QSEN: Quality & Safety

Education for Nurses

Danielle E. Fleming, BSN, RN,
SCRN
NURS 5327.060
February 20, 2017
 What is QSEN?
Quality & Safety Education for
Nurses
Website funded by the Robert Wood
Johnson Foundation
www.QSEN.org
Resources to help faculty, nursing
students, and nurses learn about quality
and safety in nursing
 What is the purpose of
QSEN?
The purpose of QSEN is to prepare
future nurses with the knowledge, skills
and attitudes (KSAs) needed to improve
the quality and safety of their practice

Resource for curricular development

for formal academic programs,
transition to practice and continuing
education programs
 What are the QSEN
competencies?
Patient-Centered Care
Safety
Teamwork & Collaboration
Quality Improvement (QI)
Informatics
Evidence-based practice (EBP)
 Patient-Centered Care
Recognize the patient or designee
as the source of control and full
partner in providing compassionate
and coordinated care based on
respect for the patients preferences,
values, and needs.
 Recognize personally
held attitudes about
working with patients
from different ethnic,
cultural and social
backgrounds.
Complete CEUs and
attend training sessions
on cultural sensitivity
Ask questions instead
of making
generalizations
 Communicate patient values,
preferences and expressed needs to
other members of the health care team
Discuss discharge needs/wants with patient
and family and communicate with the
social worker; what we think is best for the
patient may not align with what they want.
Find out what is important to the patient, it
may be as simple as chocolate ice cream as
a bed time snack!
 Remove barriers to presence of families
and other designated surrogates based on
patient preferences
Help to facilitate family presence, when
applicable, during patient conversations with
physicians and other members of the health
care team to encourage participation and
involvement
Involve family members in open discussion
about end of life options and be respectful of
patient and family choices
 Facilitate informed patient consent
for care
Ensure that the patient and family fully
understand their care plan and any
procedures
Facilitate open conversation between
patients and physicians regarding care
and procedures for best degree of
understanding
Utilize multimedia to include videos,
printouts, and brochures when available
 Safety
Minimizes risk of harm to patients
and providers through both system
effectiveness and individual
performance.
 Use appropriate strategies to reduce
reliance on memory (such as, forcing
functions, checklists)
Programs such as Micromedex to check
IV compatibility
Internet programs such as Medscape to
look up disease processes, medication
side effects, procedures, etc.
Demonstrate
effective use of
strategies to reduce
risk of harm to self
or others
Hand Hygiene!
Needle safety
Wear gloves and
encourage others to
wear gloves
Help to identify fall risk
patients, ensure bed
alarms are set, and
answer bed alarms and
call lights promptly
 Value own role in preventing errors
Waste medications appropriately and
timely
Use at least two patient identifiers when
administering medications
Check for side effects between
medications when administering more
than one medication at a time
 Teamwork & Collaboration
Function effectively within nursing
and inter-professional teams,
fostering open communication,
mutual respect, and shared decision-
making to achieve quality patient
care.
 Demonstrate commitment to team
goals.
Support co-workers in providing superior
patient care; ask for help and offer help
Seek out opportunities to go above and
beyond in both patient care and staff
support
Seek to understand and support
changes to the patient care
environment; attend meetings, read
research, etc.
 Initiate plan for self-development as
a team member
Participate in workshops and seminars
as appropriate
Seek to advance formal education
Complete institutional training and
education in a timely manner
 Initiate requests for help when
appropriate to situation
Everyone gets overwhelmed and needs
help sometimes dont be afraid to ask!
Seek a second opinion regarding nursing
decisions if you are unsure
Collaborate with team members
regarding patient care two heads are
better than one!
 Evidence-based Practice
(EBP)
Integrate best current evidence with
clinical expertise and patient/family
preferences and values for delivery
of optimal health care.
 Appreciate strengths and
weaknesses of scientific bases for
practice
Not everything will apply to your
practice and thats o.k.
EBP that has weaknesses can still be of
value to practice; is it safe and does it
work?
 Base individualized care plan on
patient values, clinical expertise and
evidence
Each patient and family is different and
requires an individualized approach to
care
EBP is a tool
Patient preference and values comes
first; just because a therapy works, if the
patient doesnt want it then it is not
right for that patient.
 Value the need for continuous
improvement in clinical practice
based on new knowledge
Change is inevitable to improve patient
care
Change is process and can be difficult,
remember that the purpose of change is
to improve the patient care environment
Be an active participant in the change
process
Play an active role in initiating change
 Quality Improvement (QI)
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.
QI: STAFFING RATIOS!
 Staffing Ratios
Cover your shift! Dont call in just because
you didnt or couldnt find someone to
cover your shift
Pick up shifts when you can, but dont
allow yourself to get burnt out its all
about balance
Call in if, and only if, you or a close family
member is sick if you are sick and come
to work, someone else will get sick, etc.
Multiple nurses calling in!
 Value local change (in individual practice or
team practice on a unit) and its role in
creating joy in work
Change is necessary but not always easy
With any change there will be resistance, try to
help embrace the changes instead of
contributing to resistance
Change is not implemented to make your job
harder, although it may seem that way at first;
change is to help improve patient care and the
health care environment for patients and staff.
 Identify gaps between local and best
practice
Know your unit and its focus (i.e. ortho,
surgical, critical care, neurology, etc.)
and be aware of the best practice
related to what you do
Utilize the internet to look up current
best practice for nursing and your
specialty
Compare what you do to what is
considered best practice
 Informatics
Use information and technology to
communicate, manage knowledge,
mitigate error, and support decision
making.
 Apply technology and information
management tools to support safe
processes of care
Transmit patient information in
accordance with HIPPA utilizing the
technology available
Dispose of unneeded HIPPA
appropriately (i.e. shred box)
Utilize electronic EMR checklists before,
during, and after procedures
 Navigate the electronic health record
If you dont understand how to do
something, ask!
Attend EMR refresher courses as needed
to ensure that you are using the EMR
effectively
Know where to find information in the
EMR!
 Document and plan patient care in a
electronic health record
If it isnt documented, it didnt happen!