Quality effective plans for the microsystem and/or

March 27, 2019 Nursing

Quality and
Safety Education
for Nurses &
Nicole Baker & Justin Blackburn
NRS 412 http://www.csub.edu/nursing/

Objectives of QSEN and QI (Essentials)
Essential II. Apply skills in leadership, quality improvement, and patient safety to provide high
quality health care in a systems environment.
Competency 2: Participate in the development & implementation of imaginative & creative strategies
to enable systems to change.
Competency 9: Apply quality improvement processes to effectively implement patient safety
initiatives and monitor performance measures, including nurse sensitive indicators in the
microsystem of care.
Competency 11: Employ the principles of quality improvement, healthcare policy, and cost
effectiveness to assist in the development and initiation of effective plans for the microsystem and/or
system wide practice improvements that will improve the quality of healthcare delivery.

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Quality and
Safety Education
for Nurses

? The purpose of Quality and Safety Education for Nurses is for future
nurses to have the knowledge and ability to consistently enhance the
quality and safety in their working environment. (Dolansky & Moore, 2013)
? QSEN identifies the need for knowledge, skills, and attitudes (KSAs)
needed by nurses to improve quality of care. (Dolansky & Moore, 2013)
? The founder of QSEN is Linda Cronenwett, PhD, RN, FAAN and QSEN was
established with the help of Robert Wood Johnson Foundation. (Dolansky
& Moore, 2013)
? QSEN is is used by nurses, physicians, pharmacists, and other
interdisciplines. (Cherry, 2017)

QSEN Competencies
? Patient -centered care
? Teamwork and Collaboration
? Evidence -Based Practice
? Quality Improvement
? Safety
? Informatics (QSEN, 2018)

Patient – Centered Care
Definition: “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, 2018)
Examples: informed consent, patient teaching,
religious/cultural preferences, abortion, physician assisted
suicide, DNR, and end of life care.

Teamwork & Collaboration
Definition: “Function effectively within nursing and inter –
professional teams, fostering open communication, mutual
respect, and shared decision -making to achieve quality
patient care.” (QSEN, 2018)
Examples: teamwork, self assessment, self evaluation, and
continued learning.

Evidenced – Based Practice
Definition: “Integrate best current evidence with clinical
expertise and patient/family preferences and values for
delivery of optimal health care.” (QSEN, 2018)
Examples: peer reviewed research, scholarly articles, using
up to date practice.

Quality Improvement
Definition: “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, 2018)
Examples: collecting data and meeting national standards.

Definition: “Minimizes risk of harm to patients and
providers through both system effectiveness and individual
performance.” (QSEN, 2018)
Examples: National Patient Safety Goals, communication,
and accountability.

Definition: “Use information and technology to
communicate, manage knowledge, mitigate error, and
support decision -making.” (QSEN, 2018)
Examples: PHI, HIPAA, screen protection, and two person
double checks.

QSEN Class Activity:
QSEN Competencies
Patient -centered care
Teamwork and Collaboration
Evidence -Based Practice
Quality Improvement
1. Determine which competency
your card is describing.
2. Meet with other students who
have the same competency.
3. Share and discuss your card
with your group (15 -20
4. Share what your competency
and KSA’s are with the class.


What is QI?
? Stands for Q uality Improvement
? QI definition is: “Using data to monitor the outcomes of care processes
and using improvement methods to design and test changes to
continuously improve the quality and safety of health care systems (QSEN,
? continuously finding ways to provide efficient patient care and services
? Working as a team and having understandable improvement aims for their work setting

Joint Commission
? The Joint Commission was one of the first accreditation agencies to
accept QI (Cherry, 2017)
? Now the Joint Commission requires institutions to show how they have
used quality improvement in their facilities in order to keep their
accreditation status up -to -date (ATI, 2016)

Focused Standards Assessment and
Intracycle Monitoring Process
? FSA: looks at an organization’s assessment of their standards along with
The Joint Commission’s knowledge about high risk areas that are
essential to a patient’s safety and quality of care
? Intracycle Monitoring process: looks at a various number of activities to
help key in on risk points in the organizations health care along with
resources that could help identify patient safety and quality problems.
(jointcommission.org, 2013)

Video 4:18 – 6:55

QI Process
1. Outcome indicators: represent the wanted client outcomes related to the area
of improvement
2. Structure indicators: represent the area/ setting the improvement is taking
place and the availability of resources
3. Process indicators: represent the guidelines used to promote the area of
improvement. The How?
4. Benchmarks: the goals that are set to determine how far along the
improvement status has come.
(ATI, 2017)

QI process

Quality Improvement
Three Cornerstones
1. Quality
a. Experience as a whole
i. Includes the quality of work by all healthcare providers, but also the materials used in these
procedures and the timeliness of interactions.
2. Scientific Approach
a. Data proven process
i. Decisions to improve specific procedures must be validated by data and everyone must
understand the guidelines.
3. All One Team
(Cherry, 2017)

One Team

Six Aims for Improving Healthcare
1. Safe -Prevent injuries
2. Effective -provide services based on knowledge to all patient who could benefit
from the care
3. Patient -centered -included patient’s preferences, needs, and values in all
decisions made
4. Timely -reduce waiting time and delays that could be harmful
5. Efficient -prevent wasting resources
6. Equitable -provide equalized care to all
(Cherry, 2017)

Fishbone Diagram
? QI tool that allows the hospital see the
true signs of the problem and not just
the symptoms
? Allows for visualization of the root of
the problem
? Helps team members have input and
say into their thoughts of the reason
the problem occurs
(health.state.mn.us, n.d.)

Case Study
We have written 4 different case studies all pertaining to the same scenario,
but are in the context and situation of each individual. The 4 individuals will be
Physician, Pharmacist, First year Nurse, and Second Nurse.
We will split you into groups by having you count off 1 -4. Once in your groups
you will have 15 -20 minutes to respond to the case study and the questions
provided. Then we will discuss afterwards your responses.

? Dolansky, M. A., & Moore, S. M. (2013). Quality and safety education for nurses (QSEN): The key is systems
thinking. Online Journal of Issues in Nursing , 18 (3). DOI: 10.3912/OJIN.Vol18No03Man01
? Fishbone Diagram (Cause and Effect Diagram) -Minnesota Dept. of Health. (n.d.). Retrieved from
? Henry, N. J. (2016). Nursing leadership and management: Review module . Stilwell, KS: Assessment Technologies
? Institute of Medicine. Health professions education: A bridge to quality. Washington DC: National Academies
Press ;2003.
? Joint Commission. (2013). Tackle your organization’s challenges using Joint Commission tools Brochure.
Author. Retrieved from https://www.jointcommission.org/assets/1/18/C -Suite_brochure1.PDF
? QSEN Institute. (2018). News. Retrieved from http://qsen.org/quality -improvement/
? Quality and Safety Education for Nurses (QSEN). (2018). http://qsen.org/competencies/pre -licensure -ksas/.


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