Integrating QSEN in Nursing Orientation:
Can It Be All Fun and Games?
Kenneth M. Miller MSN, RN, CCRN
Professional Role Development Specialist
Simulation Program Coordinator
Department of Nursing Practice, Research, and Education
May 2016
Disclosures
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Objectives
• Describe the integration and evidence that supports the use of learning games
as a strategy in nursing orientation.
• Describes the games “The Big Picture” and “The Diversity Game/Chainlinks”
and applies the QSEN competencies to the game’s outcome.
• Participates in the game “Lifeboat and applies the QSEN competencies to the
game’s outcome.
• Analyzes evaluation feedback and the potential implications for other QSEN
competencies.
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Games
The QSEN Competencies in Nursing Orientation
UCLA Health
•Rank #3 in U.S. News & World Report 2015
•One Magnet-Designated Hospital
•Two hospitals on the Magnet Journey
•Transplant Center of Excellence
•Employs over 3,000 RNs
•In 2015, 600 Nurses attended the orientation program.
5
Orientation History
•
Guest Speakers on Nurse Sensitive Indicators
•
Power Point Presentations
•
Analyzing Orientation Evaluations
6
Re-imagining Orientation with QSEN and
Adult-Learning
• Evidence Based Program
•Games
•Joseph & Diack (2015)
• Using games in IPE indicated that the pariticapants felt improvement in learning
other professional roles.
•Boctor (2012)
• Study results show that students want to increase in use of games.
•Baker (2012)
• Games motivate and alleviate stress.
•Baid & Lambert (2009)
• Less hierarchy, fosters passing of information amongst peers.
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The Big Picture
Putting Together the Big Picture
Putting the Big Picture Together
• Objective of the game is to place a series of pictures
together that are related and tell a story.
• Each participant is given a picture.
• Each participant must describe their picture to the
group, without the group actually seeing the picture.
• Following first debriefing, the participants are allowed
to show each other the pictures.
• Final debriefing.
• QSEN competencies stressed are teamwork and
collaboration along with quality.
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Place Video Here
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Debriefing Questions
• How does it feel when you cannot see the big picture clearly?
• Did anyone see the picture differently? Did you speak up?
• How did you work together as team to accomplish the goal?
• What problems did you encounter? Do you see a relationship
with any nurse sensitive indicator?
• How do you see the “big picture” influencing the quality of
patient care?
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The Diversity/Chain Links Game
Building the Most Expensive Chain
Diversity Game/Chain Links
• Objective of the game is for one group to build the most
expensive chain with construction paper.
• The end product of this activity is a rich and organic
discussion concerning diversity, society hierarchy, and its
nursing implications.
• QSEN Competencies stressed are patient centered care,
and team work/collaboration.
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The Game
• Each group (groups of 5 or 4 will work)
• Each group has a specific color of construction paper and tools
•Green paper is worth the most and yellow is the least.
•The green group will have 2 pair of siccors and tape, the rest will have one
pair, but the yellow paper group will have none.
•They may barter colored paper between groups.
•All strips must be cut, not torn.
• Rules
• Green group makes three rules and every group must abide by these new
rules.
•Yellow group members must immigrate to new group.
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Insert Video Here
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Debriefing
•Allow the participants to “Shake off” the game.
•Game can be exhausting for some. Let them share
their feelings before moving forward.
•Was there a team that was at an advantage?
•Was there a team at a total disadvantage?
•How does the other teams feel about this?
•Looking back at the game, what implications did we
discover that could be applied to your practice/
•What will you take away from this game.
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Lifeboat
Who would you save?
Who would you save?
Priest
Rabbi
Minister
12 Year old boy
29 year old pregnant woman
35 year old sailor
55 year old cook
60 year old steward
80 year old physician
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Who would you save?
• Priest
Has 5 days of food
• Rabbi
Has 5 days of fresh H2O
• Minister
Has 6 life-jackets
• 12 Year old boy
Has Cerebral Palsy
• 29 year old pregnant woman
Having a breech birth
• 35 year old sailor
Is blind.
• 55 year old cook
Is a professional fisherman
• 60 year old steward
Is a professional rower
• 80 year old physician
Is a psychiatrist
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The Evaluations and Outcomes
Outcomes 2015
–
Agree–
Somewhat
Agree–
Neutral–
Somewhat
Disagree–
Disagree–
N/A–
Total–
Weighted
Average–
–Did you find
the games
insightful with
team building?
88.73%
244
8.73%
24
1.45%
4
0.36%
1
0.36%
1
0.36%
1
275
1.14
–Did you find
the games
useful in role
developement/
delegation?
86.18%
237
9.82%
27
2.91%
8
0.36%
1
0.36%
1
0.36%
1
275
1.18
–Did you find
the games
useful in
development of
leadership
skills?
85.09%
234
9.82%
27
4.00%
11
0.36%
1
0.36%
1
0.36%
1
275
1.20
–Did you find
the games
applicable to
your practice
as a RN?
81.92%
222
7.75%
21
4.43%
12
1.11%
3
0.74%
2
4.06%
11
271
1.24
–Did you find
the games
enjoyable?
85.66%
233
9.56%
26
2.21%
6
1.47%
4
0.74%
2
0.37%
1
272
1.21
Outcomes 2016
–
–
Did you find
the games
insightful with
team building?
Agree–
Somewhat
Agree–
Neutral–
Somewhat
Disagree–
Disagree–
N/A–
Total–
Weighted
Average–
87.30%
110
11.11%
14
0.00%
0
0.79%
1
0.79%
1
0.00%
0
126
1.17
84.13%
106
12.70%
16
1.59%
2
0.79%
1
0.79%
1
0.00%
0
126
1.21
Did you find
the games
useful in
development
of leadership
skills?
85.48%
106
12.10%
15
0.81%
1
0.81%
1
0.81%
1
0.00%
0
124
1.19
–Did you find
the games
applicable to
your practice
as a RN?
71.20%
89
14.40%
18
4.00%
5
0.00%
0
1.60%
2
8.80%
11
125
1.32
–Did you find
the games
enjoyable?
83.33%
105
12.70%
16
0.79%
1
0.79%
1
2.38%
3
0.00%
0
126
1.26
–
Did you find
the games
useful in role
developement/
delegation?
–
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Do you have a clear understanding of evidenced-based
practice at UCLA Health?
Answer Choices–
Responses–
–strongly agree
75.00%
462
–agree
23.38%
144
–neutral
0.97%
6
–disagree
0.16%
1
–strongly disagree
0.49%
3
Total
616
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Summary
•Closing the gaps between previous practice and the
expected practice of the new facility can be challenging.
•Games are a fun and interactive method to learn the
concepts of the QSEN competencies.
•Nurse educators can use these games as a catalyst for
rich discussion of the concepts of QSEN competencies
and application to clinical practice.
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References
•Baid, H & Lambert, N. (2009). Enjoyable learning: The role of humour, games, and fun
activities in nursing and midwifery education . Nurse Education Today, 30(0), 548-552.
•Baker, L.M. (2012). Fun and games: Connecting for learning. International Journal of
Disability, Development and Education, 59(1), 119-123.
•Boctor, L. (2012). Active-learning strategies: The use of a game to reinforce learning in
nursing education A case study. Nurse Education in Practice, 13(0), 96-100.
•Joseph, S & Diack, L. (2015). Playing interprofessional games: Reflections on using the
interprofessional education game. Journal of Interprofessional Care, 29(3), 260-262.
•http://www.teampedia.net/wiki/index.php?title=Main_Page
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