improving Quality Discussion

7 points Responds to a classmate and/or instructor but does not further the discussion. 10 points No response post to another student or instructor. 0 points Presents information using understandable language but is somewhat disorganized (some errors in English grammar, spelling, syntax, and punctuation). 6 points Presents information that is not clear, logical, professional or organized to the point that the reader has difficulty understanding the message (numerous errors in English grammar, spelling, syntax, and/or punctuation). 0 points PARTICIPATION: Response to initial question: Responds to initial discussion question(s) by Wednesday, 11:59 p.m. M.T. 0 points lost Student posts an answer to the initial discussion question(s) by Wednesday, 11:59 p.m. MT. -5 points Student does not post an answer to the initial discussion question(s) by Wednesday, 11:59 p.m. MT. PARTICIPATION Total posts: Participates in the discussion at least three times on at least two different days. 0 points lost Posts in the discussion at least three times AND on two different days. -5 points Posts fewer than three times OR does not participate on at least two different days. NOTES: * Credited means stating where the information came from (specific article, text, or lesson). Examples: Our text discusses…. Patient Safety and Improving Quality Discussion

The information from our lesson states…, Smith (2019) claimed that…, Mary Manners (personal communication, November 17, 2020) …. APA formatting is not required. ** Assigned readings are those listed on Assigned Readings page. This may include text readings, articles, or websites. *** Scholarly source – per the APA Guidelines in Program Resources, only scholarly sources should be used in assignments. These include peer reviewed publications, government reports, or sources written by a professional or scholar in the field. Wikipedia, Wikis, .com website or blogs should not be used as anyone can add to these. For the discussions, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. Outside sources do not include assigned readings. NOTE: A zero is the lowest score that a student can be assigned. Revised 10/19 AM, VD, KC, CM The Essentials of Baccalaureate Education for Professional Nursing Practice October 20, 2008 TABLE OF CONTENTS Executive Summary 3 Background Nursing Education The Discipline of Nursing Assumptions Roles for the Baccalaureate Generalist Nurse Preparation for the Baccalaureate Generalist Nurse: Components of the Essentials 5 6 7 8 8 The Essentials of Baccalaureate Education for Professional Nursing Practice I. Liberal Education for Baccalaureate Generalist Nursing Practice II. Basic Organizational and Systems Leadership for Quality Care and Patient Safety 10 10 13 III. Scholarship for Evidence­Based Practice 15 IV. Information Management and Application of Patient Care Technology 17 V. 20 Healthcare Policy, Finance, and Regulatory Environments VI. Interprofessional Communication and Collaboration for Improving Patient Health Outcomes 22 VII. Clinical Prevention and Population Health 23 VIII. Professionalism and Professional Values 26 IX. Baccalaureate Generalist Nursing Practice 29 Expectations for Clinical Experiences within the Baccalaureate Program 33 1 Summary 35 Glossary 36 References 40 Appendix A: Task Force on the Revision of the Essentials of Baccalaureate Education for Professional Nursing Practice 45 Appendix B: Consensus Process to Revise the Essentials of Baccalaureate Education for Professional Nursing Practice 46 Appendix C: Participants who Attended Stakeholder Meetings 47 Appendix D: Schools of Nursing that Participated in the Regional Meetings 49 Appendix E: Professional Organizations that Participated in the Regional Meetings 60 Appendix F: Healthcare Systems that Participated in the Regional Meetings 61 2 Executive Summary The Essentials of Baccalaureate Education for Professional Nursing Practice (2008) This Essentials document serves to transform baccalaureate nursing education by providing the curricular elements and framework for building the baccalaureate nursing curriculum for the 21st century. Patient Safety and Improving Quality Discussion

These Essentials address the key stakeholders’ recommendations and landmark documents such as the IOM’s recommendations for the core knowledge required of all healthcare professionals. This document emphasizes such concepts as patient­centered care, interprofessional teams, evidence­based practice, quality improvement, patient safety, informatics, clinical reasoning/critical thinking, genetics and genomics, cultural sensitivity, professionalism, and practice across the lifespan in an ever­changing and complex healthcare environment Essentials I­IX delineate the outcomes expected of graduates of baccalaureate nursing programs. Achievement of these outcomes will enable graduates to practice within complex healthcare systems and assume the roles: provider of care; designer/manager/coordinator of care; and member of a profession. Essential IX describes generalist nursing practice at the completion of baccalaureate nursing education. This Essential includes practice­focused outcomes that integrate the knowledge, skills, and attitudes delineated in Essentials I – VIII. The time needed to accomplish each Essential will vary, and each Essential does not require a separate course for achievement of the outcomes. The nine Essentials are: · Essential I: Liberal Education for Baccalaureate Generalist Nursing Practice o A solid base in liberal education provides the cornerstone for the practice and education of nurses. · Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety o Knowledge and skills in leadership, quality improvement, and patient safety are necessary to provide high quality health care. · Essential III: Scholarship for Evidence Based Practice o Professional nursing practice is grounded in the translation of current evidence into one’s practice. · Essential IV: Information Management and Application of Patient Care Technology o Knowledge and skills in information management and patient care technology are critical in the delivery of quality patient care. · Essential V: Health Care Policy, Finance, and Regulatory Environments o Healthcare policies, including financial and regulatory, directly and indirectly influence the nature and functioning of the healthcare system and thereby are important considerations in professional nursing practice. Patient Safety and Improving Quality Discussion

· Essential VI: Interprofessional Communication and Collaboration for Improving Patient Health Outcomes o Communication and collaboration among healthcare professionals are critical to delivering high quality and safe patient care. 3 · · · Essential VII: Clinical Prevention and Population Health o Health promotion and disease prevention at the individual and population level are necessary to improve population health and are important components of baccalaureate generalist nursing practice. Essential VIII: Professionalism and Professional Values o Professionalism and the inherent values of altruism, autonomy, human dignity, integrity, and social justice are fundamental to the discipline of nursing. Essential IX: Baccalaureate Generalist Nursing Practice o The baccalaureate­graduate nurse is prepared to practice with patients, including individuals, families, groups, communities, and populations across the lifespan and across the continuum of healthcare environments. o The baccalaureate graduate understands and respects the variations of care, the increased complexity, and the increased use of healthcare resources inherent in caring for patients. Learning opportunities, including direct clinical experiences, must be sufficient in breadth and depth to ensure the baccalaureate graduate attains these practice­focused outcomes and integrates the delineated knowledge and skills into the graduate’s professional nursing practice. Clinical learning is focused on developing and refining the knowledge and skills necessary to manage care as part of an interprofessional team. Simulation experiences augment clinical learning and are complementary to direct care opportunities essential to assuming the role of the professional nurse. A clinical immersion experience provides opportunities for building clinical reasoning, management, and evaluation skills. 4 Introduction The Essentials of Baccalaureate Education for Professional Nursing Practice provides the educational framework for the preparation of professional nurses. This document describes the outcomes expected of graduates of baccalaureate nursing programs. The Essentials apply to all pre­licensure and RN completion programs, whether the degree is baccalaureate or graduate entry. Program curricula are designed to prepare students to meet the end­of­program outcomes delineated under each Essential. Background The healthcare delivery system has changed dramatically since The Essentials of Baccalaureate Education for Professional Nursing Practice was endorsed by the American Association of Colleges of Nursing (AACN, 1998). Patient Safety and Improving Quality Discussion

Building a safer healthcare system has become the focus of all health professions following numerous reports from the Institute of Medicine (IOM, 2000, 2001, 2004), American Hospital Association (2002), Robert Wood Johnson Foundation (Kimball & O’Neill, 2002), the Joint Commission (2002) and other authorities. Nursing has been identified as having the potential for making the biggest impact on a transformation of healthcare delivery to a safer, higher quality, and more cost­effective system. With the increasing awareness of the need for change in the healthcare system, the clinical microsystems (small, functional units where care is provided within the larger system) have become an important focus for improving healthcare outcomes (Nelson, Batalden, & Godfrey, 2007). In addition to the concern over healthcare outcomes, the United States and the global market are experiencing a nursing shortage that is expected to intensify as the demand for more and different nursing services grows. Buerhaus, Staiger, and Auerbach (2008) reported that the U.S. may experience a shortage of more than 500,000 registered nurses by the year 2025. Despite annual increases in enrollments in entry­level baccalaureate nursing programs since 2001 (Fang, Htut, & Bednash, 2008), these increases are not sufficient to meet the projected demand for nurses. According to Buerhaus et al. (2008), enrollment in nursing programs would have to increase at least 40% annually to replace the nurses expected to leave the workforce through retirement alone. Addressing the need for an increased number of baccalaureate­prepared nurses is critical but not sufficient. Nursing must educate future professionals to deliver patient­centered care as members of an interprofessional team, emphasizing evidence­based practice, quality improvement approaches, and informatics (IOM, 2003b). Nursing education and practice must work together to better align education with practice environments (Joint Commission, 2002, Kimball & O’Neill, 2002;). The environments in which professional nurses practice have become more diverse and more global in nature. Scientific advances, particularly in the areas of genetics and 5 genomics, have had and will continue to have a growing and significant impact on prevention, diagnosis, and treatment of diseases, illnesses, and conditions. The increased prevalence of chronic illness is a result of an increasingly older adult population, environmental threats, lifestyles that increase risk of disease, and enhanced technological and therapeutic interventions that prolong life. Increases in longevity of life have made the older adult the fastest growing segment of the population. In 2003, 12 % of the population was older than 65 years of age. By 2030, this population will increase to 20%, with a large majority older than 80 years of age (He, Sengupta, Velkoff, & DeBarros, 2005). Those older than 65 years of age had almost four times the number of hospitalization days than those younger than 65 years of age (Centers for Disease Control, 2007) Education for the baccalaureate generalist must include content and experiences across the lifespan, including the very young who are especially vulnerable. The percentage of the population under 18 years of age is 24.6% (U.S. Census Bureau, 2008). U.S. infant mortality in 2006 ranked 38th in the world (World Health Organization, 2008). Patient Safety and Improving Quality Discussion

Prevention is critical in addressing both acute and chronic conditions across the lifespan. The role of the nurse in prevention continues to be of utmost importance. Increasing globalization of healthcare and the diversity of this nation’s population mandates an attention to diversity in order to provide safe, high quality care. The professional nurse practices in a multicultural environment and must possess the skills to provide culturally appropriate care. According to the U.S. Census Bureau (2008), the nation’s minority population totaled 102 million or 34% of the U.S. population in 2006. With projections pointing to even greater levels of diversity in the coming years, professional nurses need to demonstrate a sensitivity to and understanding of a variety of cultures to provide high quality care across settings. Liberal education, including the study of a second language, facilitates the development of an appreciation for diversity. Strong forces influencing the role of nurses include: · scientific advances, particularly in the area of genetics and genomics, · changing demographics of patient populations, · new care technologies, and · patient access to healthcare information. These forces call for new ways of thinking and providing health care. Nursing is uniquely positioned to respond to these major forces, requiring an increased emphasis on designing and implementing patient­centered care, developing partnerships with the patient, and a focus on customer service. Nursing Education In response to calls for transforming the healthcare system and how healthcare professionals are educated, AACN has maintained an ongoing dialogue with a broad representation of stakeholders internal and external to nursing. The dialogue has focused on the knowledge, skills, and attitudes needed by nurses to practice effectively within this 6 complex and changing environment. New innovative models of nursing education have emerged, and AACN has taken a leadership role in crafting a preferred vision for nursing education. In 2004, the AACN Board of Directors reaffirmed its position that baccalaureate education is the minimum level required for entry into professional nursing practice in today’s complex healthcare environment. Baccalaureate generalist education, as defined in this document, is the foundation upon which all graduate nursing education builds. The preferred vision for nursing education includes generalist, advanced generalist, and advanced specialty nursing education. vPatient Safety and Improving Quality Discussion

Generalist nurse education occurs at a minimum in baccalaureate­degree nursing programs. Advanced generalist education occurs in master’s degree nursing programs, including the Clinical Nurse Leader (CNL®), which is an advanced generalist nursing role. Advanced specialty education occurs at the doctoral level in Doctor of Nursing Practice (DNP) or research­focused degree programs (PhD, DNS, or DNSc). End­of­program outcomes for the baccalaureate, master’s, and doctoral nursing programs build on each other. The Discipline of Nursing Roles for the baccalaureate generalist nurse are derived from the discipline of nursing. The roles of the baccalaureate generalist include: · provider of care, · designer/manager/coordinator of care, and · member of a profession. Nursing generalist practice includes both direct and indirect care for patients, which includes individuals, families, groups, communities, and populations. Nursing practice is built on nursing knowledge, theory, and research. In addition, nursing practice derives knowledge from a wide array of other fields and professions, adapting and applying this knowledge as appropriate to professional practice. In the senior college and university setting, every academic discipline is grounded in discrete inquiry­based applications that are distinctive to that discipline. Scientific advances, (particularly in the area of genetics and genomics), changing demographics ..Patient Safety and Improving Quality Discussion