Professional Documents
Culture Documents
(2000)
Crossing the Quality Chasm: A New Health
System for the 21st Century (2001)
Health Professions Education: A Bridge to
Quality (2003)
Patient Safety: Achieving a New Standard for
Care (2004)
Identifying and Preventing Medication Errors
(2007)
knowledge
Individual learning
Individual
consequences for
error
Disciplinary focus
Systems knowledge
Team/Group learning
Interprofessional/
patient focus
Patient Care
Medical Knowledge
Practice-based Learning and
Improvement
Professionalism
Interpersonal and Communication Skills
Systems-based Practice
Goals
To alter nursings professional identity so that
QSEN Personnel
QSEN Leaders based in UNC-Chapel Hill
QSEN Faculty Experts in quality and safety
from throughout the U.S.
QSEN Advisory Board Leaders of
organizations that set standards for nursing
regulation, certification, and accreditation of
nursing programs
Paul Batalden
Geraldine Bednash
Karen Drenkard
Leslie Hall
Polly Johnson
Maryjoan Ladden
Audrey Nelson
Joanne Pohl
Elaine Tagliareni
* Phase II: Jeanne Floyd
IHI, ACGME
AACN
AONE
HPEC, ACT
NCSBN
ACT
ANA Safe Patient
Handling
NONPF
NLN
ANCC
QSEN Phase I
Define the territory (desired competencies)
Describe the knowledge, skills, and attitudes
(KSAs) expected to be developed in
prelicensure curricula
Disseminate/seek feedback and build
consensus for inclusion of competencies in
prelicensure curricula
Develop teaching strategies for classroom,
group work, simulation, clinical site teaching,
interprofessional learning
Create website resource for faculty
IOM/QSEN Competencies
IOM/QSEN Competencies
IOM/QSEN Competencies
Cronenwett, Sherwood, Barnsteiner et al, 2007
QSEN Assumptions
Curricular threads
Foci of accreditation of nursing programs
Foci of licensure or certification exams
Foci of transition to work (residency) program
development
Foci of criteria for recertification or relicensure
Current Assessments of
Quality and Safety Education
Smith, E. L., Cronenwett, L., & Sherwood,
G. (2007). Current assessments of quality
and safety education in nursing. Nursing
Outlook, 55 (3), 132-137.
Summary
The overwhelming majority of schools
Summary
EBP, QI and Informatics are the competencies where
Skills
Attitudes
Examine common
barriers to active
involvement of patients
in their own health care
process
Remove barriers to
presence of families and
other designated
surrogates based on
patient preferences
Respect patient
preferences for degree of
active engagement in
care process
Describe strategies to
empower patients or
families in all aspects of
the health care process
Engage patients or
designated surrogates in
active partnerships that
promote health, safety
and well-being, and selfcare management
Example: Safety
Knowledge
Discuss effective
strategies for reducing
reliance on memory
Describe processes
used in understanding
causes of error and
allocation of
responsibility (such as,
root cause analysis)
Skills
Use appropriate
strategies for reducing
reliance on memory
(such as, forcing
functions and checklists)
Use organizational error
reporting systems for
near miss and error
reporting
Engage in root cause
analysis rather than
blaming when errors or
near misses occur
Attitudes
Appreciate the cognitive
and physical limits of
human performance
Value own role in
preventing errors
Value vigilance and
monitoring (even of own
performance of care
activities) by patients,
families, and other
members of the health
care team
QSEN Publications
NCSBN Leader to Leader article April 2007
Special issue of Nursing Outlook May-June
Policy Strategies
Shared products with professional
organizations involved in licensure and
certification or in accreditation of prelicensure
programs
QSEN Assumptions
Website Sessions
QSEN Assumptions
Each competency can be, indeed needs to be,
taught or reinforced in multiple methods and
sites
Classroom
Skills/simulation Lab
Interprofessional
Courses
Web
Modules
PBL
Papers
Nursing Courses
Readings
Case
Studies
Reflective
practice
University of Nebraska
(SC)
Curry College (MA)
Emory University (GA)
Lasalle University (PA)
St. Johns College of
Nursing/Southwest Baptist
(MO)
University of Colorado at
Denver
University of MassachusettsBoston
Medical Center
University of South Dakota,
Sioux Falls
University of Tennessee
Health Science Center,
Memphis
University of WisconsinMadison
University of Pittsburgh
Medical Center-Shadyside
School of Nursing (PA)
Wright State University (OH)
competency achievement
Produce a curricular map with the quality and safety KSAs
integrated into their pre-licensure curriculum
Develop and evaluate teaching strategies for classroom,
clinical, and simulation/skills laboratories
Share teaching strategies through submissions to the
QSEN website
Document specific challenges encountered in the process
of curricular change
Share successful strategies for overcoming challenges with
others in collaborative conferences and conference calls
QSEN Assumptions
Nurses in practice settings are critical partners
QSEN Assumptions
Graduate Education
nurses in advanced
practice responsible for:
Standards of
practice
Accreditation of
education programs
Certification of APNs
advisory board
NONPF (2)
ONCC (1)
NACNS (2)
CCNE (2)
ACNM (1)
APNA (1)
Council on
AACN Cert
Accreditation Board (1)
of CRNAs (1) (critical care)
ANCC (2)
ANA (2)
Ped Nurs
Cert Board 2)
Graduate Education
Initial conversation:
Focus on advanced practice rather than all
advanced roles
Focus on advanced practice rather than the
type of program in which the graduate student is
prepared
Focus on goal of assisting faculty who wish to
develop quality and safety competencies
already identified as essential elements
Skills
Participate in building
consensus or resolving
conflict in the context of
patient care
--------------------Provide leadership in
building consensus or
resolving conflict in the
context of patient care
Attitudes
Respect patient
preferences for degree of
active engagement in
care process
-----------------------Valued shared decisionmaking with empowered
patients and families,
even when conflict occurs
Create or change
Value cultural humility
organizational cultures
so that patient and family Value the process of
preferences are
reflective practice
assessed and supported
Skills
Attitudes
Describe own
strengths, limitations,
and values in
functioning as a
member of a team
---------------------Analyze own strengths,
limitations, and values
as a member of a team
Acknowledge own
potential to contribute to
effective team functioning
-----------------------Acknowledge own
contributions to effective
or ineffective team
functioning
Appreciate the
importance of interprofessional collaboration
Skills
Read original research
and evidence reports
related to area of
practice
----------------------------Critically appraise
original research and
evidence summaries
related to area of
practice
Determine evidence
Exhibit contemporary
gaps within the practice knowledge of best
specialty
evidence related to
practice specialty
Attitudes
Appreciate the
importance of regularly
reading relevant
professional journals
---------------------------Value knowing the
evidence base for
practice area
Value public policies that
support evidence-based
practice
Recognize importance of
search skills in locating
best evidence
Skills
Assert leadership in
Explain common
shaping the dialogue and
causes of variation in
providing leadership for
outcomes of care in the the introduction of best
practice specialty
practices
Attitudes
Appreciate how
unwanted variation
affects care
----------------------------Appreciate the
importance of data that
allows one to estimate
the quality of local care
Appreciate that all
improvement is change
but not all change is
improvement
Example: Safety
Knowledge
Discuss effective
strategies to reduce
reliance on memory
--------------------------Evaluate effective
strategies to reduce
reliance on memory
Skills
Participate appropriately
in analyzing errors and
designing system
improvements
----------------------------Design and implement
microsystem changes in
response to identified
hazards and errors
Attitudes
Value own role in
preventing errors
-----------------------------Value own role in reporting
and preventing errors
Appreciate the importance
of being a safety mentor
and role model
Value the use of
organizational error
reporting systems
Example: Informatics
Knowledge
Describe examples of
how technology and
information
management are related
to quality and safety of
patient care
--------------------------Describe and critique
taxonomic and
terminology systems
used in national efforts
to enhance
interoperability of
information and
knowledge management
systems
Skills
Navigate the electronic
health record
----------------------------Model behaviors that
support implementation
and appropriate use of
electronic health records
Attitudes
Participant Responses
Are the competency definitions relevant to
their organizations
Feedback received in November, awaiting
full analysis
Dissemination