QSEN

QUALITY AND SAFETY

EDUCATION FOR NURSES
JAIME BARDENHAGEN, CATHERINE GILES, AMANDA
HUBBARD, & LORI NOUSEN
FERRIS STATE UNIVERSITY

What is QSEN

Quality and Safety Education for Nurses

(QSEN) is a foundation created to be a
comprehensive resource to improve and
standardize quality and safety education
for nurses (QSEN, 2011).
The QSEN foundation and website is a
resource for nursing educators worldwide
to promote quality and safety
competency development in nursing
(QSEN, 2011).
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Who Created QSEN

The QSEN foundation was funded in 2005 by the Robert Wood

Johnson Foundation.
Robert Wood Johnson founder of the Johnson & Johnson firm,
felt that hospital administrators needed training which led
him to work with Malcolm Thomas MacEachern, M.D to create
the Robert Wood Foundation.
Robert Wood Johnson had an intense concern for the hospital
patient whom he saw as being lost in the often bewildering
world of medical care. He strongly advocated improved
education for both doctors and nurses, and he admired a
keen medical mind that also was linked to a caring heart
(RWJF, 2011, para. 5)
Creation of the QSEN foundation was led by Dr. Linda
Cronenwett and Dr. Gwen Sherwood from the University of of
North Carolina (Brown, Feller & Benedict, 2010).
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Why Was QSEN Created

The QSEN foundation was created to increase

the quality of health care education and meet
the goals set by the Institute of Medicine (IOM)
in 2003 (Brown, Feller & Benedict, 2010).
The overall goal for the Quality and Safety
Education for Nurses (QSEN) project is to meet
the challenge of preparing future nurses who
will have the knowledge, skills and attitudes
(KSAs) necessary to continuously improve the
quality and safety of the healthcare systems
within which they work (QSEN, 2011, para. 2).
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Three Phased
Implementation

Phase I: Nursing curricula was evaluated for quality

and safety. The need for six competencies was
identified. The six competencies include patient
centered care, teamwork and collaboration, evidencebased practice, quality improvement, safety and
informatics (Brown, Feller, & Benedict, 2010).
Phase II: Strategies were developed to incorporated
the six competencies into nursing education (Brown,
Feller, & Benedict, 2010).
Phase III: Incudes an assessment of student learning,
and includes a focus on development of faculty
expertise, (Brown, Feller, & Benedict, 2010).

Pre-Licensure and Graduate

KAS

QSEN faculty and advisory board

members outlined the KSAs appropriate
for pre-licensure education as they felt
that graduating nurses did not have
these core competencies (Cronenwett et
al, 2007, p. 126).
KSAs developed to try and answer the
question, what should nursing promise
with regards to its pre-licensure
graduates quality and safety education
(Cronenwett et al, 2007, p. 126).
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Patient Centered Care

QSEN defines patient centered care as the

nurses ability to 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 (QSEN, 2011).
The proposed targets for KAS competency in
this area can be found at:
http://www.qsen.org/ksas_prelicensure.php
and
http://www.qsen.org/ksas_graduate.php
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Teamwork and Collboration

Cronenwett et al states, the essential features

of this competency include sections related to
self, team, team communication and conflict
resolution, effect of team on safety and quality,
and the impact of systems on team
functioning(2007, p. 129).
There are several models and communication
style to develop inter-professional team
functioning. To develop teamwork and
collaboration skills is derived from
strengthening communication practices with
each other (Cronenwett et al, 2007 pg. 129).
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Evidenced Based Practice

Is more than just evidence.

EBP involves patient preference and
values and the clinical expertise
necessary for delivery of optimal health
care ( Cronenwett et al,2007 p.129).
EBP involves collection, interpretation,
integrate the evidence and evaluate the
data.

Quality Improvement and

Safety

According to QSEN the definition for quality improvement is: 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 (QSEN, 2011).
Nurses who develop the KSAs for quality improvement, would learn
and use improvement methods as part of their coursework and clinical
practice, and they would enter the work force prepared to participate in
improvement work as a part of their daily work as health professionals
(Cronenwett et al, 2007, p. 127).
According to QSEN the definition for safety is: Minimize risk of harm to
patients and providers through both system effectiveness and
individual performance (QSEN, 2011).
Nurses who develop the KSAs in Safety will know about, human
factors and safety design principles, understand the importance of
error reporting and safety cultures, and value vigilance and crossmonitoring among patients, families, and members of the health care
team (Cronenwett et al, 2007, p. 128).

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Informatics

Cronenwett et al state that health professionals and

patients will rely increasingly on information technology to
communicate, manage knowledge, mitigate error, and
support decision making (2007, p. 130).
Nurses with informatics KSAs will be prepared to
participate in design, selection and evaluation of
information technologies used in patient care (Cronenwett
et al, 2007, p. 130).
KSAs include (Cronenwett et al, 2007, p. 130):

understanding why information technology is essential

familiarity with patient database contents
the ability to identify technology benefits and limitations and their
impact on patient safety
To be familiar with what it takes to make these technologies
available and effective).
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Quality and Safety Measures and My

Daily Practice (Jaime Bardenhagen)

A core measure post open heart surgery

is for blood sugar levels to be <200
through POD 2. Protocols concerning
blood sugar control are continually being
updated and nurses are being educated
about better blood sugar control
practices as new information becomes
available. This is one of many examples
from the CTU/CTSU that exemplifies the
quality and safety measures QSEN was
created to promote.
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How QSEN Affects My Daily

Practice (Amanda Hubbard)

Quality and safety should affect every nurses

practice. I work in the operating room. I am the
patients voice because they do not have one. My
main concern is the patients safety. Safe positioning
is a big deal in my area of expertise. A patient can be
in the same position for as long as 8 or 10 hours.
With pressure being on boney prominences for that
long, skin break down can occur. One of my jobs is
safe positioning so that it does not occur. I am also
responsible for doing a timeout before surgery begins
to make sure that surgery is being preformed on the
correct patient and site and to make sure everyone
on the team is on the same page.
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Teamwork & Evidence Based Practice

in My Daily Practice (Lori Nousen)

In my current practice area of medical

surgical nursing the Relationship Based
Practice is the model adopted to improve
our teamwork and working relationships.
We learned how to have caring
conversations and skills to work as a
team.
A EBP includes a Fall Risk Assessment to
discover patients who are high risk for
falling. There has been a decrease in falls
since the implantation.
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Informatics KSAs and My Daily

Practice (Catherine Giles)

According to Buckner and Gregory (2011, p. 297), an urgent need to

improve the safety and quality of care provided in our increasingly
complex health care system, health information technology has taken a
central role in the health care system .
As a clinical analyst I work daily with patient care information systems.
The importance of nurses having the KSAs as outlined by the QSEN
foundation will be of great value. Not only will nurses be able to use the
systems that are in place more effectively but they will understand the
importance of the systems and the effects that correct usage can have
on patient safety and quality care.
Studies have shown that nurses feel that computer systems, although
they increase safety and information availability, they can be intrusive
and negatively effect the nurse patient relationship (Buckner and
Gregory, 2011). It is for this reason that nurses can and should play an
integral role in implementing current systems and in helping to develop
new systems. The art of nursing is caring for patients not computers.
Nursing should play center stage in helping care providers to remember
this and bring balance back into patient care (Giles, 2011).
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References

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.
doi:10.1016/j.teln.2010.02.005
Buckner, M., & Gregory, D., (2011). Point-of-care technology:
preserving the caring environment. Critical Care Nursing
Quarterly, 34(4), 297-305. DOI: 10.1097/CNQ.0b013e31822bac0e
Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J.,
Mitchell, P., Warren, J., (2007). Quality and safety education for
nurses. Nursing Outlook, 55(3), 122-131.
Quality and Safety Education for Nurses (QSEN), (2011). Project
overview, Retrieved from http://www.qsen.org/overview.php
Robert Wood Johnson Foundation (RWJF), (2011). Our founder,
Retrieved from http://www.rwjf.org/about/founder.jsp

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