QUALITY AND SAFETY

USING THE QSEN

COMPETENCIES
By: Megan Francis RN
 What is the QSEN?

Stands for Quality and Safety for Nurses

Continuously improve the quality and

safety of healthcare systems utilizing the
knowledge, skills, and attitudes of nurses
 The 6 Competencies

Patient-Centered Care
Teamwork and Collaboration
Evidence-based Practice (EBP)
Quality Improvement (QI)
Safety
Informatics
 Patient-Centered Care
Elicit patient values, preferences and
expressed needs as part of clinical
interview, implementation of care plan and
evaluation of care
During the initial interview, nurses should assess
the patient values, preferences and the needs
that are important to the patient
These needs are to be implemented in the
patient care plan and should be used as an
evaluation tool
As the patients needs evolve the care plan
should be update accordingly
 Patient-Centered Care
Demonstrate comprehensive
understanding of the concepts of pain
and suffering, including physiologic
models of pain and comfort.
Nurses should convey a comprehensive
understanding of pain and suffering towards
patients
Nurses should be able to demonstrate and
explain the physiology behind pain, suffering,
and comfort
Nurses should utilize alternative comfort
measures in addition to pain medication
Pain should always be rated using a pain scale
 Patient-Centered Care
Recognize that patient expectations
influence outcomes in management of
pain or suffering
Use pain scales to measure the effectiveness
of pain medications/therapeutic measures
Patient expectations should be considered
when establishing individualized care plans
Patient expectations should also be realistic in
order to achieve the goals set up between the
patient and nurse
 Patient-Centered Care
Willingly support patient-centered care
for individuals and groups whose values
differ from own
Nurses should demonstrate cultural
competencies at all times and should
complete yearly evaluations of cultural
competencies
Know that not all individuals convey pain the
same way
Not everyone sees western medicine as a
positive thing
Patient-Centered Care
 Teamwork and
Collaboration
Recognize contributions of other
individuals and groups in helping
patient/family achieve health goals
Understand that working in interdisciplinary
teams is effective in managing care as a
whole for patients
It is important that everyone within the
interdisciplinary team collaborates and works
together
Inclusion of the patient and family with health
care goals is a necessity
 Teamwork and
Collaboration
Integrate the contributions of others who
play a role in helping patient/family
achieve health goals
Utilize the interdisciplinary team members
such as physical therapy or speech therapy
when it is warranted
Ensure that the patient is following
instructions given by other team members
such as using the inspirometer via respiratory
therapist
Elicit help from others to meet the goals of
your patient if you cannot do it alone
 Teamwork and
Collaboration
Respect the unique attributes that
members bring to a team, including
variations in professional orientations and
accountabilities
Value perspectives and expertise of everyone
in the interdisciplinary team
Utilize the attributes that team members
possess for the good of the patient
Dont take on all of the responsibility of the
patient goals, instead everyone should work
together to meet the health goals of the
patient
 Teamwork and
Collaboration
Assume role of team member or leader
based on the situation
During stressful situations such as codes, a
nurse needs to step up and control the chaos
as much as possible to reestablish order
All nurses should strive for leadership
positions/roles
Teamwork and
Collaboration
 Evidence-based Practice
(EBP)
Describe EBP to include the components
of research evidence, clinical expertise
and patient/family values.
Nurses should be able to research the most
current EBP for any
intervention/method/guideline
Nurses should be constantly evolving and
adding EBP to their clinical practice
With knowledge of a multitude of EBPs, the
nurse will be able implement interventions
based on the individual patient and family
values~ such as those who dont use
traditional pain medications
 Evidence-based Practice
(EBP)
Question rationale for routine approaches
to care that result in less-than-desired
outcomes or adverse events
Nurses should be able to research for a better
EBP intervention/process that can potentially
improve upon the current standards
Whenever there is an adverse event we
should be thinking Can we fix this? What
can we do to prevent this from happening
again Thus, EBPs should be researched and
presented to those in charge
 Evidence-based Practice
(EBP)
Value the need for continuous
improvement in clinical practice based on
new knowledge
Do NOT be stuck in the old ways and Do NOT
say Well, thats how we have always done it.
Technology is a blessing in an rapidly
changing world and scientific discoveries are
being made constantly. Do not resist change,
embrace it.
We should be striving to improve patient care
and clinical practice such as with the new vein
finders and ultrasounds to start IVs. These are
blessings to patients when used correctly
 Evidence-based Practice
(EBP)
Read original research and evidence
reports related to area of practice
Stay up to date on current practices that
relate to your field of nursing
Collect enough supporting material to back
changes being made to current practice
guidelines
Evidence-based Practice
(EBP)
 Quality Improvement (QI)
Recognize that nursing and other health
professions students are parts of systems
of care and care processes that affect
outcomes for patients and families
Students play a vital role in patient care and it
is instrumental that they are incorporated in
the care of patients
Students need to develop their skills and gain
experience to maximize performance
Most patients appreciate students being
active in their care and witnessing their
learning
 Quality Improvement (QI)
Use tools (such as flow charts, cause-
effect diagrams) to make processes of
care explicit
Clinical care pathways should be developed
specifically for each department according to
their specialty
These pathways should be implemented as
soon as the patient arrives to the floor
The pathways will provide a smooth flow of
care to expedite care and decrease length of
stay
 Quality Improvement (QI)
Appreciate that continuous quality
improvement is an essential part of the
daily work of all health professionals
Quality Improvement forms should be
examined thoroughly for the potential to
improve upon
EBP should be assessed and implemented in
order to improve existing standards of care
that are not optimal
Understand that changes being implemented
to improve patient safety and outcomes are
good
 Quality Improvement (QI)
Participate in a root cause analysis of a
sentinel event
Be an active member of peer review
committees or other quality improvement
organizations
Understand the root cause of a sentinel event
and develop ways to improve upon existing
patient care practices to prevent it from
happening again
Quality Improvement (QI)
 Safety
Examine human factors and other basic
safety design principles as well as
commonly used unsafe practices (such as,
work-arounds and dangerous abbreviations)
Realize that as humans we make mistakes, but
there are safety measures in use to prevent these
mistakes such as using the barcode scanner to
give medications to the right patient with the
right dose at the right time
Limit/avoid the amount of overrides in the pixis
machine
Only use universal short hand writing
 Safety
Demonstrate effective use of technology
and standardized practices that support
safety and quality
For instance, do not override the barcode
scanning of the patient or medication when
giving any medication
Know how to handle surgical equipment that
pertains to post surgical care
Understand the components of medication
pumps and how to use them
 Safety
Appreciate the cognitive and physical
limits of human performance
Celebrate the little wins and accomplishments
with patients
Understand that physical recovery starts with
a little motivation
Sympathize with the patients who are
depressed/frustrated due to their physical
limitations
 Safety
Value the contributions of
standardization/reliability to safety
Realize that we do things a certain way for a
reason
Safety of our patients is a top priority
Do not create short cuts in routine nursing
skills that lead to bad habits
Safety
 Informatics
Recognize the time, effort, and skill required
for computers, databases and other
technologies to become reliable and
effective tools for patient care
It is useless for hospitals to invest money into a
new computer charting system if none of the
employees are properly trained on how to use it
Employees need to utilize new technologies to
their fullest once trained in order for them to
become effective tools for patient care
Understand that these tools are to benefit the
patients as well as the staff
 Informatics
Document and plan patient care in an
electronic health record
Nurses should know how to navigate,
document, and create care plans in the EHR
Nurses should know how to use the clinical
pathways set up for certain disease processes
and where to find these pathways
 Informatics
Appreciate the necessity for all health
professionals to seek lifelong, continuous
learning of information technology skills
Realize that the world is technologically evolving
and it is imperative that the healthcare industry
keep up with the changes
Training is needed to develop new skills
Value being involved in the design, selection,
implementation, and evaluation of information
technologies
We as nurses can create improvements upon
existing technologies
 Informatics
Protect confidentiality of protected health
information in electronic health records
HIPPA should never be violated or taken lightly
Always close out and log off of EHR/EMR
Only discuss patient information with those
directly involved with patient care
Informatics
 Reference
QSEN Competencies. Retrieved from
http://qsen.org/competencies/pre-
licensureksas/