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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

Development and Evaluation of Competency Based Quality Improvement and Safety Education Program for Undergraduate Nursing Students

A Young Park, Ph.D., APN1, Kye Ha Kim, Ph.D., RN2
Korean Journal of Adult Nursing 2016;28(5):559-571.
Published online: October 31, 2016

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Corresponding author: Kim, Kye Ha Department of Nursing, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Korea. Tel: +82-62-230-6326, Fax: +82-62-230-6329, E-mail: kyehakim@hanmail.net
• Received: July 27, 2016   • Accepted: October 26, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this study is to examine the effects of a competency based safety and quality improving education program for undergraduate nursing students.
  • Methods
    A quasi-experimental study of a non-equivalent control group pre and post test design was used. The participants were sixty-eight undergraduate nursing students recruited from the two universities in G and M cities. They were assigned to either a treatment group (n=35) or a comparison group (n=33). A five-day educational program developed based on the ADDIE Instructional Design Model was offered to the treatment group whereas the comparison group did not receive any instruction. Data were collected using self-report structured questionnaires. The data were analyzed using the SPSS/WIN 21.0 with the x2 test, and independent t-test.
  • Results
    The students in the treatment group reported significant positive changes for patient safety knowledge, skill and perception of quality and safety competencies.
  • Conclusion
    Findings from this study supports that competency based quality improving and safety education program is a useful intervention strategy to promote student's knowledge, skill and perception of quality and safety competencies.
  • Key Words: Quality improvement; Safety; Education program; Undergraduate; Nursing student
Table 1.
Competency Based Quality Improvement and Safety Education Program
Day Module /competency Lesson contents Time (min) Teaching method
Day 1 [Module 1] /safety Patient safety over view, QSEN competencies 100 Video, group discussion, lecture, reflection
[Module 2] /safety Error theory, the system approach, contribute to a culture of patient safety 100 Video, group discussion, lecture, reflection
[Module 3] /safety Under standing managing clinical risk. 100 Video, lecture, role play, reflection
Day 2 [Module 4] /safety Hazard prediction training: falls, verbal orders, patient identification, medication error 100 Small group study, hand on practice, reflection
[Module 5] /safety Error reporting, safety tool 100 Lecture, role play, group discussion, reflection
[Module 6] /safety Error disclosure 100 Discussion, lecture, role play, reflection
Day 3 [Module 7] /T&C Key principles of TeamSTEEPPS, Practice of TeamSTEEPPS 200 Lecture, group discussion, role play, reflection
[Module 8] /PCC Patient centered care, engaging with patients, families and caregivers. 100 Group discussion, case study, video, lecture, reflection
Day 4 [Module 9] /EBP What is evidence based practice? Popular-intervention-comparison-outcome search 100 Video, group discussion, lecture, hand on practice, reflection
[Module 10] /QI Quality Improvement, planning a plan-do-study-act cycle 100 Lecture, small group study, hand on practice, reflection
[Module 11] /informatics Informatics 100 Video, lecture, group discussion, reflection
Day 5 [Module 12] /six competencies Case analysis using root cause analysis, establishment of patient safety & QI action plan, drawing up of declaration n 100 Video, hand on practice, Group discussion

T&C=teamwork and collaboration; TeamSTEPPS=strategies and tools to enhance performance and patient safety; QI=quality improvement; PCC=patient centered care; QI=quality improvement.

Table 2.
Homogeneity Test of General Characteristics and Dependent Variables between the Treatment and Comparison Groups (N=68)
Characteristics Categories Treatment group (n=35) Comparison group (n=33) x2 or t p
n (%) or M±SD n (%) or M±SD
Age (year)   21.80±1.55 21.79±1.24    
Satisfaction with major Very high 4 (11.4) 6 (18.2)   .798
High 23 (65.7) 20 (60.6)
Moderate 7 (20.0) 7 (21.2)
Poor 1 (2.9) 0 (0.0)
Grade point average† 4.00~4.50 6 (17.1) 2 (6.1) - .082
3.51~3.99 21 (60.0) 15 (45.5)
3.00~3.50 8 (22.9) 14 (42.4)
2.51~2.99 0 (0.0) 2 (6.1)
Perceived knowledge about patient safety† Very high 1 (2.9) 1 (3.0) - .718
High 12 (34.3) 10 (30.3)
Moderate 12 (34.3) 16 (48.5)
Poor 10 (28.6) 6 (18.2)
Patient safety education experience Yes 28 (80.0) 26 (78.8) 0.02 .902
No 7 (20.0) 7 (21.2)
Perceived knowledge about QI† Very high 0 (0.0) 1 (3.0) - .218
High 5 (14.3) 6 (18.2)
Moderate 8 (22.9) 13 (39.4)
Poor 21 (60.0) 13 (39.4)
Very poor 1 (2.9) 0 (0.0)
QI education experience Yes 1 (2.9) 0 (0.0) 0.96 1.000
No 34 (97.1) 33 (100)
Knowledge   6.37±0.26 5.70±2.38 1.45 .154
Skills   38.46±4.27 37.25±5.14 1.05 .298
Perception   43.43±2.52 43.39±3.25 0.49 .961

QI=quality improvement;

†Fisher's exact test.

Table 3.
Differences between Treatment and Comparison Groups for Dependent Variables (N=68)
Groups Pretest Posttest Difference t p
M±SD M±SD M±SD
Knowledge          
   Treatment group (n=35) 6.37±1.26 16.34±1.64 9.97±1.70 1.68 ＜.001
Comparison group (n=33) 5.70±2.38 5.18±2.32 -0.52±1.37
Skills          
   Treatment group (n=35) 38.46±4.27 67.69±6.95 29.23±7.38 24.21 ＜.001
   Comparison group (n=33) 37.25±5.14 34.61±4.69 -2.59±2.34
Perception          
   Treatment group; (n=35) 43.43±2.52 57.11±2.78 13.69±3.13 22.45 ＜.001
   Comparison group (n=33) 43.39±3.25 42.27±3.77 -1.12±2.26
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    Development and Evaluation of Competency Based Quality Improvement and Safety Education Program for Undergraduate Nursing Students
    Korean J Adult Nurs. 2016;28(5):559-571.   Published online October 31, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.5.559
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    Development and Evaluation of Competency Based Quality Improvement and Safety Education Program for Undergraduate Nursing Students
    Korean J Adult Nurs. 2016;28(5):559-571.   Published online October 31, 2016
    DOI: https://doi.org/10.7475/kjan.2016.28.5.559
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    Development and Evaluation of Competency Based Quality Improvement and Safety Education Program for Undergraduate Nursing Students
    Development and Evaluation of Competency Based Quality Improvement and Safety Education Program for Undergraduate Nursing Students

    Competency Based Quality Improvement and Safety Education Program

    Day Module /competency Lesson contents Time (min) Teaching method
    Day 1 [Module 1] /safety Patient safety over view, QSEN competencies 100 Video, group discussion, lecture, reflection
    [Module 2] /safety Error theory, the system approach, contribute to a culture of patient safety 100 Video, group discussion, lecture, reflection
    [Module 3] /safety Under standing managing clinical risk. 100 Video, lecture, role play, reflection
    Day 2 [Module 4] /safety Hazard prediction training: falls, verbal orders, patient identification, medication error 100 Small group study, hand on practice, reflection
    [Module 5] /safety Error reporting, safety tool 100 Lecture, role play, group discussion, reflection
    [Module 6] /safety Error disclosure 100 Discussion, lecture, role play, reflection
    Day 3 [Module 7] /T&C Key principles of TeamSTEEPPS, Practice of TeamSTEEPPS 200 Lecture, group discussion, role play, reflection
    [Module 8] /PCC Patient centered care, engaging with patients, families and caregivers. 100 Group discussion, case study, video, lecture, reflection
    Day 4 [Module 9] /EBP What is evidence based practice? Popular-intervention-comparison-outcome search 100 Video, group discussion, lecture, hand on practice, reflection
    [Module 10] /QI Quality Improvement, planning a plan-do-study-act cycle 100 Lecture, small group study, hand on practice, reflection
    [Module 11] /informatics Informatics 100 Video, lecture, group discussion, reflection
    Day 5 [Module 12] /six competencies Case analysis using root cause analysis, establishment of patient safety & QI action plan, drawing up of declaration n 100 Video, hand on practice, Group discussion

    T&C=teamwork and collaboration; TeamSTEPPS=strategies and tools to enhance performance and patient safety; QI=quality improvement; PCC=patient centered care; QI=quality improvement.

    Homogeneity Test of General Characteristics and Dependent Variables between the Treatment and Comparison Groups (N=68)

    Characteristics Categories Treatment group (n=35) Comparison group (n=33) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Age (year)   21.80±1.55 21.79±1.24    
    Satisfaction with major Very high 4 (11.4) 6 (18.2)   .798
    High 23 (65.7) 20 (60.6)
    Moderate 7 (20.0) 7 (21.2)
    Poor 1 (2.9) 0 (0.0)
    Grade point average† 4.00~4.50 6 (17.1) 2 (6.1) - .082
    3.51~3.99 21 (60.0) 15 (45.5)
    3.00~3.50 8 (22.9) 14 (42.4)
    2.51~2.99 0 (0.0) 2 (6.1)
    Perceived knowledge about patient safety† Very high 1 (2.9) 1 (3.0) - .718
    High 12 (34.3) 10 (30.3)
    Moderate 12 (34.3) 16 (48.5)
    Poor 10 (28.6) 6 (18.2)
    Patient safety education experience Yes 28 (80.0) 26 (78.8) 0.02 .902
    No 7 (20.0) 7 (21.2)
    Perceived knowledge about QI† Very high 0 (0.0) 1 (3.0) - .218
    High 5 (14.3) 6 (18.2)
    Moderate 8 (22.9) 13 (39.4)
    Poor 21 (60.0) 13 (39.4)
    Very poor 1 (2.9) 0 (0.0)
    QI education experience Yes 1 (2.9) 0 (0.0) 0.96 1.000
    No 34 (97.1) 33 (100)
    Knowledge   6.37±0.26 5.70±2.38 1.45 .154
    Skills   38.46±4.27 37.25±5.14 1.05 .298
    Perception   43.43±2.52 43.39±3.25 0.49 .961

    QI=quality improvement;

    †Fisher's exact test.

    Differences between Treatment and Comparison Groups for Dependent Variables (N=68)

    Groups Pretest Posttest Difference t p
    M±SD M±SD M±SD
    Knowledge          
       Treatment group (n=35) 6.37±1.26 16.34±1.64 9.97±1.70 1.68 ＜.001
    Comparison group (n=33) 5.70±2.38 5.18±2.32 -0.52±1.37
    Skills          
       Treatment group (n=35) 38.46±4.27 67.69±6.95 29.23±7.38 24.21 ＜.001
       Comparison group (n=33) 37.25±5.14 34.61±4.69 -2.59±2.34
    Perception          
       Treatment group; (n=35) 43.43±2.52 57.11±2.78 13.69±3.13 22.45 ＜.001
       Comparison group (n=33) 43.39±3.25 42.27±3.77 -1.12±2.26
    Table 1. Competency Based Quality Improvement and Safety Education Program

    T&C=teamwork and collaboration; TeamSTEPPS=strategies and tools to enhance performance and patient safety; QI=quality improvement; PCC=patient centered care; QI=quality improvement.

    Table 2. Homogeneity Test of General Characteristics and Dependent Variables between the Treatment and Comparison Groups (N=68)

    QI=quality improvement;

    Fisher's exact test.

    Table 3. Differences between Treatment and Comparison Groups for Dependent Variables (N=68)

    Table 1.

    Table 2.

    Table 3.

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