ABC's of Quality and Safety Based Practice Education in Gerontological Nursing

Purpose:
Evaluate ABCDE pedagogy (A = Anatomy & physiology, B = Best care, including assessment and interventions, C = Complications, D = Drugs, E = Evidence-based practice)in community gerontology and its effect on critical thinking, faculty and student satisfaction, quality and safety of student care.

Background/Significance:
Innovative methods for clinical learning; ABCDE pedagogy (A = Anatomy & physiology, B = Best care, including assessment and interventions, C = Complications, D = Drugs, E = Evidence-based practice) used for diseases/conditions, signs/symptoms, diagnoses (medical and nursing), medications and research updates. Successfully used 6 years in acute care clinicals. Critical thinking skills are developed leading to quality and safe patient practice.

Methods:
BSN students enrolled in gerontological nursing course selected diseases/conditions related to their assigned home visit residents, prepared the ABCDE's, presented to peers and faculty, and discussed the information within the group. The process facilitated clinical discussions, synthesis and sharing of knowledge, and consideration for patient-specific care leading to quality and safety associated care. Students (N=66) rated the use of the ABCDE format on a 15-item self-developed Likert scale (0=poor through 10=excellent) to indicate their critical thinking abilities on 15 statements related to their progress. Faculty and students evaluated the ABCDE's at the end of the clinical semester.

Results:
Self-ratings critical thinking abilities positively related to use of ABCDEs. When compared between groups, there was a difference between junior students' (n=33) self-rating of critical thinking with a positive correlation coefficient of 0.618, p=0.0002; seniors (n=33) [r=0.21, p=0.196]. For seniors learning had been developed. Positive correlation coefficient for juniors and seniors(N=65) relative to cognitive mapping and clinical reasoning, was 0.436, p=0.0003. Chronbach's alpha for 15-item tool was 0.94 (juniors=0.96, seniors=0.92). Faculty report student increases in patient quality and safety of care. Students overwhelmingly (96%) prefer ABCDE pedagogy to care plans.

Conclusions and Implications for Practice:
Juniors developing critical thinking. Outcomes(learning, care, competence)enhanced, NCLEX passing rates 96%. Positive student and faculty responses to quality and safety care. ABCDE preferred learning approach by students and faculty and adds to quality and safety of patient care.