faculty identification of competencies addressing quality and safety education in alabama ...

173 Pages·2013·2.13 MB·English

FACULTY IDENTIFICATION OF COMPETENCIES ADDRESSING QUALITY
AND SAFETY EDUCATION IN ALABAMA ASSOCIATE
DEGREE NURSING EDUCATION PROGRAMS

by
REITHA CABANISS
FELECIA WOOD, COMMITTEE CHAIR
MELODIE CARTER
AARON KUNTZ
SHARRON SCHLOSSER
STEPHEN TOMLINSON

A DISSERTATION

Submitted in partial fulfillment of the requirements
for the degree of Doctor of Education in the
Department of Educational Leadership,
Policy, and Technology Studies
in the Graduate School of
The University of Alabama

TUSCALOOSA, ALABAMA
2013
Copyright Reitha Cabaniss 2013
ALL RIGHTS RESERVED
ABSTRACT

This study described the extent to which Alabama associate degree nursing faculty,
implementing a standardized curriculum, implement the Quality and Safety Education in Nursing
(QSEN) selected competencies of safety and teamwork and collaboration. Full-time nursing
faculty with a minimum of three years teaching in the Alabama Community College System
associate degree schools of nursing participated in a web survey. The survey instrument was
created to incorporate the two selected QSEN competencies’ knowledge, skills, and attitude
statements.
The participants were predominantly female holding a master’s degree in nursing with
teaching responsibilities in both the classroom and clinical setting and had ten years of teaching
experience on average. Faculty were asked to identify the hours of direct classroom and clinical
instruction dedicated to each knowledge and skill statement and rate the attitude statements in
relation to importance of inclusion in the curriculum.
The data reflected inconsistencies between hours of instruction and the importance rating
for each attitude statement. The findings of this study did not indicate QSEN knowledge, skills,
or attitudes had current widespread inclusion in the Alabama associate degree nursing
curriculum.
This was the first study to explore evidence of the QSEN knowledge, skill, and attitude
statements within the Alabama standardized curriculum. Implications from this study suggest the
concepts of quality and safety, though familiar to faculty, are not identifiable nor taught at the
complexity level which relates to 1) safety and 2) teamwork and collaboration. A review of the
state-wide curriculum may be warranted.

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LIST OF ABBREVIATIONS AND SYMBOLS

a Cronbach’s index of internal consistency
df Degrees of freedom: number of values free to vary after certain restrictions have been
placed on the data

F Fisher’s F ratio: A ration of two variances
M Mean: the sum of a set of measurements divided by the number of measurements in the
set

p Probability associated with the occurrence under the null hypothesis of a value as
extreme as or more extreme than the observed value

r Pearson product-moment correlation
sd Standard deviation
t Computed value of t test
< Less than
= Equal to

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ACKNOWLEDGMENTS

I would like to thank my family, friends, and professional colleagues for their continued
support. There have been days when I was sure I could not make it. I am thankful for the
encouragement and “pep” talks over the course of the past five years.
Dr. Felecia Wood, dissertation chair, has provided leadership and guidance along this
dissertation journey. She has shared her expertise and coached me through some difficult days
when I did not believe in myself. I feel that I have grown as an educator and scholar under her
supervision and direction.
Dr. Rick Houser has spent several hours with me guiding the statistical procedures and
analysis of this dissertation. He did this on his own time without being assigned to my
dissertation committee. Thank you Dr. Houser for everything!
Members of my dissertation committee have supported me through each step of this
journey. Their efforts, wisdom and experience have been essential to the development of this
scholarly work. Thank you for your dedication.

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CONTENTS

ABSTRACT ................................................................................................................................... ii
LIST OF ABBREVIATIONS AND SYMBOLS .......................................................................... iii
ACKNOWLEDGMENTS ............................................................................................................ iv
LIST OF TABLES ...................................................................................................................... viii
CHAPTER I: INTRODUCTION .....................................................................................................1
Defining the Problem ...........................................................................................................1
Quality and Safety................................................................................................................2
Nursing Education ...............................................................................................................4
Community Colleges ...........................................................................................................5
Alabama Standardized Nursing Curriculum ........................................................................6
Purpose Statement ................................................................................................................7
Organizing Framework ........................................................................................................8
Related Theory ...................................................................................................................13
Significance of the Study ...................................................................................................14
Research Questions ............................................................................................................16
Summary ............................................................................................................................17
Operational Definitions ......................................................................................................18
CHAPTER II: REVIEW OF THE LITERATURE .......................................................................20
Background ........................................................................................................................20
Associate Degree Nursing Programs .....................................................................22
Faculty Role ...........................................................................................................24
Quality and Safety Education for Nurses ...........................................................................25
Curricular Focused QSEN Research ..................................................................................28
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Safety .....................................................................................................................29
Teamwork and Collaboration ................................................................................34
Summary ............................................................................................................................38
Literature Gaps...................................................................................................................39
CHAPTER III: METHODOLOGY ...............................................................................................43
Survey Research.................................................................................................................43
Sample................................................................................................................................44
Data Collection ..................................................................................................................45
Instrument ..........................................................................................................................46
Data Analysis .....................................................................................................................48
Procedures ..........................................................................................................................49
Ethical Considerations .......................................................................................................50
Summary ............................................................................................................................50
CHAPTER IV: RESULTS .............................................................................................................51
Demographic Characteristics .............................................................................................52
Expectations in Associate Degree Programs .....................................................................54
Safety Competency ................................................................................................54
Teamwork and Collaboration ................................................................................56
Research Question One ......................................................................................................60
Frequency of Hours per Nursing Course ...............................................................65
Safety Competency Frequencies ............................................................................66
Teamwork and Collaboration Competency ...........................................................67
Research Question Two .....................................................................................................68
Research Question Three ...................................................................................................71
Summary ............................................................................................................................73
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CHAPTER V: DISCUSSION ........................................................................................................75
Organizing Framework ......................................................................................................75
Significant Findings ...........................................................................................................75
Conclusions ........................................................................................................................78
Study Limitations ...............................................................................................................79
Recommendations for Further Study .................................................................................80
REFERENCES ..............................................................................................................................84
APPENDICES ...............................................................................................................................93
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LIST OF TABLES

1. QSEN Teamwork and Collaboration Competency with Knowledge,
Skills and Attitude Statements ..............................................................................................10

2. QSEN Safety Competency with Knowledge, Skills and Attitude Statements......................12

3. Safety Competency Knowledge Statements with Sample Percentage
for Affirmative Responses ....................................................................................................55

4. Safety Competency Skill Statements with Sample Percentage for Affirmative Responses .56

5. Teamwork and Collaboration Knowledge Statements with Sample Percentage for
Affirmative Responses ..........................................................................................................57

6. Teamwork and Collaboration Skill Statements with Sample Percentage for Affirmative
Responses ..............................................................................................................................59

7. Means and Range of Hours Spent Teaching per QSEN Competency Statement .................61

8. Standardized Associate Degree Nursing Curriculum ..........................................................65

9. Cronbach Alpha Reliability Coefficients for QSEN Attitudes (N=28) ................................69

10. Importance Attributed by Faculty for Safety Attitude Statements (N=28) ...........................69

11. Importance Attributed by Teamwork and Collaboration Attitude
Statements (N=28) ................................................................................................................70

12. Pearson Correlation for Safety Classroom Hours and Attitudes Score ...............................71

13. Pearson Correlation for Teamwork and Collaboration Classroom Hours and Attitudes
Score ....................................................................................................................................72

14. Pearson Correlation for Safety Clinical Hours and Attitudes Score .....................................73

15. Pearson Correlation for Teamwork and Collaboration Classroom Hours and Attitudes
Score .....................................................................................................................................73

16. First Semester ADN Courses NUR 102, NUR 103, NUR 104 ...........................................108

17. First Semester ADN Courses NUR 102, NUR 103, NUR 104 ...........................................109

18. Second Semester ADN Courses NUR 105 and NUR 106 ..................................................110
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19. Second Semester ADN Courses NUR 105 and NUR 106 ..................................................111

20. Third Semester ADN Course NUR 201..............................................................................112

21. Third Semester ADN Course NUR 201..............................................................................113

22. Fourth Semester ADN Course NUR 202 ............................................................................114

23. Fourth Semester ADN Course NUR 202 ............................................................................115

24. Fifth Semester ADN Courses NUR 203, NUR 204 ............................................................116

25. Fifth Semester ADN Courses NUR 203, NUR 204 ............................................................117

26. First Semester ADN Courses NUR 102, NUR 103, NUR 104 ...........................................118

27. First Semester ADN Courses NUR 102, NUR 103, NUR 104 ...........................................119

28. Second Semester ADN Courses NUR 105 and NUR 106 ..................................................120

29. Second Semester ADN Courses NUR 105 and NUR 106 ..................................................121

30. Third Semester ADN Course NUR 201..............................................................................122

31. Third Semester ADN Course NUR 201..............................................................................123

32. Fourth Semester ADN Course NUR 202 ............................................................................124

33. Fourth Semester ADN Course NUR 202 ............................................................................125

34. Fifth Semester ADN Courses NUR 203, NUR 204 ............................................................126

35. Fifth Semester ADN Courses NUR 203, NUR 204 ............................................................127

36. First Semester ADN Courses NUR 102, NUR 103, NUR 104 ...........................................128

37. First Semester ADN Courses NUR 102, NUR 103, NUR 104 ...........................................130

38. Second Semester ADN Courses NUR 105 and NUR 106 ..................................................132

39. Second Semester ADN Courses NUR 105 and NUR 106 ..................................................134

40. Third Semester ADN Course NUR 201..............................................................................136

41. Third Semester ADN Course NUR 201..............................................................................137
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