QSEN Competencies In Nursing
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QSEN project-Quality and Safety Education for Nurses
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Upload your resume. Sign in. Career Development. What is collaboration? The benefits of collaboration. Solving problems and examining the big picture Collaboration results in together a significant amount of talent, including professionals across a wide range of skills and knowledge. This allows you to benefit from a variety of perspectives. Inspiring self-analysis Working collaboratively can help you become more aware of your strengths as well as your weaknesses. This will help you leverage your best skills , and identify which areas you may need assistance from people with different expertise.
As a result, you and your teammates can work better together to fill in competency gaps. Teaching and learning You learn things from other team members every time you come together to collaborate. An organization that values collaboration encourages constant teaching and learning. Collaboration skills examples. How to improve your collaboration skills. Set clear goals and objectives. Communicate your intentions. Listen and learn to compromise. Overcome challenges and solve problems without assigning blame. Be open-minded. The QSEN website serves as a national educational resource and a repository for nurses to publish contemporary teaching strategies focused on the six competencies: patient-centered care, teamwork and collaboration, evidenced-based practice, quality improvement, and informatics.
Currently, there are over teaching strategies posted. Funded 15 pilot schools to use the IHI Learning Collaborative method to develop, test, and disseminate teaching strategies. American Association of Colleges of Nursing AACN funded to further develop graduate competencies and coordinate 5 graduate level faculty development conferences. Funding for a series of workshops for faculty and clinical leaders. Innovative educational model for undergraduate education that includes a clinical integration partner to assist with the QSEN-based clinical education model.
The full effect of the QSEN competencies to improve the quality and safety of care can only be realized when nurses apply them at both the individual and system levels of care. Many nurse educators report that the QSEN competencies are already integrated into their curriculum, but in our practice, we have noted that often this integration is at the individual level of care, rather than at the level of the system of care. Figure 1 provides a display of how the six QSEN domains are linked to optimal patient care through both vigilant individual care and vigilant systems of care. Traditionally, nurses have focused primarily on vigilant individual care ; less attention has been given to assisting nurses to provide vigilant systems of care.
Systems thinking is the ability to recognize, understand, and synthesize the interactions and interdependencies in a set of components designed for a specific purpose. This strategy includes the ability to recognize patterns and repetitions in interactions and an understanding of how actions and components can reinforce or counteract each other. These relationships and patterns occur at different dimensions: temporal, spatial, social, technical or cultural Oshry, Systems thinking can be viewed as a continuum, ranging from the individual to the larger internal and external environmental components.
Figure 2 shows examples of care approaches that represent increasing levels of systems thinking. How nurses view both themselves as nurses, and their work, is shaped by the structures and processes of the systems in which they work. Most nurses provide care in healthcare organizations that are characterized as complex, multilevel, and multifunctional. Greater knowledge and application of systems thinking skills by nurses have the potential to mitigate errors in practice, improve nurse priority setting and delegation, enhance problem solving and decision-making, improve timing and quality of interactions with other professionals and patients, and enhance workplace quality improvement initiatives.
Systems thinking is required to redesign healthcare to improve the quality and safety of care. Given the hypothesized importance of systems thinking in the success of quality and safety in healthcare, it is probable that if nurses engage in better systems thinking, greater improvements in outcomes will be achieved. Knowledge and skills associated with systems thinking, however, are seldom addressed in basic or continuing nursing education. The next sections describe strategies for teaching and learning systems thinking, especially as related to QSEN competencies, and a newly developed tool for measurement of systems thinking. Systems thinking is an essential skill for nurses.
Yet, there has been little knowledge disseminated about how to assist nurses to better engage in this type of thought process, despite their key roles in planning, delivering, and improving patient care in complex organizations. The clinical environment is an ideal place to teach systems thinking in undergraduate, graduate, and staff development education. Table 2 provides examples of this continuum of systems thinking using the QSEN competencies. An example of a teaching technique for systems thinking is to have learners create grids such as those presented in Table 2 to expand their scope of thinking from the individual to the system level of care. Students might obtain outcome data from their unit and identify reasons for variation across time.
Enhancing systems thinking skills also can be done by having learners complete an assessment of their unit or microsystem. Assessment tools are available from the Clinical Microsystem Green Books for inpatient, emergency room, long-term care, and outpatient groups. These free workbooks from the Dartmouth Institute have been developed to help individuals assess the complexity of the system in which they work.
Nurses can also learn systems thinking by creating flowcharts or process diagrams that elicit the steps of a care process and the multitude of healthcare workers involved in that process. This mapping technique is one of the first steps of a quality improvement project. Root cause analysis RCA is a widely used technique to assist people to move beyond blame of an individual for errors made in the workplace to understanding the system factors that may have contributed to errors. Healthcare organizations routinely perform RCA after an event so that appropriate changes can be made in the system to prevent future errors. For example, having students conduct an RCA for addressing a medication error may lend a new perspective to how system level factors interact with individual level factors in the creation of that error.
In the classroom setting, systems thinking also can be enhanced by using case studies. The book Set Phasers to Stun Casey, includes stories of design, technology, and human error that can be discussed in class. These stories identify the close connection between technology and humans. Highly effective and very interactive, the game Friday Night in the ER guarantees learning and fun. The game is played by four people and simulates the challenge of managing a hospital during a hour period. Each player is in charge of a unit. The demands of the game demonstrate that systems thinking is the key to success.
Lastly, teaching systems thinking requires guided reflection. Faculty need to assist learners to look for and recognize patterns in systems of care by standing back, reflecting on data, and considering the system as a whole. Too often in healthcare we make quick judgments that are based on limited information and preconceived ideas. Teaching nurses to step back and consider the dependencies and interconnectedness of system components will lead to a broader understanding of the healthcare system and the quality of care that results from that system. To improve systems thinking, we need to be able to measure it.
A valid and reliable measure of systems thinking is now available. There were no differences in STS mean scores at pretest. The STS is now publicly available for use and a website has been established to provide information on its use Case Western Reserve University, a. Almost 10 years have passed since the QSEN competencies were developed, and the field of quality and safety is rapidly advancing. The time has come to consider what new competencies should be added. Do the KSAs need to be updated, reclassified, or expanded? Should a systems perspective be made more prominent in the QSEN model?
The QSEN competencies were developed to be a tool to promote better education for nurses in healthcare quality and safety. We need to update the QSEN competencies to be as useful as possible to prepare all nurses to ensure the highest level of care possible. However, we have observed that, despite the fact that contemporary approaches to quality and safety emphasize a systems view, much of the nursing education approach to teaching quality and safety including application of the QSEN competencies emphasizes personal effort at the individual level of care. Although we believe that personal expertise of the nurse with individual patients is necessary, a safe and high quality system of care requires that all healthcare professionals take responsibility to learn and apply skills associated with improving the wider system of care.
We argue, therefore, that the QSEN competencies should be integrated into nursing curriculum and practice with a strong systems-perspective emphasis. Nurse faculty and staff development educators must critically evaluate the extent to which they apply QSEN competencies and at what levels. She has co-published two books on quality improvement, co-authored several book chapters and articles, and was guest editor on a special quality improvement education issue in the Journal of Quality Management in Health Care.
Shirley M. Moore is the Edward J. She also is conducting NIH-funded studies testing a process improvement approach to health behavior change with patients. Abourmatoar, H. Development and evaluation of a 3-day patient safety curriculum to advance knowledge, self-efficacy and system thinking among medical students. BMJ Quality and Safety. Amer, K. Quality and safety for transformational nursing. These may seem like trivial and easy tasks; however, when conducted improperly they can severely hinder patient safety by increasing the risk of spreading infection.
I have also participated in several research and projects pertaining to evidence-based practice. The link below is an example of a article review on an evidence-based practice journal article. Patient Centered Care: During my employment at Pinnacle Health as a patient care assistant and as a nursing student with the Pennsylvania State University, I have been able to utilize patient centered care techniques such as involving family and friends in the care of my patients, using effective communication for diverse patient populations and respecting all of my patients values, preferences and needs. An example of how I use patient centered care every shift at the hospital is by participating in bedside shift report in the beginning and end of every shift.
During bedside shift report I am able to introduce myself and involve the patient in the plan of care for the day while assessing the patients comfort and safety. These electronic medical record systems give hospital staff ways to communicate and report knowledge and a means to recognize, report and prevent errors.