Quality and safety education for nurses(QSEN) Practice Standards

1. Quality and safety education for nurses(QSEN) Practice Standards Randi Sniegowski Cassandra Arvoy Denise Montero

2. HONORABLEMENTION Florence Nightingale played an integral part of quality care and safety years before QSEN was developed. She set a higher standard for nurses and improved the sanitary conditions in hospitals. Nightingale dedicated her life to improving health care while providing safe and compassionate treatment to patients.

3. QSEN: QSEN is a national initiative created to recognize competencies, knowledge, skills and attitudes required by health care professionals to improve safety and quality of care (Disch, 2012).

4. History In 1999 the Institute of Medicine (IOM) brought to the attention of health care workers and patients that 98,000 to 187,000 patients were dying each year from preventable mistakes (Disch, 2012).

5. History cont. For over a decade the Institute of Medicine (IOM) had reported substantial shortcomings in the quality of care and safety of patients.

6. History cont. Countless efforts were suggested to create high reliability organizations and encourage employee involvement; however, many facilities nationwide were falling short of these objectives (Disch., 2012).

7. History cont.

9. RWJF funding • RWJF funded the national study RWJF awarded the University of North Carolina at Chapel Hill School of Nursing a $590,000 grant for Phase I. • The grant was to evaluate and enhance nursing school curricula in quality and safety that was called for by the IOM(Brown, Feller & Benedict, 2010).

10. Dr. Linda Cronenwett the School of Nursing dean in 2005, at the University of North Carolina, became project director for phase I of the QSEN initiative. • The phase I panel included 17 national nursing leaders and an interprofessional advisory board. Phase I ended in early 2007. • (Brown et al, 2010).

11. QSEN: Phase II • Phase II funding was $1,094,477 • (2007-2009) • Created a website: QSEN.org. • Offered resources for teaching the QSEN competency requirements. (QSEN, 2013)

12. QSEN: Phase III & IV • Phase III funding of $4.25 million • (2009-2012) • Initiated competency teaching strategies. • Promoted faculty expertise • Competency in textbooks were initiated. • Phase IV began in 2012 focusing on Advanced education for nurses expected to use $4.3 million in grants. (QSEN, 2013)

13. QSEN: Core activities • Creating definitions of the IOM competencies applicable to nursing. • Developing knowledge, skills, and attitudes that serve as learning objectives for each competency. • Supplying faculties the necessary tools to teach safety and quality of care applicable to each competency.

14. QSEN: Core activities cont. By partnering with textbook authors and publishers, QSEN has developed and implemented competencies for quality and safety content in hundreds of training facilities across the country (Disch,2012).

15. QSEN: QSEN addresses the challenge of preparing future nurses with the knowledge, skills, and attitudes (KSAs) necessary to continuously improve the quality and safety of the healthcare systems in which they work. The 2005 QSEN initiative has rapidly gained traction in enhancing nursing curricula, practice–academic partnerships, and clinical practice . (Barnsteiner, Disch, Johnson & McGuinn, 2013)

16. QSEN cont. • It was determined that if nursing graduates are to be effective members of the health care team, interprofessional education must be a part of the curriculum. • Interprofessional education involves students learning from other professions; in this case, other members of the health care team (Disch, 2012).

17. QSEN cont. Since the introduction of QSEN competencies, higher teaching has been established such as: • Applying practical expectations for today’s graduates. • Faculty are learning approaches to teach all content, not only that of quality and safety. • Teaching has shifted from nursing faculty to include clinical leaders as a partnership to instruct and implement the competencies.

18. QSEN Initiatives: Completing a national survey of baccalaureate program leaders and a state survey of associate degree educators. • To assess beliefs about the extent to which the competencies are included in current curricula. • The level of satisfaction with student competency achievement and the level of faculty expertise in teaching the competencies.

19. Denise’s Practice Standards As a cardiovascular nurse, my practice standards are reinforced on a daily basis, while always keeping my patient’s safety and well being as a priority. Examples are: • Continuously monitor my patient’s heart rate and rhythm. • Assess for chest pain as dictated by protocol or more often if I feel necessary. • Verify compatibility of all IV medications, especially those specific to cardiac patients. • Contact the physician with any changes in heart rate or rhythm as well as any abnormal lab values immediately. • Provide thorough patient teaching upon discharge, especially following a cardiac procedure.

20. ATTITUDE As a student nurse I received baseline knowledge and skills that I continually build upon as a practicing nurse. QSEN competencies are vital when caring for another human being. Every day I learn something new that I can improve upon as a nurse to apply safer and quality patient care. I believe attitude plays an integral part when providing quality care for patients. As I start my shift I always try to have a good attitude. Example: When a nurse gives me report and starts off with a remark such as, “this patient is the biggest jerk or they drove me crazy all night wanting their pain meds”. I respond with, “what is this patient here for and what are we doing to help them”? You can have all the knowledge and skills in the world but with a bad attitude you can not provide quality patient centered care. One bad attitude can affect the entire team and jeopardize the safety and care of the patients. C.Arvoy, RN Practice standards

21. Influence in my nursing practice As a geriatric nurse for over 7 years, I use the KSAs on a daily basis. It is important to have a knowledge base for understanding all of the complexities that effect the body as we age both naturally and during acute illnesses. Having the skill level to initiate and follow through with the care needed is essential. One of the most important KSAs is attitude. I believe a nurse can be full of knowledge, but if he/she does not have an attitude that creates trust, understanding and a sense of friendship, the care will suffer. Our patients look to us for comfort on a physical and emotional level. I spend each day striving to be the best nurse possible for the residents, their families and my co-workers. • Randi Sniegowski, RN

22. References: Barnsteiner, J., Disch, J., Johnson, J., & McGuinn, K. (2013). Quality and safety education for nurses.Journal of Professional Nursing, 29(2), 65. Doi: http://dx.doi.org/10.1016/j.p Brown, R., Feller, L., Benedict, L. (2010). Reframing nursing education: the quality and safety education for nurses initiative. Teaching and Learning in Nursing, 5(3) 115-118. Cronenwett, L., Sherwood, G., Gelmon, S.B. (2009). Improving quality and safety education: The QSEN learning collaborative. Nursing Outlook, 60(6), 304-312.doi:10.1016/j.outlook.2009.09.004 Disch, J. (2012). Qsen? what is qsen?. Nursing Outlook, 60(2), 58-9. Doi: http://dx.doi.org/10.1016/j.outlook.2012.01.001rofnurs.2013.03.002 QSEN. (2013). Project overview. Retrieved from http://qsen.org/about- qsen/