SC25\u2005Improving safety and quality of care in nursing education for the ‘future nurse’

Abstract

Background The University of Portsmouth vision for the ‘Future Nurse’ curriculum (NMC 2018), builds on existing opportunities for simulation based education (SBE). In particular, the course philosophy is specifically designed to integrate the use of SBE to improve patient safety and the quality of care, whilst maintaining a safe learning environment. New entrants to university may have unrealistic expectations of higher education, exacerbated by a less well developed ability to communicate effectively in complex unfamiliar situations. Summary of work The Universities learning and teaching strategy for pre-registration nursing is designed for diverse learners that typically commence nursing courses. We have systematically woven the key themes in the standards of proficiency (NMC 2018) throughout the undergraduate nursing curriculum, linking these elements to SBE and embedding the use of simulated patients (SPs) within evidence informed scenarios. Summary of results Our strategy includes a three-tiered, progressive approach to SBE. The acquisition of fundamental skills (physical and psychosocial) through SBE, supports the new learner to develop confidence and competence, prior to commencing placements. The introduction of SPs in evidence informed scenarios focusing on patient safety, challenges further, with learners practicing skills in a simulated environment and receiving feedback directly from the perspective of the patient, through SPs. In the final year, the scenarios, originating from errors and near misses in practice, capture the potential complexity and reflect the reality of healthcare in the 21st century, where serious untoward events may progress to the Coroners Court or NMC tribunal. Discussion Significant challenges are posed in placement based learning (PBL), where the population is becoming sicker and frailer and there is a clear policy for hospital avoidance (NHS 2019). Therefore, developing the learners’ ability to make informed decisions and to have caring conversations with the patient, is of increasing importance. Conclusion and recommendations SBE and engagement with SPs, as advocates for real patients and carers, offers opportunities to enrich the nursing curriculum and students’ experience. By embedding simulation in a systematic way, our curriculum supplements PBL and provides a series of inclusive opportunities to develop the knowledge, skills, attitudes and values required for the ‘Future Nurse’. The iterative approach to increasing complexity within scenario development and subject enhances learners’ skills in problem solving, relationship-building, communication and collaboration, whilst keeping people at the centre of care. Objective evaluation of these approaches is essential, in order to ensure that it is cost-appropriate, whilst remaining real and relevant. References National Health Service 2019 The NHS Long Term Plan. Nursing and Midwifery Council 2018 Future nurse: Standards of proficiency for registered nurses.