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Development of a master’s student assignment to promote safety and quality improvement in ambulatory settings

Hill, MG, Reed, L


This Master’s level assignment describes an approach to educating adult nurse practitioner students to critically consider potential safety and quality issues in advanced practice ambulatory settings. Eighty-one nurse practitioner students selected a process or protocol that occurred in their clinical setting to analyze for potential error. Root cause analysis was utilized as the examination tool. Following root cause analysis, students developed recommendations that would decrease the likelihood of an error occurring in the future with the chosen process/protocol. The outcome of the analysis was submitted as a paper. Additionally, faculty wanted students to see the linkage of education to practice, and to feel that implementation of recommendations for their identified safety and quality process/protocol could be implemented in practice following graduation.

Eighty-four percent of the submitted papers fell into four categories that students believed had a potential for error. The major categories were: medication errors (50.6%), laboratory analysis errors (23.5%), and missed diagnoses (9.9%). The fourth category of “Other” (16%) included various paper topics with two or less in the same area. The importance of the particular processes/protocols selected and analyzed by students for error potential was supported by the similarity of student outcomes to studies published in the literature regarding ambulatory care errors. Additionally, the students communicated through the course evaluation system that the assignment was interesting, promoted safer practice, and had the potential for implementation following graduation.

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