Enhancing Patient Safety and Student Nurses' Clinical Experiences through the Use of Student Competency Checklists
Repository Posting Date2017-03-03T14:34:56Z
Author(s)Ramsey, Rachel A.; Herring, Mackenzie; van Frankenhuyzen, Heather; Milicevic, Milica; Allen, Zachery; Khamalah, Laurine
Author DetailsRachel A. Ramsey, RN, CNE; Mackenzie Herring; Heather van Frankenhuyzen; Milica Milicevic; Zackery Allen; Laurine Khamalah
Lead Author Sigma AffliationXi Nu-at-Large
Session presented on Saturday, March 18, 2017: The student nurse experience is unforgettable. It is one of exciting opportunities, new knowledge, and challenges. Clinical experiences in particular offer student nurses chances to step out of their comfort zones, experience the full spectrum of the nursing role, and undergo personal and professional growth. When health care providers, faculty, clinical instructors, and student nurses work according to the same expectations, these experiences can produce seamless learning for the students and cohesive, quality, safe patient care. Unfortunately, the complexity of the clinical environment presents many opportunities for inconsistent, confusing, disorganized, and intimidating situations for the student nurse (Bjorg, Leland, & Gunnar Dale, 2013; Coyne & Needham, 2012). These circumstances not only impact the learning experience for student nurses, they also lead to unsafe conditions and dangerous opportunities for error (Krautscheid, 2008). A group of student nurses at one Midwest university investigated the factors that produce these situations. This investigation became the impetus for a student nurse-driven project focused on improving clinical experiences for student nurses and facilitating safe patient care. Communication has been identified repeatedly as a major factor in the quality and safety of patient care (Maxfield, Grenny, Lavandaro, & Groah, 2011), as well as student nurses' learning experiences (Bjorg et al., 2013; Coyne & Needham, 2012; Krautscheid, 2008; Morley, 2014). Based on this knowledge, the student nurses conducted informal surveys with other students and nursing staff to identify how those involved felt about the clinical experience at the large urban hospital where clinical learning experiences are arranged. The major issue identified was that both students and nurses are unsure of their roles and responsibilities during the learning partnership. The student nurses then identified strategies to combat this problem. The first strategy involved creating a course-specific list of nursing competencies and skills that students should achieve during their clinical experiences. The students collaborated with nursing faculty in the university's medical surgical nursing course to identify specific and general nursing competencies and skills, which became known as 'competency checklists.' The items were organized into the following categories: Independent; with supervision; and observation only. The document produced from these lists was a checklist for the clinical instructor, nursing staff, and the student nurses that would clarify what students can and cannot do during their clinical experiences, thereby facilitating communication and appropriate delegation. A second document was created from this list, which became known as the 'self-assessment' list. This list provided students with a tangible interpretation of the clinical learning objectives and was meant to promote student nurses' self-assessment and to guide them in identifying learning opportunities. A pilot study for the competency checklist and self-assessment began in the fall semester of 2016. The competency checklists were distributed to lead course faculty, who incorporated the documents into the clinical learning experiences. Surveys were administered to participants at the implementation of the pilot study and will be administered again after 6 weeks. The aims of this pilot study are to increase student nurse and patient safety by improving communication among those involved in the clinical learning partnership. Specifically, the project focused on clarifying the scope of practice, responsibilities, and learning goals of the student nurses involved in the medical surgical course at this university. At the end of this pilot study the project leaders hope to find that student nurses experienced clarity regarding their role in the clinical learning partnership, improved communication with clinical staff, increased confidence in seeking relevant learning experiences, and increased opportunities to participate in relevant learning experiences. Learning Objectives: Recognize the effects of nurse communication on student nurses' confidence. Review strategies to improve communication between student nurses and nursing staff in the clinical setting. Identify the benefits of establishing clear expectations for student nurses in the clinical setting. Recognize the importance of a self-assessment tool to help students seek out learning opportunities.