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QSEN Competencies

By: Sarah Bennett, Katie Cheuvront, and Keri Dunlop

Learning Objectives:

Learning Objectives

  • Explore the history of QSEN in the nursing profession.

  • Identify the six competencies of QSEN.

  • Discuss pressure ulcers and how QSEN effects their treatment in the clinical setting.

History of QSEN in the Nursing Profession:

History

  • QSEN stands for quality and safety education in nursing.

  • ANA says purpose of QSEN is to improve quality and safety in nursing.

  • Began in 2005 funded by the Robert Wood Johnson Foundation.

The 6 QSEN Competencies:

Competencies

1. Patient- Centered Care

2. Evidenced Based Practice

3. Teamwork and Collaboration

4. Safety

5. Quality Improvement

6. Informatics

Patient- Centered Care:

Patient- Centered Care

Definition- Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs.

  • Knowledge:
  • Explore ethical and legal implications of patient- centered care.
  • Describe the limits and boundaries of therapeutic patient- centered care.
  • Skills:
  • Recognize the boundaries of therapeutic relationships.
  • Facilitate informed patient consent for care.
  • Attitudes:
  • Acknowledge the tension that may exist between patient rights and the organizational responsibility for professional, ethical care.
  • Appreciate shared decision- making with empowered patients and families, even when conflicts occur.

Evidenced Based Practice:

Evidence Based Practice

Definition- integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care

  • Knowledge:
  • Includes components of research evidence, clinical expertise and patient values
  • Understand the difference between research evidence and opinions
  • Determine best clinical practice
  • Skills:
  • Participating in data collection and research
  • Integrating the evidence into clinical practice
  • Attitudes:
  • Understand the need for quality improvement and research
  • Being adaptable in the clinical setting to ever changing research

Teamwork and Collaboration:

Teamwork and Collaboration

Definition- Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care

  • Knowledge:
  • Describe scopes of practice and roles of health care team members
  • Describe strategies for identifying and managing overlaps in team member roles and accountabilities
  • Recognize contributions of other individuals and groups in helping patient/family achieve health goals
  • Skills:
  • Function competently within own scope of practice as a member of the health care team
  • Assume role of team member or leader based on the situation
  • Initiate requests for help when appropriate to situation
  • Clarify roles and accountabilities under conditions of potential overlap in team member functioning
  • Integrate the contributions of others who play a role in helping patient/family achieve health goals
  • Attitudes:
  • Value the perspectives and expertise of all health team members
  • Respect the centrality of the patient/family as core members of any health care team
  • Respect the unique attributes that members bring to a team, including variations in professional orientations and accountabilities

Safety:

Safety

Definition- minimizes risk of harm to patients and providers through both system effectiveness and individual performance

  • Knowledge:
  • Understanding human factors and safe practice vs unsafe practice
  • Understand the causes of errors and how to improve
  • Understand how technology can reduce human error when used correctly
  • Skills:
  • Using safe and standardized practice in the clinical setting
  • Communicating and reporting errors when they are witnessed
  • Attitudes:
  • Value own role in preventing errors in the clinical setting

Quality Improvement:

Quality Improvement

Definition- Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.

  • Knowledge:
  • Recognize that nursing and other health professions students are parts of systems of care and care processes that affect outcomes for patients and families
  • Give examples of the tension between professional autonomy and system functioning
  • Skills:
  • Use tools (such as flow charts, cause-effect diagrams) to make processes of care explicit
  • Participate in a root cause analysis of a sentinel event
  • Attitudes:
  • Value own and others’ contributions to outcomes of care in local care settings

Informatics:

Informatics

Definition- use information and technology to communicate, manage knowledge, mitigate error, and support decision making.

  • Knowledge:
  • Identify essential information that must be available in a common database to support patient care
  • Contrast benefits and limitations of different communication technologies and their impact on safety and quality.
  • Skills:
  • Navigate the electronic health record.
  • Document and plan patient care in an electronic health record.
  • Employ communication technologies to coordinate care for patients.
  • Attitudes:
  • Value technologies that support clinical decision-making, error prevention, and care coordination.
  • Protect confidentiality of protected health information in electronic health records.

How the six competencies of QSEN effect the treatment of pressure ulcers in the clinical setting:

QSEN and Pressure Ulcers

Patient- Centered Care:

Patient- Centered Care

  • Educate the client and caregiver on the treatment and prevention of pressure ulcers.

  • Provide client with physical and emotional support/comfort.

  • Providing quality care in the treatment and prevention of pressure ulcers by maintaining skin integrity and setting up a rotation schedule for the client to distribute weight over bony prominences.

Evidence Based Practice:

Evidence Based Practice

  • Evidence supports pressure ulcer prevention is multidisciplinary, multidimensional, customizable, needs to be routine.

  • Evidence supports pressure ulcer prevention is a comprehensive skin assessment, standardized pressure ulcer risk assessment, and planning and implementing addressing the areas at risk or affected.

Teamwork and Collaboration:

Teamwork and Collaboration

  • Multidisciplinary approach is crucial in assessing and treating pressure ulcers:
  • Nurses measure, assess and treat the wounds.
  • Nursing assistants can turn and reposition clients as well as perform continence care.
  • Dietitians can help provide clients with appropriate nutrition to help aid the healing process.
  • Social services can be available to help patients and families make decisions.

  • It is our job as students to demonstrate the value of teamwork in order to heal the pressure ulcer.

Safety:

Safety

  • Braden scale is widely used to determine patients at high risk for a pressure ulcer.

  • Multidisciplinary but a lot of the responsibility is on the nurse to be turning patients (q2 if needed) and performing sterile wound care and dressing changes if needed .

Quality Improvement:

Quality Improvement

  • Quarterly skin prevalence studies.

  • Developing a pressure ulcer prevention and treatment program can benefit nurses in the care of their patients.

  • Establishing a Risk Assessment-based Treatment plan- Pressure Ulcer Prevention Prevention Protocol (PUPP).

Informatics:

Informatics

  • Using electronic health record to document the treatment and prevention of pressure ulcers.

  • Use electronic database for plan of care

  • Use electronic health record to document rotation schedule to allow other nurses to know the process of the client’s care.

Discussion Questions:

Discussion Questions

1. How as a student can you incorporate QSEN into your clinical experience at the bedside or how have you already seen QSEN incorporated at the bedside during clinical?

2. Which QSEN competency do you believe you have used the most in the clinical setting?

3. As nursing students and now have been in the clinical setting, is there anything you would change or add to the QSEN competencies that you feel are important and not incorporated? If so, what would you add?

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