The Quality And Safety Education For Nurses

The six Quality and Safety Education for Nurses competencies that were developed for pre-licensure and graduate nursing programs are patient-centered care, teamwork and collaboration, evidence-based practice (EBP), quality improvement (QI), safety, and informatics.

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

In the article “What Do Nurses Really Do?”, Suzanne Gordon explores what nurses truly do. She concludes that nurses “save lives, prevent complications, prevent suffering, and save money” (Gordon 2006). Nurses provide care for their patients in the physical and emotional sense. Emotionally caring for a patient and being sensitive to his or her needs result from interacting with patients while performing the skills and using the knowledge that nurses learned in school. Nurses grow in their skills, knowledge, and attitudes through practice. Quality and safety education for nursing incorporates competencies that all nurses must use in their practice. These nursing competencies include evidence-based nursing practice, quality improvement, safety, teamwork and collaboration, patient-centered care, and informatics.

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).

Quality and Safety Education for Nurses (QSEN) was developed with the purpose of providing professional nurses with the knowledge, skills and attitudes (KSA) necessary to continuously improve the quality and safety of the health care systems within which they work (QSEN, 2014). However, since its implementation and integration in nursing education, studies show little progress in improving quality and safety in health care delivery (Dolansky & Moore, 2013). The purpose of this article critique is to evaluate the cause analysis and recommendations made by the authors.

QSEN is quality and safety in nursing. It is designed for nurses to continuously improve the quality and safety of patient care delivered. Interdisciplinary friction can threaten the delivery of quality patient care. In addition to ineffective communication and teamwork which can be very detrimental and result in adverse effects in patient care. These adverse reactions lead to the need for incident reports to be filled out, however, some reports end up incomplete or overlooked. The implementation of new skills can change the outcomes in patient safety.

In choosing one of the QSEN competencies to describe and how it impact our practice, and the future of our practice teamwork and collaboration and informatics both came to mind. It was difficult to separate the two, because for many of us technology (informatics), has changed the way we all communicate in our individual practices, and many nurses feel that health informatics and its clinical application at the bedside in some instances actually take away from patient care, some facilities have not yet made the integration from paper to electronic records and documentation.

The second category of provisions relates to the nurse’s responsibility to maintain their own proficiency and health environments, delegate appropriately, preserve integrity, and keep their practice and competence current. It is crucial that nurses are proficient and maintain competency in order to deliver high quality care to patients. "The virtue of professional competence calls for continual professional growth and a commitment to lifelong learning. You must practice nursing that’s evidence-based, be knowledgeable about the scope and standards of nursing practice, and have the necessary skills to perform nursing tasks effectively” [ (Lachman, 2008, p. 44) ].

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 Institute of Medicine (IOM) has recognized five key core competencies (CCs) that all healthcare professionals should be aware of during practice. The initial competency described concentrates on patient-centered care. Throughout history, the nursing community has continued to evolve, both in the practicing aspect and in level of caring for patients. During this evolution of nursing care, nurses providing hands on care to patients must refer to the Institute of Medicine, peer reviews and/or evidenced-based research to guide them properly as it applies to the core concepts of nursing. The first core competency according to the IOM is patient-centered care.

Mary considers “Competencies for registered nurses” is affecting her career the most. It helps her to maintain the high standards as a nurse. This document has been implemented by Nursing Council of New Zealand (NCNZ) to ensure the on-going education and compliance with standards for nursing care. It consists of four main parts. They are competences in professional responsibility, management of nursing care, interpersonal relationships and interprofessional care and quality improvement. It requires ability to show knowledge and judgment, and being responsible for own actions and decisions, while assuring safety of the patients, their independence and quality of life and health. Also it requires competences in client assessment and managing the care. The clients care should be sensitive to his/her needs. It is supported by nursing knowledge and evidence based research. Besides to comply with “Competences for registered nurses” the patient care should be cultural sensitive (Nursing Council of New Zealand, 2007). Every 3

The five core competencies identified by IOM and the sixth added by QSEN, safety, are believed to be necessary to improve both quality and safety of the healthcare system within which nurses work (Multimethod teaching). The six core competencies outlined are patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety (Diffusing Qsen). While all competencies are significant to the healthcare system, patient centered care is vital to positive patient outcomes and focuses on the patient’s perspective within the healthcare system.

As a competent registered nurse, my career goal is to become a healthcare quality improvement leader, a position that would enhance my commitment in promoting patient safety. I not only believe in enhancing the capacity of other care providers, but also in improving the quality of the healing environment for the benefit of both patients and their care providers. This means not only promoting collaboration with the multidisciplinary teams, but also building the necessary healing partnerships with our patients. To enhance the quality of the healing environment, I aspire to continue analyzing researches for evidence based practices and advocating for their actualization. I will continue focusing my time and energy in encouraging other nurses to improve their skills through formal education, so they can empower themselves as advocates of quality improvement for the benefit of their patients and coworkers.