The Development of a Nursing Quality and Patient Safety Fellowship

Purpose:
The purpose of this innovative program is to provide staff nurses with a broader understanding of Quality and Patient Safety in today's healthcare and regulatory environment. Also, assist staff nurses to design, implement and evaluate quality improvement projects specific to their unit's needs.

Significance:
Staff nurses participate in the quality improvement process, perceive experiences as improving the quality of patient care delivered and improve the safety of their patients. Staff nurse's participation in the program strengthens knowledge, level of comfort and sustains a culture of safety.

Strategy and Implementation:
Information on the program was disseminated through fliers, posters & announcements at local Quality Councils. Candidates applied by writing an essay about their role in quality & safety, included a resume, & two letters of recommendation (one from their nurse leader). Quality and Safety leaders at the hospital were recruited to present. The curriculum included classes such as: Role of Quality Fellow; Evolving State of Quality & Safety; Culture of Safety; Introduction QI Projects; What is DMAIC?; What the Current Infection Data Tell Us; Patient Services: Errors, Events, Families & Regulatory Agencies; RN/MD Communication; Nursing Documentation: Core Measures & Pay for Performance; Patient Satisfaction: Press Ganey & HCAHPS; and, Everything You Wanted To know About The Joint Commission But Were Afraid To Ask. With minimal budgetary impact the program has developed unit based Nursing Quality Fellows engaged in transforming practice, improving outcomes & sustaining a culture of safety.

Evaluation:
Program evaluations were conducted based on objectives, class content and class experiences. 99 out of 158 rated the program as Excellent, 44 out of 158 rated the program as Good and Excellent and 5 out of 158 rated the program as poor. The program is now offered annually.

Implications for Practice:
Over 100 Performance Improvement Projects were developed and implemented, including: Hand off communication, Pain management, Medication safety, & Hospital Acquired Conditions: CLABSI, CAUTI, VAP, HAPU. A new program has been designed to support and strengthen nurse leader engagement.