Discussion on Quality and Safety Improvement
Nursing education on quality and safety Dr. Linda Cronenwett, RN, FAAN PhD, RN, FAAN Gwen Sherwood PhD, RN, FAAN Jane Barnsteiner PhD, RN, FAAN Joanne Disch PhD, RN-C, FAAN Jean Johnson Dr. Pamela Mitchell, CNRN, FAAN Dori Taylor Sullivan is a PhD, RN, CNA, and CPHQ. On whether the KSAs for pre-licensure education are appropriate goals for students preparing for basic practice as a registered nurse, Judith Warren, PhD, RN, BC, FAAN, FACMI. Quality and Safety Education for Nurses (QSEN) addresses the challenge of equipping nurses with the knowledge and skills needed to continuously improve the quality and safety of the health care systems in which they work. The QSEN faculty members adapted the Institute of Medicine1 competencies for nursing (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics), proposing definitions of what it means to be a competent and respected nurse.
The authors propose statements of knowledge, skills, and attitudes (KSAs) for each competency that should be developed during pre-licensure nursing education based on the competency definitions. Faculty and advisory board members of Quality and Safety Education for Nurses (QSEN) invite the profession to comment on the competencies and their definitions. A number of national commissions have identified significant issues with safety and quality in the US health-care system. 1–5 In light of these issues, multiple national committee reports concluded that if health care is to improve, providers must be prepared with a different set of competencies than are currently taught in educational programs. 1,6 Using scientific evidence, health professionals must be able to describe what constitutes good care, identify gaps between good care and the local care provided in their practices, and know what activities, if any, they can initiate to close any gaps. 7
The 2003 Institute of Medicine (IOM) Health Professions Education report1 challenges faculties of medicine, nursing, and other health professions to mindfully alter learning experiences that form the basis for professional identity formation so that graduates are educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics. 1 To incorporate the development of the aforementioned competencies in nursing education, will, ideas, and execution are required. In contrast to medicine, where a commitment to an adapted version of the IOM competencies has now been made for the entire continuum from medical school to residency program to certification, 8,9 There is no agreement in nursing on the competencies that could apply to all nurses and define what it means to be a respected and qualified nurse.
However, at the heart of nursing is an incredible historical will to ensure patient quality and safety. Nursing publications,10 -12 standards of practice,13 and accreditation guidelines all show a value for quality and safety competencies. 14,15 The Task Force on the Essential Patient Safety Competencies for Professional Nurses of the American Association of Colleges of Nursing Linda Cronenwett is a Professor and Dean at the University of North Carolina at Chapel Hill’s School of Nursing. Gwen Sherwood is a Professor and Associate Dean for Academic Affairs at the University of North Carolina at Chapel Hill’s School of Nursing. Jane Barnsteiner is a Professor and the Director of Translational Research at the University of Pennsylvania School of Nursing and Hospital in Philadelphia, PA. Joanne Disch is the Kathyrn R. and C. Walton Lillehei Professor and Director of the Densford International Center for Nursing Leadership at the University of Minnesota School of Nursing in Minneapolis, Minnesota.
Jean Johnson is a Professor of Health Sciences and Senior Associate Dean at The George Washington University in Washington, DC. Pamela Mitchell is the Elizabeth S. Soule Professor and Associate Dean for Research at the University of Washington School of Nursing in Seattle, Washington. Dori Taylor Sullivan is an Associate Professor and Chair of the Nursing Department at Sacred Heart University in Fairfield, Connecticut. Judith Warren is an Associate Professor of Nursing at the University of Kansas and the Director of Nursing Informatics at the Kansas University Center for Healthcare Informatics in Kansas City, Kansas. Requests for reprints should be addressed to Linda Cronenwett, PhD, RN, FAAN, Dean and Professor, School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC 27599-7460. Contact: lcronenwett@unc.edu 0029-6554/07/$-see front matter. Nurs Outlook 2007;55:122-131. Copyright Mosby, Inc., 2007. Every right is reserved. http
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