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Группа авторов. Quality and Safety in Nursing
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Quality and Safety in Nursing. A Competency Approach to Improving Outcomes
We dedicate this work
Contributors
Foreword
References
Preface
References
About the Companion Website
1 Driving Forces for Quality and Safety: Changing Mindsets to Improve Health Care
Twenty Years Advancing Quality and Safety
The Call to Action: Institute of Medicine Quality Chasm Reports
Textbox 1.1 Summary: The Institute of Medicine Quality Chasm Series
Examining Progress: The Impact on Quality and Safety
Textbox 1.2 Eight Recommendations for Improving Quality and Safety
National Initiatives for Quality and Safety
The Compelling Case for Quality and Safety: A Systems Approach
Safety Science: Building a Safety Culture
Textbox 1.3 Error Classification
Safety Culture
Just Culture
A Systems Approach
High‐Reliability Organizations
Science of Improvement
Workforce: Impact of the Work Environment
Consumer Engagement
Textbox 1.4 Patient Engagement: Key to Healthcare Improvement
Social Determinants of Health
A Way Ahead: Drivers for the Future
Textbox 1.5 Seven Core Principles That Guided Safer Together: A National Action Plan to Advance Patient Safety
Education: The Bridge to Quality
QSEN: Taking the Lead for Patient Safety and Quality
Evolving Nurses' Roles
Educator Development
Safety Challenges in the COVID‐19 Pandemic
Textbox 1.6 Quality and Safety during the COVID‐19 Pandemic
Safety
Quality Improvement
A Call to Action: It Is Time for a “Moonshot”
Textbox 1.7 Creating Urgency in Addressing Patient and Health Worker Safety
Summary
Acknowledgments
References
Resources
2 Policy Implications Driving National Quality and Safety Initiatives
Policy in the Context of Health Care Quality and Safety
The Landscape of Formal Stakeholders in the Ongoing Quality Dialogue
Recent Efforts and Initiatives Supporting the Safety and Quality Movement
Patient Family Centered Care Partners
Planetree International
Project Patient Care
National Partnership for Women & Families
National Governors Association
Academy of Oncology Nurse & Patient Navigators
A Step Back: Affordable Care Act Emerged Where Efforts Converged
Improving Health Care Quality and Efficiency
Linking Payment to Quality Outcomes
Encouraging Integrated Health Systems
Paying Providers Based on Value, Not Volume
Partnership for Patients
National Quality Strategy Is the Future
Building the Momentum for Quality
National Quality Forum: A Strategic Model
National Priorities Partnership and Implementation of the National Quality Strategy
Measure Applications Partnership Driving Selection of Measures
National Quality Partners
Textbox 2.1 NQP Efforts Involving Nursing
National Quality Forum Measure Incubator
National Database of Nursing Quality Indicators: Capturing the Data
Institute for Healthcare Improvement Focused on System Improvement
Textbox 2.2 Safer Together: A National Action Plan to Advance Patient Safety
Textbox 2.3 Institute for Healthcare Improvement National Action Plan Cross‐Cutting Themes
Informatics, Electronic Health Records, and Impact of Technology on Quality and Policy
Quality Alliances Influence Policy Actions through a Professional Lens
Nursing Alliance for Quality Care
Alliance for Home Health Quality Innovation
Federal Agencies Engage with Alliances
Centers for Medicare and Medicaid Services
Agency for Healthcare Research and Quality
Standard Setting by Nonfederal Agencies
Joint Commission
National Committee for Quality Assurance
Utilization Review Accreditation Commission
Common Strategies Run through Formalized Initiatives
Challenges All Collective Efforts Face in Improving the Quality of Care
What Can Every Nurse Do to Influence Policy That Improves Quality?
Textbox 2.4 Nurses’ Engagement in Policy at Every Level of the System
Summary
References
Resources
3 A National Initiative: Quality and Safety Education for Nurses
QSEN Origins: 2000–2005
Building Will: Phase I (October 2005–March 2007)
Phase I Impact Factors
Generating and Sharing Ideas: Phase II (April 2007–October 2008)
Phase II Impact Factors
Embedding New Competencies: Phase III
Textbox 3.1 QSEN Phase III: Three Aims
Phase III Impact Factors
QSEN and Beyond Phase III
QSEN: 2012–2017
Education
Expanding Focus
QSEN: 2018–2022
Significant Accomplishments
The Ongoing Evolution of the QSEN Initiative
The Next Five Years
Acknowledgments
References
4 Person/Family‐Centered Care1
Definitions and Key Concepts
Textbox 4.1 Definitions of Patient‐ and Family‐Centered Care. The Picker Institute
Institute for Patient‐ and Family‐ Centered Care
Planetree
Textbox 4.2 Person‐Centered Care Definitions. Institute for Healthcare Improvement
American Geriatrics Society Expert Panel
Textbox 4.3 Dimensions of Patient‐Centered Care
Reflective Practice
Background: What Do Patients and Families Want?
National Standards and Regulations
Textbox 4.4 Basic Tenets for Addressing Health Disparities
Reflective Practice
Global Perspectives
Textbox 4.5 Person‐Centered Care Exemplar from Iceland
Reflective Practice
Reflective Practice
Teaching the Competencies
Didactic Strategies: Narrative Pedagogy
Textbox 4.6 Matrix of Competencies
Evaluating the Hospital Experience through the Patient’s Eyes
Reflective Practice
Art interpretation
Films
Classroom Forums with Patient/Family Advisors or Student Health Care Narratives
Personal Pedagogy
Reflective Practice: Personal Knowing and Values Identification Exercises. Family Healing Traditions
What Do We Need to Know About Ourselves to Provide Culturally Competent Care?
Personal Reflection Exercise
Narrative and Arts‐Informed Exercise #1
Narrative and Arts‐Informed Exercise #2: Cardiac Assessment
Community Health Aesthetic Reflection Exercise
Identify professional values
Reflective Practice: Professional Values
Identify Organizational Values
Use of technology to support learning
Textbox 4.7 Teaching What PFCC Looks Like in Action: Examples of Patient‐Family
Simulation
Exercise: Simulate a Family Meeting
Clinical Strategies. Evaluating Clinical Environments
Eliciting Patient/Family Preferences and Values
Textbox 4.8 Organizational Assessment Tools for Patient‐ and Family‐Centered Culture
Textbox 4.9 Kleinman’s Questions
Textbox 4.10 Patient‐ and Family‐Centered Care Storytelling
Reframing Constructive Criticism Using Reflection Based on the QSEN Competencies
Sharing Patient‐ and Family‐Centered Care Stories
Applying the Competencies in the Clinical Setting. Respecting Patient Values, Preferences, and Needs
Textbox 4.11 Exemplar: Veterans’ Administration (VA) Health Care System
Reflective Practice
Coordinating and Integrating Care
Communicating, Informing, and Educating
Providing Physical Comfort
Offering Emotional Support
Involving Family and Friends
Conclusion
Acknowledgment
References
Resources
Note
5 Teamwork and Collaboration
Teams and Teamwork
Creating Expert Teams, Not Teams of Experts
Who Should Be on the Team?
Collaboration
Challenges to Teamwork and Collaboration
Models of Teamwork and Collaboration
Team Training
Clinical Learning Environments
Textbox 5.1 Key Definitions and a Vision for Optimal Clinical Learning Environments. Definition of “Learning Environment”
Definition of “Learners”
The Vision
Textbox 5.2 Key Recommendations for Achieving Optimal Clinical Learning Environments. Interprofessional Education
Challenges in teaching Teamwork and Collaboration
Textbox 5.3 Interprofessional Learning Experiences over an Extended Timespan
Textbox 5.4 The CLARION National Case Competition
The Quality and Safety Education for Nurses (QSEN) Competency of Teamwork and Collaboration
Who Teaches Interprofessional Education?
Textbox 5.5 Examples of Interprofessional Learning Opportunities with Community Agencies
Teaching Methods for Promoting Teamwork and Collaboration
National Collaboratives Promoting Teamwork and Collaboration
Summary
References
Resources
6 Quality Improvement
Background to Quality Improvement
Leadership in Quality by Florence Nightingale
The Evolution and Activities of Quality Improvement Organizations
Value‐Based Purchasing as an Impetus for Quality
Hospital Value‐Based Purchasing
Provider Value‐Based Payment
Textbox 6.1 Case Example
Quality Improvement Approaches
Six Sigma
Textbox 6.2 Six Sigma
Lean
Total Quality Management
Textbox 6.3 Case Example
Measuring Nursing Care Quality. Overall Framework to Improve Health Care
Framework for Quality Measures
Measures Reflecting Nursing Care
Textbox 6.4 Nursing‐Related Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey Questions. Nursing‐Specific Questions
Nursing‐Related Questions
Characteristics of a Useful Measure
Choosing a Measure
Quality Measures and Health Information Technology
Publicly Reported Measures and Benchmarking
Quality Improvement Process
Identify Structures, Processes, and Outcomes to Measure
Problem Identification
Cause of the Problem
Textbox 6.5 Five Whys Example
Plan–Do–Study–Act
Organization of Data
Teaching Quality Improvement
Textbox 6.6 Case Example
Bridging Education and Clinical Practice
Summary
References
Resources
7 Evidence‐Based Practice
Definition and Description of Evidence‐Based Practice
Evidence‐Based Practice: Models and Process
Develop a Searchable Question
Search for the Best Evidence Available
Critical Analysis and Synthesis of the Evidence
Develop Recommendations for Practice
Implementation of the Recommendations
Evaluate the Outcome of Evidence‐Based Practice Changes
Dissemination of Evidence‐Based Practice Change
The Evidence for Evidence‐Based Practice. Evidence‐Based Practice Skills in Learners and New Graduates
Teaching Evidence‐based Practice
Barriers to Evidence‐Based Practice in Clinical Practice
Teaching Strategies for Students
Didactic Strategies. Exposure to Evidence‐Based Practice Models
Grading of Evidence
Evaluation of Website Resources
Journal Clubs
Evidence‐Based Projects
Simulation or Skills Lab Strategies. Utilize Evidence‐Based Practice Simulation Scenarios
Learner‐Led Simulation Scenarios
Clinical Strategies. Use of Journals for Reflection
Sacred Cows Contest
Use of Technology
Post‐clinical Discussion and Debrief
Attendance at Nursing Practice or Research Committee Meetings
Role Playing
Teaching Strategies for Clinical Staff
Organizational Evidence‐Based Practice Models
Teach through Council and Committee Projects
Textbox 7.1 Evidence‐Based Nurse‐Driven Heart Failure Care
Broadening the Evidence‐Based Practice Perspective
Academic and Clinical Partnerships
Summary
References
Resources
8 Safety
Extent of the Problem
Categories of Adverse Events
Culture of Safety
High‐Reliability Organizations
Fair and Just Culture
Human Factors
What Students and Clinicians Need to Know about Safety
Safety across the Continuum of Care
Making Care Safer
Textbox 8.1 Nurses as Leaders in Patient Safety
Health Equity and Health Care Safety
Workplace Safety for Clinicians
Putting Safe Systems in Place
Transitions in Care and Handoffs
Textbox 8.2 Jordan: Patient Safety and Evidence‐Based Practice Exemplar
Processes for Examining Safety Threats
Transparency
Voluntary versus Mandatory Adverse Event Reporting Systems
Challenges
Second Victim
Integrating a Culture of Safety into the Curriculum and Ongoing Education of Clinicians
Textbox 8.3 Good Catch by a New‐to‐Practice Nurse
Tenets of Teaching Safety
Textbox 8.4 Classroom Education Activities to Teach Safety Competency
Textbox 8.5 Simulation Education Activities to Teach Safety Competency
Textbox 8.6 Clinical Education Activities to Teach Safety Competency
Summary
References
Resources
9 Informatics
Development of the QSEN Informatics Competencies
Informatics Competencies
Educational Strategies for Teaching Informatics. Educating Nurse Educators
Creating Curricula
Educating Students
Strategies for Building an Informatics Curriculum
Implications for Nursing Practice
Emerging Informatics Trends and Implications for Nurse Educators
Telehealth
Virtual and Augmented Reality
Summary
References
10 Transforming Education to Transform Practice: Integrating Quality and Safety in Interactive Classrooms Using Unfolding Case Studies
Education to Integrate QSEN Competencies across Nursing
QSEN: A Model to Transform Education and Practice
Rethinking Fundamentals of Nursing: Lessons from the Pilot School Learning Collaborative
Preparing Nurses as Leaders in Quality and Safety: The New Reality
Textbox 10.1 QSEN in Practice: Examples of QSEN Competencies in Nurses’ Roles and Responsibilities for Improving Quality and Safety Outcomes
Rethinking Nursing Education: Changing the Role of Educator
Knowledge, Skills, and Attitudes: Three Apprenticeships of Professional Education
Situated Coaching to Promote Interactive Knowledge Use
Textbox 10.3 Example of Situated Coaching as a Signature Pedagogy in Nursing with Suggested QSEN Competencies to Add to the Discussion
Textbox 10.4 Handoff Report from the Emergency Department Registered Nurse
Reflection 1: Disrupting When a Pandemic Disrupts
Textbox 10.5 Situated Coaching to Guide Learners' Critical Reasoning
Reflection 2: Disrupting Cis‐Gender–Biased Health Care
Reflection 3: Disrupting Race‐Based Health Care
Innovative Ideas to Redesign the Nursing Classroom. Subject‐centered Teaching and Learning
Unfolding Case Studies Using Situated Coaching
Textbox 10.6 Decontexualized Content for Oxygenation
Slide #1, Left‐sided Heart Failure: Signs and Symptoms
Slide #2, Heart Failure: Medical Treatment
Textbox 10.7 Interactive Classroom Strategies That Can Be Subject Centered
Teacher as Coach
Constructing an Unfolding Case Study
Objectives
Textbox 10.8 Constructing an Unfolding Case Study
Concepts and Content
Context
Developing the Narrative
Textbox 10.9 Outpatient Clinic Visit
Textbox 10.10 Adaptation of Socratic Questions to Discuss an Unfolding Case Study
Assessment of Learning Objectives
Reflective Practice and Questioning Strategies for Situated Coaching
Global Perspectives on Quality and Safety Education
Textbox 10.11 QSEN: An Integral Part of Nursing in Sweden
Textbox 10.12 QSEN Academic Partnership: Saginaw Valley State University and Jinan University
Safety
Evidence‐Based Practice
Implications
Summary
References
Resources
11 Reflective Practice: Using Narrative Pedagogy to Foster Quality and Safety
Teaching Nursing Practice
The Complementary Nature of Narrative Pedagogy and Reflective Practice
Textbox 11.1 Cone in a Box Exercise to Assess Perceptions and Assumptions
Textbox 11.2 Evidence‐Based Outcomes of Story‐Generated Reflective Practice
Cycles of Interpretation through Reflection
Textbox 11.3 Interpretive Questions to Examine Story
Interpretive Questioning
Shelly’s Story
Theresa’s Story
Textbox 11.4 Analyzing Shelly’s and Theresa’s Narratives with QSEN
Reflection 1
Reflection and Narrative Pedagogy: Developing a Mindset for Quality and Safety
Reflection 2
Summary
References
Resources
12 Quality and Safety Education in Clinical Learning Environments
Academic–Practice Partnerships: Infusing QSEN in Practice‐Based Learning
Reflective Practice: A Framework for Engaged Mindful Clinical Learning
Textbox 12.1 Reflective Papers: Connecting QSEN Competencies in Clinical Learning
Textbox 12.2 Using Visual Thinking Strategies to Question Assumptions. Developing Clinical Observation and Communication: Visual Thinking Strategies
Building Clinically Relevant Assignments
Safety Culture: Systems Thinking, High Reliability, Human Factors, Interprofessional Teams and Just Culture
Systems Thinking
Textbox 12.3 Low‐Fidelity Simulation Using Gaming to Develop Systems Thinking
High Reliability
Human Factors
Interprofessional Teams
Textbox 12.4 Applying Human Factors to Teach a Mindful Approach to Medication Safety
Just Culture
Dedicated Education Units: Bringing Academic and Clinical Learning Together in the Workplace
Quality Improvement: Standards and Benchmarks That Guide Practice
Developing QSEN Competencies through Clinical Learning in the Workplace
Textbox 12.5 Student Clinical Learning Assignment to Develop Knowledge and Awareness of Quality and Safety Goals and Standards. Clinical Learning Primary Learning Aim: To Develop Awareness and Application of Quality and Safety Standards
Textbox 12.6 QSEN Competency Person‐Centered Care: Pain Management Knowledge, Skills, and Attitudes. Clinical Learning Assignment: Patient‐Centered care, Evidence‐Based Practice, Quality Improvement, Safety, and Informatics
Exemplars: Clinical Assignments to Develop QSEN Competencies
Safe Approaches to Medication Administration
Evidence‐Based Practice and Quality Improvement
Care across the Continuum: Safety and Quality in Primary Care Settings
Textbox 12.7 Quality and Safety in Primary Care: Real‐World Examples Working with Vulnerable Populations
Textbox 12.8 Using Teach‐Back to Improve Discharge Planning
Textbox 12.9 Engaging Patients in Their Care to Improve Patient Care Outcomes
Textbox 12.10 Using Medication Management to Improve Quality of Care
Textbox 12.11 Warm Handoff Plus Used to Increase Patient and Provider Information and Improve Care Quality
The Impact of the 2020 Pandemic on Clinical Learning
Assessing Student Learning: QSEN Competencies and Evaluation of Student Performance
Textbox 12.12 QSEN‐Based Clinical Evaluation Tools
Summary
References
Resources
13 Integrating Quality and Safety Competencies in Simulation
Simulation in Nursing Education
Overview of Simulation‐Based Learning
Reflection Point
Reflective Practice: Before and After Simulation
Regulations Affecting Simulation
Textbox 13.1 Best Practice Criteria for Debriefing after Simulation
Textbox 13.2 Frameworks for Debriefing
Reflection Point
Benefits of Simulation‐Based Learning
Pre‐licensure Nursing Education
Textbox 13.3 Simulation as an Adaptable Instructional Medium Fits in All Levels of Nursing Education and Practice
Textbox 13.4 Interprofessional Simulation Combining Prelicensure and Graduate Learners
Textbox 13.5 Prelicensure Example in Maternal Newborn Nursing Course Partnering Academic and Practice Settings
Graduate Nursing Education
Professional Development in Clinical Practice
Educator Development
Textbox 13.6 Educator Development Opportunities in Simulation
Interprofessional Simulation
QSEN Competencies and Simulation
Patient‐Centered Care
Textbox 13.7 Ostomy Pre‐simulation Exercise
Teamwork and Collaboration
Evidence‐Based Practice
Textbox 13.8 Interprofessional Simulation for Teamwork and Collaboration
Quality Improvement
Textbox 13.9 Quality Improvement Embedded in Interprofessional Simulation
Safety
Informatics
Role of Simulation in a Pandemic
Simulation in the Socio‐cultural Context
Global Network for Simulation in Healthcare
Textbox 13.10 Synopsis of Global Network for Simulation in Healthcare 30‐minute Weekly Team Engagement Cases. Sepsis
Medication Errors
Healthcare‐Associated Infections
Care Teams
Textbox 13.11 30‐Minute Weekly Team Engagement Initiative
Conclusion
References
14 Interprofessional Approaches to Quality and Safety Education
The Added Value of Interprofessional Education to the Quality and Safety Learning Process
Learning with, from, and about Each Other: Managing Bias
Textbox 14.1 Learning Roles and Responsibilities
Best‐Practice Considerations to Take into Account When Designing Interprofessional Education Strategies for Quality and Safety
Organizing Frameworks for Interprofessional Education in Quality and Safety Education
Models of Interprofessional Education
Interprofessional Core Competencies
Design of Interprofessional Education Strategies
Textbox 14.2 Key Questions to Consider in Planning Interprofessional Learning Experiences
Textbox 14.3 Example of a Theory‐Based Clinically Relevant Interprofessional Education Program. VA Centers of Excellence in Primary Care Education (http://www.va.gov/OAA/coepce/index.asp )
Cooperative Learning
Textbox 14.4 Features of Cooperative Learning
Reflection
Experiential Learning
Textbox 14.5 Example of an Interprofessional Education Project That Includes Experiential Learning and Impacts Clinical Care
Transfer of Learning
Textbox 14.6 Example of Transfer of Learning
Moving from Interprofessional Education to Interprofessional Collaborative Practice
Reflection Point
Assessment
Examples of National Interprofessional Training Programs in Quality and Safety Education
Educator Development for Interprofessional Education
Textbox 14.7 Criteria Demonstrating Organizational Commitment to Interprofessional Education (IPE)
Interprofessional Education in COVID‐19
A Call to Action
Better Together: Creating a New Workforce for Interprofessional Education and Practice
An Exemplar. Building from the Ground Up
Developing a Pan‐university Model through Infrastructure Support
National Guidelines to Steer the Future
Textbox 14.8 Implementing Interprofessional Education in Rural Settings
Textbox 14.9 Interprofessional Education to Address the Challenges of COVID‐19
Interprofessional Education Addressing the Challenges of the COVID‐19 Pandemic
Interprofessional Education Increasing Access to Health Care
Assessment of Institutional Interprofessional Education and Practice
Summary
References
Resources
15 Improving Quality and Safety with Transition‐to‐Practice Programs
Early Thought Leaders
What Is a Transition‐to‐Practice Program?
Extent of Transition‐to‐Practice Programs
Why Should an Organization Adopt a Transition‐to‐Practice Program?
Evidence Supporting a Standardized Transition‐to‐Practice Program
Research on Key Outcomes
Research on Best Practices
Exemplars of Transition‐to‐Practice Programs
National Council of State Boards of Nursing Transition‐to‐Practice Program
Textbox 15.1 Examples of Teaching the QSEN Competencies in the National Council of State Boards of Nursing’s Transition‐to‐Practice Model (QSEN Competencies: Safety, Quality Improvement)
Versant
Vizient
Role of the Preceptor
Textbox 15.2 Example of Teaching the QSEN Competencies in a Versant Transition‐to‐Practice Program in a Home Health Organization (QSEN Competency: Informatics)
Textbox 15.3 Example of Teaching the QSEN Competencies in a Vizient Transition‐to‐Practice Program: Safeguarding a Healthy Work Environment with Training to Combat Incivility (QSEN Competency: Teamwork and Collaboration)
Textbox 15.4 Example of Teaching the QSEN Competencies in a Vizient Transition‐to‐Practice Program: Pain Management for Oncology Patients in Both Inpatient and Outpatient Settings (QSEN Competency: Patient‐Centered Care)
Transition‐to‐Practice Programs in Non‐hospital Settings
Accreditation
Accreditation Commission for Education in Nursing
Commission on Collegiate Nursing Education
American Nurses Credentialing Center
National Nurse Practitioner Residency and Fellowship Training Consortium
Building the Business Case for a Nurse Residency Program
American Association of Colleges of Nursing
American Academy of Nursing
Magnet Recognition Program
Retention/Turnover
National funding for residency programs
Academic–Practice Partnerships
Regulation
Summary
Acknowledgment
References
Resources
16 Leadership to Create Change
The Context for Leadership Today
The Evolution of Leadership
Paradox, Ambiguity and Uncertainty
Textbox 16.2 Examples of Ambiguity
Example #1
Example #2
Example #3
Textbox 16.3 Clinical Case #1: A Creative Adjustment to a Person’s Plan of Care
Textbox 16.4 Clinical Case #2: An Example of Nursing Creativity Preserving the Quality of Life
A Framework for Safe, Reliable, Effective Patient Care
The Role of Nurses in Quality and Safety
Nursing Leadership in Policy Formation
The Role of the Nurse Executive in Patient Safety
Developing a Capacity for Leadership
Textbox 16.5 Clinical Case #3: Nursing Innovation in Patient Care: Ambulatory Front‐Line Nurses Ask a Clinical Question and Lead Change That Results in a New Practice Recommendation
Textbox 16.6 Clinical Case #4: Leadership from Nursing Students
Textbox 16.7 Clinical Case #5: Integration of Leadership Principles in Executing a Doctorate in Nursing Practice (DNP) Project to Improve the Quality and Safety of Health Care for Pregnant Women
Textbox 16.8 Reflections from Barbara Nichols, PhD, RN, FAAN, a Nursing Leader with 40 Years’ Experience
Levels of Leadership Preparation
Seeking Help
Textbox 16.9 Rethinking Mentoring: Reflections from Angela Barron McBride, PhD, RN, FAAN, Distinguished Professor and University Dean Emerita, Indiana University School of Nursing
Summary
References
Resources. Books to Stimulate Creativity
Videos on Being a Leader
Foundational Leadership Documents
Answers to Ambiguity Challenges
Appendix A. Prelicensure Competencies
Appendix B. Quality and Safety Education for Nurses Graduate/Advanced Practice Nursing Competencies
Appendix C. Quality and Safety Education for Nurses
Appendix D. Simulation Development Template. Section I: Scenario Overview
Section II: Curriculum Integration
Section III: Scenario Script
Appendix D.1: Health Care Provider Orders
Appendix D.2: Digital Images of Manikin and/or Scenario Milieu
Appendix D.3: Debriefing Guide
Glossary
Index
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