Zonsius Mary C, Miller Joanne M, Lamb Karen V
Department of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, Illinois.
J Am Assoc Nurse Pract. 2019 Nov 5;33(1):57-65. doi: 10.1097/JXX.0000000000000314.
Current trends dictate that advanced practice registered nurses (APRNs) must be competent to address quality/safety issues specific to older adults. A gap analysis and review of key competencies in an adult-gerontology APRN-Doctorate of Nursing Practice (DNP) curriculum prompted the design and evaluation of an innovative online course, Quality and Safety for the Aging Adult. Course objectives align with key competencies, including graduate-level Quality and Safety Education for Nurses (QSEN) and the DNP Essentials. The course purpose was to prepare adult-gerontology APRN-DNP students as leaders to promote quality/safety outcomes for aging adults. The six-step Knowledge-to-Action Framework guided course development and evaluation. Select graduate-level QSEN competencies were used to construct a 20-item Quality and Safety Survey (4-point Likert scale) (Cronbach's alpha, 0.916). This survey was used during week 1 (pre) and week 15 (post) of the semester to evaluate students' preparation and confidence to perform key QSEN competencies. Significant improvements (p < .000) between pre/post scores on the Quality and Safety Survey were found across five classes. Students felt more prepared and confident to apply selected QSEN competencies on course completion. Moreover, nearly 60% (primary care) and nearly 35% (acute care) adult-gerontology APRN students selected the older adult population for their DNP projects. The Quality and Safety for the Aging Adult course positively influenced five classes of adult-gerontology APRN-DNP students. Integrating QSEN competencies with gerontology and quality/safety content is an effective strategy to prepare APRNs to lead quality/safety initiatives in aging adults. This innovative online course offers a successful model for innovative DNP education of adult-gerontology APRNs.
当前趋势表明，高级执业注册护士（APRNs）必须有能力解决老年人特有的质量/安全问题。对成人-老年护理高级实践护士-护理实践博士（DNP）课程中的关键能力进行差距分析和审查后，促使设计并评估了一门创新的在线课程《老年人的质量与安全》。课程目标与关键能力相一致，包括研究生水平的护士质量与安全教育（QSEN）和DNP核心要素。该课程的目的是培养成人-老年护理高级实践护士-DNP学生成为领导者，以促进老年人的质量/安全成果。六步知识到行动框架指导了课程的开发和评估。选择了研究生水平的QSEN能力来构建一份包含20个项目的质量与安全调查问卷（4点李克特量表）（克朗巴哈系数为0.916）。该调查问卷在学期第1周（课前）和第15周（课后）使用，以评估学生在执行关键QSEN能力方面的准备情况和信心。在五个班级中发现，质量与安全调查问卷的课前/课后得分有显著提高（p < .000）。学生们在课程结束时感觉更有准备和信心应用所选的QSEN能力。此外，近60%（初级保健）和近35%（急性护理）的成人-老年护理高级实践护士学生在他们的DNP项目中选择了老年人群体。《老年人的质量与安全》课程对五个班级的成人-老年护理高级实践护士-DNP学生产生了积极影响。将QSEN能力与老年医学以及质量/安全内容相结合是培养高级实践注册护士在老年人中引领质量/安全倡议的有效策略。这一创新的在线课程为成人-老年护理高级实践护士的创新DNP教育提供了一个成功的模式。
