Integrating QSEN and ACES:An NLN Simulation Leader Project

Abstract

CARING FOR THE SPECIAL NEEDS OF THE AGING ADULT IS AN INCREASINGLY IMPORTANT FOCUS IN NURSING EDUCATION. Knowledge continues to evolve, creating exciting learning opportunities for nursing students and challenges for nurse educators. one such challenge is to use simulation to operationalize knowledge around safe care of the aging adult. the 2010-2011 national League for nursing (nLn) Simulation Leader Curriculum integration team - nurse educators selected to participate in a yearlong simulation leadership development program - examined key issues in the design, development, use, and integration of simulation in nursing education. the group noted that resources to guide faculty on how to tailor simulation to incorporate competencies around quality and safety in care of the aging are not easily accessible. this article provides an overview of the resources developed by the team for SirC, the nLn Simulation innovation resource Center. it is intended as a guide to incorporate concepts of quality and safety education for nurses into an unfolding simulation focused on care of the aging adult. Background Quality and Safety Education for nurses (QSEn) addresses the nursing competencies needed to assure the quality and safety of patient care. adapted from the institute of Medicine (ioM) competencies for nursing (2003), QSEn outlines essential features of competent nursing practice (nursing competencies) to improve patient safety and quality in health care settings. the six QSEn competencies are: patient-Centered Care, teamwork and Collaboration, Evidence-Based practice, Quality improvement, Safety, and informatics (Cronenwett et al., 2007). Subsets of each QSEn competency include knowledge, skills, and attitudes achievable during the educational process. results of the QSEn national delphi Study (Barton, armstrong, preheim, Gelmon, & andrus, 2009) led to the leveling of QSEn competencies into beginner, intermediate, and advanced learning objectives for integration across a nursing curriculum. The use of an unfolding case study correlates well with a leveled approach in the teaching of quality and safety for care of the older adult. unfolding case studies expose students to multiple aspects of a clinical situation and promote problem solving using an experiential learning method (page, Kowlowitz, & alden, 2010). the curriculum integration team determined that a scenario that unfolded over time would be an ideal simulation exemplar to demonstrate the integration of beginner, intermediate, and advance level QSEn competencies in care of the aging adult client. The NLN, in partnership with the Community College of philadelphia and with funding from the John a. Hartford Foundation, Laerdal Medical, and the independence Foundation, developed the aCES (advancing Care Excellence for Seniors) project to teach nursing students how to care for the older adults. the aCES project features four cases that unfold over time, take place in a variety of health care settings, and require complex decisionmaking. the team determined that blending QSEn with aCES was a natural choice for the focus of the project. Millie Larsen (reese, 2010), one of four aCES cases, includes a web-based text document with links to audio files and other supportive information. aCES provides teaching tools, evidence-based resources, and, importantly, a framework for incorporating the complexities of caring for the aging adult. permission was granted by the nLn to utilize the aCES scenario featuring Millie for inclusion in the curriculum integration project. Millie Larsen's case unfolds in three scenarios, with settings in an outpatient clinic and in an acute care hospital. it concludes with conflict regarding discharge from the inpatient setting. the scenarios reveal a compelling story illustrating the interaction of the multiple factors that affect a geriatric client's health. table 1 illustrates how the simulation leader project integrated the QSEn competencies by level into Millie's unfolding health care encounters. …