BACKGROUND: Caring practice is foundational to the nursing profession. Currently, traditional baccalaureate nursing education stresses the science of nursing care with little education spent on the art of nursing--caring practice as it relates to Quality and Safety in nursing practice (Benner, Tanner & Chelsea, 2009). The Caring Studio Experience (CSE) was implemented as a pilot program and a repeat study has been conducted. The CSE was implemented integrating the Quality and Safety in Educating Nurses (QSEN) competencies with caring practice strategies with the goal of strengthening the student nurse’s caring practices and quality outcomes. The CSE is a series of experiential sessions for student to attend outside of class time. Caring practice and the impact on quality outcomes are explored under three guiding principles; caring for self, caring for colleagues and caring for patients and families The CSE blends a variety of teaching strategies including role-play, reflective practice, mentoring, and dialogue to engage students in learning about caring practice. Students learn about caring practice from the perspective of caring for self, colleagues as well as patients and families. The CSE integrates the resources from the all the arts; music, theater and dance and collaborates with students in Theater & Dance department to incorporate simulated care experiences, improvisational theater experiences with care studies to illustrate the range & depth of care experiences. Outcome measures include a pre-posttest measuring caring abilities and quality knowledge and student evaluations.
SIGNIFICANCE TO NURSING: This study explores the impact of using caring practice teaching methods integrated with the Quality and Safety Education in Nursing (QSEN) framework to seamlessly meld caring and quality into foundations of nursing practice as students learn these concepts and application to practice (Penprase, Oakley & Tenres, 2013). Today’s healthcare environment is challenged with continuous quality improvement. Quality research is strongly linked to the skillset associated with the QSEN competencies of Patient Centered Care, Teamwork & Collaboration and Evidence Based Practice. (AHRQ, 2017; QSEN, 2017). Caring practice competencies will enhance a person’s ability to provide patient centered care, work better in teams while understanding how it all relates to QSEN and best practice. Academia needs to incorporate innovative educational methods to prepare future nurses to address the quality chasm as we shift to higher expectations of quality care through QSEN.
CONCEPTUAL FRAMEWORK: The Evolving Nature of Caring Knowledge and Practice (Grobbel, 2017, Watson, 1999) is the conceptual model for this study. It is based on the belief that quality patient care is influenced by who a person is and what a person knows. In other words, the nurse’s values, attitudes, experiences, and behaviors combined with what the nurse has learned through education, practice, and experience directly influence the quality of patient outcomes. Enhancing students’ knowledge and perceptions will increase their knowledge and influence their quality and caring practices.
METHODS: A quasi-experimental pretest posttest and correlational design using a convenience sample of self-selected pre-licensure baccalaureate nursing students (N = 74) completed the CSE. Caring and quality were measured using the Nursing Quality and Safety Self-Inventory (NQSSI), an 18-item self-rated inventory developed to measure nursing students’ self-rated knowledge, skills, and attitudes regarding quality and safety competencies (Piscotty & Grobbel, 2012) and the Caring Abilities Inventory (CAI), a 37-tem self-rated inventory developed to measure students’ perceptions about their ability to care for others (Nkongho, 1990).
RESULTS: Initial pilot study in 2012 and the repeat study in 2016 both demonstrated significant results in the Knowing subscale of the Caring Ability Inventory (CAI) (t 1; p = 0.0022, t2; p = 0.043) and the Quality and Safety Self Inventory (NQSSI) (t1; p =.000, t2 p = 0.000). Both studies indicate an ongoing effectiveness of using Caring Studios to increase caring abilities and QSEN knowledge.
CONCLUSION: Nursing students whose foundation for clinical practice is based on caring and quality knowledge will be better prepared to deliver safe, high quality, patient-centered care and understand the important link between caring and QSEN competencies (Buckley, 2014).