From Books to Bedside: Bridging the Gap - Hospital Quality & Safety Initiatives

Abstract

Background: Hospitals are the largest employer of new registered nurses (RNs). In fact, most of the 12,000 RNs gained in Florida between 2011 and 2013 were new nurses (Florida Center for Nursing, 2014) with new RN graduates constituting about 10% of most hospital’s nursing staff (Nursing Executive Center, 2007). It is imperative that nursing programs prepare their graduates with the education and skills necessary to meet the challenges of caring for patients whose lives may well depend on it. Are new graduates fully prepared to provide safe and effective care? Ninety percent of academic leaders say “yes”, while only 10% of hospital leaders agree (Berkow, Virkstis, Stewart & Conway, 2008).</p><p>The Quality and Safety Education for Nurses (QSEN) project, began in 2005, and was designed to address the challenges of educating future nurses with the knowledge, skills and attitudes required to positively impact the quality and safety of health care that they provide (QSEN, n.d). This requisite knowledge is based on six competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics.</p><p>Particular to the QSEN quality improvement and safety competencies, local hospital nurse leaders including unit managers and educators, have reported that new graduates lack knowledge of important hospital initiatives designed to improve the quality and safety of patient care. Not only are these initiatives important in improving care for patients, but some of these initiatives also factor into how well the hospital will be reimbursed for care. These initiatives include The Joint Commission’s National Patient Safety Goals (NPSGs), goals for specific improvement in patient safety which include reducing the occurrence of Hospital Acquired Conditions (HACs) and Hospital Acquired Infections (HAIs), the Centers for Medicare and Medicaid Services (CMS) Core Measures which standardize best practices surrounding care for specific conditions, and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a patient satisfaction survey created by the CMS, which affects hospital reimbursement for patient care.</p><p>Purpose: Nurse leaders from a major Jacksonville hospital teamed with faculty from a local university to survey the degree of preparedness of new RN graduates in the Jacksonville area in relation to the aforementioned hospital quality and safety initiatives.</p><p>Methods: New RNs employed within local Jacksonville hospital systems were surveyed on their knowledge of hospital quality and safety initiatives learned from nursing school. Nursing faculty employed at local colleges and universities were surveyed on the extent that these same hospital quality and safety initiatives were taught in their classes.</p><p>Findings/Implications: The survey results found that many new RNs lack knowledge of hospital quality and safety initiatives and likewise that many nursing school faculty do not include these initiatives in their classroom teachings. As a result of the study findings, the researchers developed and presented workshops to local nursing schools on partnering to incorporate education of hospital quality and safety initiatives into nursing school curriculum.