QSEN Competencies: Core, Care & Confid

ence.
Marvin Delfin, BSN, RN, CCRN, CEN, CPEN, TRCN, CNRN
Clinical Educator- Surgery Unit
Objectives

At the end of this session, the members of t

he health team will be able to:
Describe the process of using the QSEN compet
encies and to integrate these competencies into
the hospital setting, particularly in the surgical u
nit.
Compare the QSEN competencies to current ne
eds of the organization and construct a progra
m, protocol or guidelines to meet the specific ch
allenges of the surgical unit.
What is QSEN?

The QSEN (Quality and Safety Education for Nur

ses) project was funded by the Robert Wood Joh
nson Foundation in an effort to advance safe, ef
fective and quality healthcare in response to the
Institute of Medicines (IOM) reports (Cronenwe
tt, et al, 2007).
Initially, the QSEN initiative was designed to hel
p academic nursing professors combine compet
encies for safety and quality into education. No
w, QSEN would like to spread to all nurses, in all
nursing environments (Cronenwett, et al, 2007).
 Why is QSEN was created?

In 2003, the Institute of Medicine (IOM) challen

ged faculties in the health professions to imple
ment fundamental changes in their curriculums
to produce professionals who can function effec
tively in a reformed health care system focused
on quality and safety (Cronenwett, et al, 2007).
 Why is QSEN important?

QSENs mission is to ensure that nurses every

where have the knowledge, skills and attitude
s (KSA) necessary to continuously improve the
safety and quality of healthcare.
Linda Cronenwett, the founder of QSEN has b
een quoted as saying, QSEN helps nurses ide
ntify and bridge the gaps between what is and
what should be and help nurses focus their w
ork from the lens of quality and safety, (Dola
nsky and Moore, 2013).
 Whats the Issue?
Top Sentinel Event for
Rank Sentinel Event Cases
2015-2016 Reported
1 Wrong Patient, Wrong Site, Wrong 1,225
Procedure
2 Unintended Retention of Foreign 1,167
Body
3 Delay in Treatment 1,053
4 Suicide 972
5 Operative/Post-Op Complications 902
6 Fall 833
7 Other Unanticipated Events* 609
8 Medication Error 460
9 Criminal Event 429
* Other
10 unanticipated events include:
Perinatal DeathAsphyxiation, Burn, Choked
357
on food, drowning, found unresponsive
What are the QSEN Competenci
es?

Patient/Family Centered Care Teamwork and Collaboration Safety

Evidence-based Practice Quality Improvement Informatics

How does QSEN competencies
relate to my practice?
Nurses need to be able to apply QSEN at both a
n individual level of care (what work can I do sa
fely, as the patients nurse?) and systems level
of care (how can we, as a team, provide the saf
est care for the patient?) in each of the six com
petencies (Cronenwett, et al, 2007).
It is by understanding and recognizing the impo
rtance of how different elements within the hea
lthcare system come together to provide patient
care.
 How does QSEN competencies
relate to my practice?
It is a delivery of care that utilizes each of the man
y different components that create the system to
provide safe, effective, high-quality patient care.
As nurses, we focus on what I need to do, but sys
tems thinking goes beyond the I thinking and tak
es the whole patient care team into consideration.
It is every piece that comes together to provide pa
tient care. Not just the people but also the tools/in
struments.
 Patient/Family Centered C
are
Definition: Recognize the patient or designee
as the source of control and full partner in pr
oviding compassionate and coordinated care
based on respect for patients preferences, val
ues, and needs (Cronenwett, et al, 2007).
The patient and family are in a partnered relat
ionship with their health care providers and a
re equipped with relevant information, resour
ces, access and support to fully engage in and
/or direct the health care experience as they c
hoose.
 Patient/Family Centered C
are
Institute of Medicine (IOM) (2001) states patie
nt-centered care is providing care that is resp
ectful of and responsive to individual patient
preferences, needs, and values and ensuring t
hat patient values guide all clinical decisions
 It is NOT!!!!

Patient focused care: The patient/family may

be involved, but the health care provider retai
ns control over decision-making, patient need
s and preferences mayor may not besought, a
nd rarely drive care decisions (IOM, 2001).
 Incorporating into practice
QSEN Competency: Patient/ Family Centered
Health Care
Concerns/
Issues Individual Level of Care
Systems Level Strategy
Strategy
Recognize cultural
differences and the
diversity of the population
in the area where you are
providing care
Build self-awareness and
examining own beliefs,
bias, nonverbal reactions,
gestures and prejudice.
Conduct cultural
Cultural
assessments to elicit
Sensitivity
clients perceptions and
beliefs.
Use of appropriate
medical interpreters.
Develop, plan and provide
care to patients and
family that is compatible
Demonstrate a
commitment to
diversity in their
policies, and
educational materials.
Provide access to
resources, and
linkages with agencies
or groups providing
care to specific cultural
groups.
Provide cultural
competency and
sensitivity education to
all staff.
Providing available
medical interpreters or
language line.
 Incorporating into practice
QSEN Competency: Patient/ Family Centered
Health Care
Concerns/
Issues Individual Level of Care Systems Level
Strategy Strategy
Assessing, acknowledging and Initiate a pain-
accepting the patients pain. control policy
Developing the patients plan Review the
of care that includes an process for pain
interdisciplinary plan for medicine delivery
effective pain management from the
involving patient, family and pharmacy to the
significant other unit.
Implementing pain Standardize
management strategies and education for all
indicated nursing interventions hands-on
Pain
including educating the patient providers about
Management
and family regarding their role, pain assessment
expected outcome, and and management.
overcoming barriers to Monitor and
effective pain management. evaluate pain
Documenting and reporting the reassessment
interventions, and patients documentation
 Incorporating into practice
QSEN Competency: Patient/ Family Centered
Health Care
Concerns/
Individual Level of Care Systems Level
Issues
Strategy Strategy
Include the patient and Provide program
family as full partners in the specific assessment
discharge planning process screening,
Discuss with the patient and reassessment and
family important areas to monitoring.
prevent problems at home Standardized
like medications, danger patient/family
signs, test results and discharge education
follow-up appointments. Provide list of
Discharge
Educate the patient and available community
Planning
family in plain language resources or
about the patients treatment options
condition, discharge process suited for the family
and next step throughout and patients needs.
the hospital experience.
Listen and honor the
patients and familys goals,
 Teamwork and Collaboration

Definition: Function effectively within nursing

and inter-professional teams, fostering open c
ommunication, mutual respect, and shared de
cision making to achieve quality patient care
(Cronenwett, et al, 2007).
Safe, effective, satisfying patient care requires
: teamwork, collaboration, communication am
ong all team members
Patient and Family are Members of the Team
 Teamwork and Collaboration
This is NOT Teamwork!
Poor team work and communication are contributi
ng to the lack of improvement and death in the nu
mber of patients (Mayor, 2002)
When medical care teams do not work together, a
number of marked issues arise that include ineffici
encies, communication breakdowns, occupational
stress, medical errors, and other operational failur
es that are becoming alarmingly common in health
care today (Center for Health Design, 2006).
 Teamwork and Collaboration

Lets have a BREAK!

The Penguins of Madagascar (Good Teamwork)

https://
www.youtube.com/watch?v=DI4zp7yeuMU

The Birds and the other bird (Bad Teamwork)

https://www.youtube.com/watch?v
=fUXdrl9ch_Q
 Incorporating into practice
Health
QSEN Competency: Teamwork and Collaboration
Concerns/ Individual Level of Care
Issues Systems Level Strategy
Strategy
A nurse should able to
assess patients
deteriorating condition
that requires emergent
attention and activates
rapid response.
Identify nurses role
during the rapid response
process.
Identify and collaborate
Rapid with trained individuals
Response and their roles and
Team responsibilities during
rapid response.
Use close loop
communications and able
to provide constructive
criticism.
Formulate and Initiate
standardize policies
and procedures for
activation of rapid
response
Required education
among staff members
regarding identification
of patients that
requires emergent
medical attention and
rapid response team.
Use mock codes and
training sessions to
simulate rapid
response
Monitoring and
evaluation of rapid
 Incorporating into practice
QSEN Competency: Teamwork and
Health Collaboration
Concerns/ Issues Individual Level of Care Systems Level
Strategy Strategy
participate actively in unit- Integrates unit
based meetings. council work with
Identify care gaps, risks and the organizations
possible occurrences that mission, values and
affects quality of care in the goals.
unit. Provides an
Implement and monitor environment for
evidence based practice shared governance,
Unit-Based interventions in involvement and
collaboration with other decision-making.
Council/
health team members Provides guidelines,
Shared recommended by the Unit- chain of command,
Governance based Council understanding of
Collaborate with team empowerment and
members regarding valuable clear roles for unit-
evidence-based findings, based councils.
recommendations, risk Monitor and
assessments to the UBC to evaluate unit-based
 Incorporating into practice
QSEN Competency: Teamwork and Collaboration
Health Concerns/
Issues
Individual Level of
Systems Level Strategy
Care Strategy
Strict compliance and
participation to the
standardized counting
system.
Members of the
perioperative team
should be aware, fully
accountable and identify
their roles and actions all
throughout the
Team approach perioperative process.
Implement evidence-
to prevent
based policy and
retained procedure regarding
foreign object prevention of retained
foreign object through
collaboration and
teamwork across the
disciplines.
Create a highly reliable
and standardized
counting system to
prevent retained
foreign object making
sure all surgical items
are identified and
accounted for.
The counting system
should be supported by
organizational leaders,
and developed using a
multidisciplinary
approach, involving
surgeons, nurses,
surgical technologists,
anesthesiologists,
radiologists, and
radiology technologists
 Incorporating into practice
QSEN Competency: Teamwork and Collaboration
Health Concerns/ Individual Level
Issues of Care Systems Level Strategy
Strategy
Implement Develop and implement
proper and clear effective evidence- based
communication organization-wide standardized
hand-off to all policy and procedures for the
members of the prevention of unintentional
perioperative retained foreign object through
team. a collaborative process
Perioperative promoting consistency in
personnel practice to achieve zero defects
should evaluate Institute team briefings and
Team approach existing and debriefings as a standard part of
to prevent emerging the surgical procedure to allow
retained adjunct the opportunity for any team
foreign object technology to member to express concerns
determine the they have regarding the safety
application that of the patient, including the
may be most potential for a retained foreign
suitable in their object.
setting. Research the potential of using
 Safety

Definition: "Minimizes risk of harm to patients

and providers through both system effectiven
ess and individual performance (Cronenwett,
et al, 2007).

What is Patient Safety?

https://www.youtube.com/watch?v
=BJP2rvBchnE
 Safety

Points to remember:
What is patient safety? Decreased risk o
f harm by individual actions or system des
ign

Who is responsible or patient safety? All

of us

When do we address a safety issue As

soon as we recognize it
 Safety
This story will always remind us how important patient safety is all

The Lewis Blackman Story

 Incorporating into practice
Health
QSEN Competency: Safety
Concerns/ Individual Level of
Issues Systems Level Strategy
Care Strategy
Utilize a bar coding Collaborate with other
medication scanning departments, hospital or
system. This allows health- system senior
nurses to verify the leadership, frontline staff, and
six medication rights nursing and medical staff
(correct medication, leadership to identify and
patient, route, dose, prioritize safety issues and
time, and develop risk- reduction
documentation) strategies using the methods
more accurately. listed above to identify
Take an active role in opportunities to improve
consulting with the medication safety.
interdisciplinary Adequate drug information
Medication team, including the resources should be available
Error pharmacy, to ensure for all health-care providers
all look-alike or involved in the drug use
sound-alike process.
medications aren't The review group should
stored near each investigate causes of errors
other. and develop programs for
 Incorporating into practice
Health
QSEN Competency: Safety
Concerns/ Individual Level of Care
Issues
Strategy
Double check all high-alert
medications with another
nurse. This can prevent
errors such as neonates
being administered an adult
dose of heparin.
Understand and know the
medications that are being
administered, along with
adverse reactions. Tell each
patient or family what
medication is being
Medication
administered, the purpose
Error and side-effects.
Consult with other
healthcare team members,
such as senior nurses, for
their insight and advice.
Systems Level Strategy
Standard drug
administration times
should be established for
the hospital by the
committee (or its
equivalent), with input
from the departments of
nursing and pharmacy.
Policies and procedures
should allow for
deviations from the
standard times when
necessary.
The pharmacy
department, in
conjunction with nursing,
risk management, and
the medical staff, should
conduct ongoing
 Incorporating into practice
Health
QSEN Competency: Safety
Concerns/ Individual Level of Care Systems Level
Issues Strategy Strategy
Develops and maintains a Formulate and
collaborative, therapeutic Initiate standardize
relationship with the patient and policies and
family procedures for
Performs screening and risk patients on suicide
assessment, violence and collects precautions.
accurate information and Required education
communicates the risks to the among staff
treatment team and appropriate members regarding
persons. safety, use of
Participates as a member of suicide simulation,
interprofessional team for guidelines and
ongoing formulation of risk based evidence-based
Suicide on assessment data. practices.
Develops and ongoing nursing Implement a suicide
plan of care based on a prevention/
continuous assessment. assessment/
Implements evidence based and screening of
best practice problem solving specific populations
 Incorporating into practice
Health
QSEN Competency: Safety
Concerns/ Individual Level of Care
Issues Strategy
Encourage patients and family
members to ask for help when they
get out of bed, and make sure there
are no obstacles to the restroom or
around the bed.
Standardized hand-off
communication or bedside reporting
process.
Fall Assess the patient's gait when out of
bed and offer assistance
Perform hourly rounding. Studies
have directly correlated rounding
with decreased falls in the hospital.
Basic needs can be taken care of at
this time, such as toileting, moving
objects within reach, offering food,
and asking about pain.
Systems Level
Strategy
Standardize education
for patients and family,
including a fall
prevention video that is
pushed to every
patient via their room
Television within four
hours of admission.
Conduct compliance
review for the use of
visual tools to identify
patients at risk: yellow
socks, door magnets,
and magnets on
patient locater board.
 Incorporating into practice

Health
QSEN Competency: Safety
Concerns/ Individual Level of Care Systems Level
Issues Strategy Strategy
Awareness and knowledge of any Conduct post-fall
medications that may cause management, which
drowsiness, dizziness, or impaired includes: a post-fall
judgment. You should also discuss huddle; a system of
this with the healthcare provider. honest, transparent
Use protective measures, such as reporting; trending and
Fall nonslip socks and bed alarms, to analysis of falls which
decrease the risk of falls. can inform
improvement efforts;
and reassess the
patient.

 Evidence- Based Practice

Definition: Integrate best current evidence wi

th clinical expertise and patient/family prefere
nces and values for delivery of optimal health
care (Cronenwett, et al, 2007).
This is a key point in making sure that we alwa
ys do what is best for our patients. It uses evi
dence to back the decisions made in how we c
are for our patients.
 Evidence- Based Practice
What is Evidence Based Practice?

CLICK LINK:
vidence-Based Practice: Improving Practice, Improving Outcome
 Incorporating into practice
Health
QSEN Competency: Evidence-Based Practice
Concerns/ Individual Level of Care
Issues
Strategy
Create and Implement
Perioperative policies based
on the Joint Commissions
Universal Protocol and
evidence-based measures.
Continuously re-educate and
train personnel regarding
evidence-based practice in
perioperative setting.
Wrong Create a specific,
Patient, standardized and detailed
preoperative verification
Wrong site, process and time-out that
wrong includes a checklist.
procedure Create and implement a
standardized handoff
communication checklist from
another department to
perioperative unit.
Attend OR briefings, huddles
Systems Level Strategy
Appropriate use of the
standardized checklist to
correctly identify patient,
site and procedure.
Involve the patient and
family to the identification
of site, verification, and to
assess and evaluate the
level of their
understanding regarding
the procedure.
Use of appropriate
checklist like SBAR and
proper hand-off
communication to another
health care provider.
participate in evidence-
based committee, huddles,
and briefings to identify
possible risks, probable
 Incorporating into practice
Health
QSEN Competency: Evidence-Based Practice
Concerns/
Issues Systems Level Strategy
Create and Implement Care
Bundle policies based on the
evidence-based research
findings.
Continuously re-educate
and train personnel
regarding evidence-based
care bundles like ABCDE
Care Bundles, prevention of
Care Ventilator-associated
pneumonia and central-line
Bundles associated infection care
bundles.
Monitoring and evaluation of
care bundles used in clinical
areas for data analysis and
Individual Level of Care
Strategy
Implement evidence-
based care bundles
appropriate to the
clinical setting.
Collaborate with other
members of the health
team for the
implementation,
monitoring and
evaluation of evidence-
based care bundle.
Actively participate to
the monitoring and
evaluation of care
bundles for research and
quality measures.
Attend conferences,
seminars or continuing
 Incorporating into practice
Health
QSEN Competency: Evidence-Based Practice
Concerns/
Issues Systems Level Strategy
Create and Implement Care
Bundle policies based on the
evidence-based research
findings.
Continuously re-educate
and train personnel
regarding evidence-based
care bundles like ABCDE
Care Bundles, prevention of
Care Ventilator-associated
pneumonia and central-line
Bundles associated infection care
bundles.
Monitoring and evaluation of
care bundles used in clinical
areas for data analysis and
Individual Level of Care
Strategy
Implement evidence-
based care bundles
appropriate to the
clinical setting.
Collaborate with other
members of the health
team for the
implementation,
monitoring and
evaluation of evidence-
based care bundle.
Actively participate to
the monitoring and
evaluation of care
bundles for research and
quality measures.
Attend conferences,
seminars or continuing
 Incorporating into practice
Health
QSEN Competency: Evidence-Based Practice
Concerns/
Issues Systems Level Strategy
Formulating the need for
information into a question
that can be linked to an
existing practice,
intervention, or outcome.
Finding the best evidence
out there and assess its
validity.
Designing a change in
EBP Council practice and a method for
evaluating its effectiveness.
Implementing and
evaluating the practice
change; decide whether it
should be accepted,
rejected, or modified.
Individual Level of Care
Strategy
Participate actively in in
evidence based practice
meetings.
Identify care gaps, risks
and possible occurrences
that affects quality of
care.
Implement and monitor
evidence based practice
interventions
recommended by the EBP
Council
share valuable evidence-
based findings,
recommendations, risk
assessments to the EBP
 Quality Improvement

Definition: "Use data to monitor the outcomes of car

e processes and use improvement methods to desig
n and test changes to continuously improve the qual
ity and safety of health care systems (Cronenwett, e
t al, 2007).
By continuously monitoring patient outcomes, we ar
e able to ensure that what we are doing is the right t
hing, and that we are achieving the expected outco
mes. In the cases, where we are not achieving the de
sired outcomes, we are able to find the breakdown i
n the system and fix it.
 Quality Improvement

What Quality Improvement means?

Improving patient care requires a systematic pr
ocess of defining problems in order to identify p
otential causes and develop strategies to improv
e care. This process requires the ability to meas
ure care. We can only improve if we measure ho
w well we are doing and compare our performa
nce against others.

To find out more please click the link:

https://www.youtube.com/watch?v=jq52ZjMzqyI
 Incorporating into practice

Health
QSEN Competency: Quality Improvement
Concerns/ Individual Level of
Issues Systems Level Strategy
Care Strategy
Implementation Provide consistent
and use of a education for all members of
standardized the health care team on the
communication concepts of teamwork,
tool, the SBAR, as a psychological safety, and
guide for open, effective
communicating communication and its
Improving changes in patient impact on patient safety.
rounds with status.
Integrate safe
communicati Proper communication strategies
ons implementation of into the organizational
an escalation culture.
process tool to
Sustain the culture of
facilitate timely
teamwork, psychological
communication.
safety, and open, effective
communication.
 Incorporating into practice

QSEN Competency: Quality Improvement

Health Concerns/
Issues
Individual Level of
Systems Level Strategy
Care Strategy
Attends to daily Maintain consistency and
multidisciplinary high quality in all
patient-centered educational efforts.
rounds using a daily
Develop educational
goals sheet.
tools that allow for
Improving Team huddles during flexibility in use and
rounds with each shift and application in diverse
informing any practice settings.
communicati
concerns, goals and
ons Monitor and evaluate
identify roles.
efficiency of SBAR
communications through
research and quality
improvement

 Incorporating into practice

QSEN Competency: Quality Improvement

Health Concerns/
Issues
Individual Level of
Systems Level Strategy
Care Strategy
Identify areas of improve patientcare by
concerns like greater improving the quality
number of outcome ofpatient care through
variations, higher consistent management by
mortality, increased encouraging patient
length of stay. involvement and by
Standardizin Plan and develop a identifying and measuring
multi-disciplinary improvements in
g protocols
clinical care pathway patientcare and outcomes.
and clinical based from best care To maximize the efficient
pathways process and evidence useof resources by
based practices. reducingunnecessary
documentation and
overlap and reduced
length of hospital stay for
particular conditions.
 Incorporating into practice

QSEN Competency: Quality Improvement

Health Concerns/
Issues
Individual Level of
Systems Level Strategy
Care Strategy
Implement protocols To help identifyand clarify
and clinical pathways theclinical processes by
in collaboration with ensuringcontinuity of
the health team with patient care by reducing
continuous education. unnecessary variations.
Monitor and evaluate The development and
efficacy of the protocol implementation of clinical
Standardizin and address variances pathways increases
for improvement. collaboration between the
g protocols
disciplines,
and clinical support the
pathways implementation of
evidence-based practice
improve clinical processes
by reducing risk reduce
duplication through the
use of a standardized tool
 Incorporating into practice

QSEN Competency: Quality Improvement

Health Concerns/
Issues
Individual Level of
Systems Level Strategy
Care Strategy
Form a multi- Provide implementation
disciplinary CAUTI support and
prevention team or acknowledge the work of
group that is in line the CAUTI group.
with the institutions Provide resources to
mission, goals and address safety concerns
objectives to and promote
decrease and prevent sustainability of the QI
CAUTI QI
CAUTI. project.
Program
Implement evidence Formulate policies
based CAUTI Bundle regarding
program and provide implementation of
continuous update evidence-based CAUTI
through staff Bundle program to all
involvement, huddles units and disciplines.
and briefing.
 Incorporating into practice

QSEN Competency: Quality Improvement

Health Concerns/
Issues
Individual Level of
Systems Level Strategy
Care Strategy
Educate, train and Collaborate with clinical
update competencies and administrative
of staff members leaders to develop a
regarding CAUTI coordinated plan for
prevention and best CAUTI reduction in all
practices. units.
Involved patient and Monitor the progress of
family by providing the program monthly and
CAUTI QI information on determine quality
Program prevention and improvements.
identification of CAUTI
symptoms.
Monitor and evaluate
progress monthly and
report performance
and findings to all
staff and the
 Informatics

Definition: "Use information and technology t

o communicate, manage knowledge, mitigate
error, and support decision making (Cronen
wett, et al, 2007).
Applies information obtained from technology
and informatics sources to promote safe, qual
ity patient care and protect patient privacy.
 Informatics

These are NOT informatics!

(Click links to see the video)
4.5 million affected in hospital data breach
Nurse Arrested for Stealing Patients' Personal
Information
Nurse accused of stealing patient
information to using drugs
 Incorporating into practice
QSEN Competency: Informatics
Health Concerns/
Issues
Individual Level
Systems Level Strategy
of Care Strategy
Access only the Ensure that institutional
information you policies and practices with
need and keep respect to confidentiality,
records relevant security and release of
and accurate. information are consistent
Keep information with regulations and laws.
and records secure Educate healthcare
and confidential personnel on confidentiality
Dont share your and data security
usernames and requirements, take steps to
passwords. Keep ensure all healthcare
Patient
them secret and personnel are aware of and
confidentiality
change your understand their
password regularly. responsibilities to keep
patient information
confidential and secure, and
impose sanctions for
violations.
Develop systems that enable
 Incorporating into practice
Health
QSEN Competency: Informatics
Concerns/ Individual Level of
Issues Systems Level Strategy
Care Strategy
Follow the Hospital Implement technical (which
Policy before in most cases will include
sharing or releasing the use of encryption under
information the supervision of
(including checking appropriately trained HIT
who a person is and personnel), administrative
that they are and physical safeguards to
allowed access to protect electronic medical
the information), records and other
and when sending, computerized data against
transporting or unauthorized use, access
transferring and disclosure and
confidential reasonably anticipated
Patient
information. threats or hazards to the
confidentiality
Keep and destroy confidentiality, integrity and
information in line availability of such data.
with local policy and Conduct periodic data
national guidelines. security audits and risk
Always report actual assessments of the potential
and possible risks and vulnerabilities to
 Incorporating into practice
Health
QSEN Competency: Informatics
Concerns/ Individual Level of Care
Issues Strategy
Nurses should undergo
training and competency
review regarding the use of
e-MEWS and responsible
access to patients chart.
Nurses should document
accurate and relevant
information to patients
electronic record especially
vital signs to generate MEWS
Score.
Electronic
Nurses should know how to
Modified
interpret the generated score
Early
and must alert health care
Warning
providers and team if score
Score (e-
requires emergent medical
MEWS)
intervention.
Monitoring
Continuous monitoring of
patients through accurate
and relevant vital signs
Systems Level
Strategy
Formulate policies
regarding the
standard application
and implementation
of e-MEWS
throughout the health
system.
Provide training,
education and
simulation on the use,
interpretation and
appropriate
intervention of e-
MEWS scores.
Conduct periodic data
security audits and
risk assessments of
the potential risks
and vulnerabilities to
the confidentiality,
 Incorporating into practice
QSEN Competency: Informatics
Health Concerns/
Issues
Individual Level of
Systems Level Strategy
Care Strategy
Nurses must recognize Ensure that
that they have an institutional policies
ethical and legal and practices on
obligation to maintain responsible social
patient privacy and media use with respect
confidentiality at all to confidentiality,
times. security and release of
Nurses are strictly information are
prohibited from consistent with
transmitting by way of regulations and laws.
any electronic media Educate healthcare
any patient-related personnel on
Use of Social
image. In addition, appropriate social
Media nurses are restricted media use, patient
from transmitting any confidentiality and data
information that may be security and awareness
reasonably anticipated to keep patient
to violate patient rights information confidential
to confidentiality or and secure, and impose
 Incorporating into practice
QSEN Competency: Informatics
Health
Systems
Concerns/
Issues Individual Level of Care Strategy Level
Strategy
Nurses must not share, post or otherwise
disseminate any information or images
about a patient or information gained in the
nurse/patient relationship with anyone
unless there is a patient-care-related need
to disclose the information or other legal
obligations to do so.
Nurses must not identify patients by name,
or post or publish information that may lead
to the identification of a patient. Limiting
Use of Social
access to postings through privacy settings
Media
is not sufficient to ensure privacy
Nurses must not refer to patients in a
disparaging manner, even if the patient is
not identified. Nurses must not take photos
or videos of patients on personal devices,
including cell phones. Nurses should follow
employer policies for taking photographs or
 CONCLUSION

QSEN helps to better prepare future and curr

ent nurses in providing quality patient safety
and care. The six competencies set a concrete
model to exemplify important aspects of nursi
ng care. Facilities are able to incorporate the
QSEN standards into their own policies and pr
ocedures to provide a parallel level of care in
accordance to national standards.
SAFETY & QUALITY

BEGINS WITH YOU!

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