Introduction. Qsen Is Quality And Safety In Nursing. It

4. Please choose two Quality and Safety Education for Nurses (QSEN) competencies and give an example in your own words for

In October 2005 the Quality and Safety Education for Nursing program was established. This program is funded by the Robert Wood Johnson Foundation. QSEN was developed specifically for future nurses to understand and be aware of key challenges such as the knowledge, skills, and attitudes that are essential to constantly advance the quality and safety of the way healthcare systems work. The goal for QSEN is to reshape the identity of nursing so it includes the recommendations by the Institute of Medicine so there is a commitment to the quality and safety proficiency (Dycus, 2009).

Quality and Safety Education in Nursing (QSEN) was started around 2005 by the Robert Wood Johnson Foundation. QSEN's main goal is to “prepare future nurses with knowledge, skills and attitudes (or KSAs) necessary to continuously improve the quality and safety of the healthcare system,” (QSEN, 2017). “Integration of clinical skills with the intellectual capacity to safely manage the complexity of nursing work in key to quality care in a time of diminishing resources,” ( Dolansky, 2013). “It is vital for schools of nursing to meet the needs of today's complex health care systems by including principles of quality and safety throughout the curriculum,” (Lewis, 2016). Within the KSAs are six main categories; patient-centered care, teamwork

The QSEN competences which are affected are the focus on patient safety and teamwork and collaboration. QSEN defines teamwork and collaboration as the “ability to function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care.” (Pre-Licensure KSA 's). QSEN defines patient safety as “Minimizes risk of harm to patients and providers through both system effectiveness and individual performance” (Pre-Licensure KSA’s). Failure to work with and collaborate with each other can break down morale and communication which in turn can negatively affect the patient. It is important to continue research and studying this topic, because the lasting effects of lateral violence can affect the health of the nurse and the patient long term and affect the revenue and budget of the hospital.

The health care institution has been considering a wide array of solutions to improving the quality of patient care within the facility, and it is now believed that a suitable course of action is represented by the improvement of the nurse reporting at the bed of the patient, at the change of the shifts. This strategy is beginning to draw more attention within the medical community, but it has yet to be fully adopted by the health care institutions.

The overall goal through all phases of The Quality and Safety Education for Nurses (QSEN) is to address the challenge of preparing future nurses with the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems in which they work. In order to accomplish this goal, six competencies were defined. These competencies from the Institute of Medicine (IOM) are patient centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics and safety. Over a decade has passed since the Institute of Medicine’s reports on the need to improve the American healthcare system. The Quality and Safety Education for Nurses

Over time the health care industry has become more complex. Health care is rapidly evolving and continuing to complicate our delivery of care, which in turn has the same effect on quality of care. This steady evolution and change results in nursing shortages and an increase in the prevalence of errors being made. In hopes of preventing these errors and creating safe and high quality patient care, with the focus on new and improved ways of thinking, The Quality and Safety Education for Nurses (QSEN) initiative was developed. The QSEN focuses on the following competencies: patient-centered care, quality improvement, safety, and teamwork and collaboration. Their initiatives work to prepare and develop the knowledge, skills, and attitudes that are necessary to make improvements in the quality and safety of health care systems (Qsen.org, 2014).

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

Dolansky and Moore (2013) argued that the development and integration of QSEN competencies into nursing education had not have the outcomes intended. They stated "over a decade has passed since the Institute of Medicine (IOM) report, To Err Is Human: Building a Safer Health System" and national initiatives to improve quality, especially QSEN, have been futile in significantly improving quality and safety. "QSEN is a national movement that guides nurses to redesign the "what and how ' they deliver nursing care so that they can ensure high-quality, safe care" (Dolansky & More 2013).

Bedside reporting involves giving information or a report to the oncoming nurse in the presence of a patient. This method gives the patient an opportunity to ask questions and get clarification regarding his or her care. Bedside reporting increases patient satisfaction, quality of healthcare and nurse-to-nurse responsibility. Hospitals need to design a better handoff process that can easily reduce patient risks and increase patients’ involvement in their care. Emergency rooms shift reports usually take place at the nursing station of every patient care area. The departing nurse gives information verbally to the oncoming shift. Therefore,

The Quality and Safety Education for Nurses (QSEN) Institute developed six core competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (Quality and Safety Education for Nurses Institute, 2017). At my facility, it is clearly evident that they have adopted these six core competencies to improve patient quality and safety. My facility created the Office of Patient Experience which supports care that is safe, of high quality and high value. Patient satisfaction is a top priority which is why our guiding principle is known as “Patients First”. Through teamwork and collaboration, we deliver care that is patient-centered by working together in multidisciplinary rounds on the inpatient units. Also, the nursing education department supports quality, safety and consistent nursing care through a database of policies and procedures developed using evidence-based research. Lastly, the nursing informatics department is working towards making our EPIC system more patient-centered. They are doing this by decreasing the redundancy in charting for the nursing staff and finding ways to improve processes which automate tasks. This in turn will reduce the time that the nursing staff spends with their computer and increase the time that the nursing staff can spend with their patients.

The patient has the right to every aspect of their care and this includes being involved in the change-of-shift bedside report. The purpose of this study is to identify the benefits of bedside report and its impact on patient safety, satisfaction, and quality of care. The participants of this study were randomly selected and of varying ages. The methodology utilized in this study is a qualitative and quantitative research. The results of the study will determine the benefits of incorporating bedside report into nursing care.

In order to successfully implement this change at Pelham Medical Center, several key professions needed be involved. The staff nurses need to actively participate in bedside shift report.

The shift report is an integral component of patient care due to the fact that it advances patient safety and maintains continuity of care. Shift reporting promotes best practices through communication among nursing staff, therefore, promoting professional socialization. Furthermore, shift report influences staff retention and quality of patient care by improving informational, social and organizational functions. The expertise and knowledge in shift reporting can be used to promote interdependence and teamwork. When compared to traditional reporting, bedside shift reporting has such advantages as enhancing time management, social interaction, peer support and procedural training. Shift reports taken and given at the bedside benefit patients as well. Many patients have expressed improved satisfaction and nursing accountability with bedside shift reports. For instance, an orthopedic unit manager, who dropped the traditional staffroom reporting and handover and replaced it with a patient-led system, reported increased patient satisfaction because her patients felt that they were in control.

Verbal communication between the nurses during shift change or simply writing a progress report on the status of the patient does not cater to the needs of the patient, it is a mere communication method that is unreliable and nurse perception of the written report are often molded with bias and does not wholly represent the patient’s holistic health care needs. As dictated by Caruso (2007), “Change of shift signifies a time of carful communication in order to promote patient safety and best practices... [the risk exists of] relaying important information becomes muddled by irrelevant information instead...” (p.17). In essence, implementation of bedside nurse shift report/handover deems to provide the most opportune outcomes and focuses on patient-centered