The Quality and Safety Education for Nurses (QSEN) initiative was established to prepare future nurses for the complexities of modern healthcare by integrating contemporary concepts of safety and quality into nursing education. The overarching goal is to equip new nurses with the necessary knowledge, skills, and attitudes (KSAs) to continually enhance the quality and safety of their practice environments. QSEN defines six core competencies that provide a framework for this goal, ensuring that all pre-licensure nurses are educated to a consistent standard for entry into practice.
Defining the Six Core Competencies
Patient-Centered Care focuses on recognizing the patient as the source of control and a full partner in their care, respecting their preferences and values. Teamwork & Collaboration requires functioning effectively within interprofessional teams, using open communication and shared decision-making to achieve high-quality patient care. Evidence-Based Practice (EBP) is the integration of the best current research evidence with clinical expertise and patient values to deliver optimal health care. Quality Improvement (QI) involves using data to monitor outcomes and employing methods to test and design changes for continuous improvement of healthcare systems. Safety centers on minimizing the risk of harm to both patients and providers through effective systems and individual performance. Finally, Informatics involves using information and technology to manage knowledge, mitigate errors, and support clinical decision-making.
Competencies Focused on Process and Improvement
Three QSEN competencies are specifically dedicated to the processes and administrative actions that drive continuous improvement within a healthcare system.
Evidence-Based Practice (EBP)
EBP is defined by the nurse’s ability to integrate the most current, best evidence with their own clinical judgment, while also considering the patient’s individual preferences and values. This requires a skill set that includes formulating focused clinical questions and efficiently searching for the strongest available research to guide practice. Nurses must demonstrate an attitude of appreciating the need for continuous inquiry and critically appraising research findings to determine their applicability to a specific patient population.
Quality Improvement (QI)
QI is the use of data to monitor care processes and outcomes, employing methods like the Plan-Do-Study-Act (PDSA) cycle to continuously improve the quality and safety of the system. Nurses practicing this competency must understand that quality is a systems-level issue, not just an individual one. They must be able to use quality data, such as patient outcome metrics, to identify areas for change and implement improvements in care delivery.
Safety
Safety is the minimization of the risk of harm to patients and providers, achieved through both effective system design and individual performance. The required knowledge includes understanding the human factors that contribute to errors, such as fatigue or communication breakdowns. A nurse’s skill in this area involves utilizing standardized practices, communicating concerns through established reporting systems, and actively participating in root cause analyses of sentinel events. This competency requires an attitude that values a non-punitive, safety-minded culture where errors are viewed as opportunities for system improvement.
Competencies Focused on Interaction and Information
The remaining three QSEN competencies focus on the human and technological dynamics of care delivery, emphasizing communication, partnership, and data management.
Patient-Centered Care
Patient-Centered Care requires the nurse to recognize the patient as the ultimate source of control and a full partner in planning and implementing care. This involves knowing how to explore and respect a patient’s unique preferences, values, and cultural traditions, especially when making decisions about treatment. Nurses must demonstrate skills in providing empathetic and compassionate care while actively soliciting and integrating the patient’s perspective into the plan of care.
Teamwork & Collaboration
Teamwork & Collaboration focuses on the ability to function effectively within interprofessional teams, which include not only other nurses but also physicians, therapists, pharmacists, and the patient’s family. This competency demands open, respectful communication and a shared commitment to decision-making, acknowledging the expertise of each team member. A skilled nurse can manage conflict, negotiate roles, and utilize communication tools, such as SBAR (Situation, Background, Assessment, Recommendation), to ensure clear and accurate information transfer, which is known to reduce errors.
Informatics
Informatics addresses the use of information and technology to support clinical workflow, manage knowledge, and mitigate medical errors. Nurses must possess the knowledge to navigate and utilize electronic health records (EHRs) and other information management tools effectively. The skills involved include documenting patient data accurately, using technology to monitor patients, and applying clinical decision support tools to enhance safety and efficiency. This competency requires nurses to maintain an attitude of recognizing technology’s ability to prevent errors and a commitment to lifelong learning in information technology.