A Collaborative Project to Improve Associate Degree Nursing Students Knowledge, Skills and Attitudes about Quality Improvement

Problem: Associate degree nursing (ADN) students were having challenges understanding their role in the quality improvement (QI) process furthermore, NCLEX was including more questions on QI.

A collaborative project was developed between a community college ADN program and the county hospital. The topic selected was the nonconformity on restraints from the most recent hospital regulatory survey. 

Students attended a class on QI, EBP, regulatory agencies, and how to create scientific posters. Students were randomized into groups of 4. The student groups then created a group charter outlining each team member’s responsibility, timelines, and consequences of failing to participate fully in the project.  Students received copies of most recent regulatory survey findings, current hospital policy, and web links to Center for Medicare & Medicaid Services (CMS) information on restraints.  Students examined the regulations regarding restraints, differentiated the types of restraints and learned about the nurses responsibilities when caring for patients in restraints.  This information was then translated into a scientific poster.  Students also participated in QI during clinical rotations by helping during NDNQI Skin Survey day, and attending Quality Management (QM) meetings.

 Students presented posters at hospital shared governance council meeting. Posters were set up conference style and students presented as hospital staff rotated between posters.  Hospital staff completed an evaluation form and a winning poster was determined. Students also presented posters to second and third semester nursing students and advisory board members.  Posters were then given to hospital educators to use for in-services on restraints.

The project helped address QSEN competencies in the areas of evidence-based practice (EBP), quality improvement (QI), teamwork and collaboration.

Students were asked to evaluate the project process and accomplishment of identified objectives and evaluate their team members participation in the project (peer eval).

Outcomes: Improved scores on ATI predictor test Indicator: QI from 78.5% to 91.2%, students stated they “felt professional during the presentation”, became more “focused on safety”, began “looking for ways to improve care”, and were more “patient centered when providing care during clinical rotations”. Several students connected to the project on an emotional level, and discussed how they would feel if their family members were restrained.