and dedication to keeping patients safe. More than ever, quality and safety are defining aspects of care. Indeed, providing safe quality care begins with adequate resources and system leadership committed to safety culture.
Simultaneously, the disproportionate numbers of deaths of Black and Brown people from COVID‐19 underscore the inequity in health care delivery. Throughout their lives, people of color lack equal access to health care and often receive services of lower quality than the general population. Judith Graham (2020) points out how social and economic disadvantage, reinforced by racism, plays a significant part in unequal health outcomes, all of which threaten quality safe care and the moral fiber of health care.
The need for systemic change in health care and in the education of our future clinicians to ensure safety and quality has become even more apparent. The recently released report Frontline Nurses (WikiWisdom, 2020) poignantly describes the experiences of nurses working at the front lines of the COVID‐19 pandemic. The authors propose solutions to improving health care settings that align with the Quality and Safety Education for Nurses (QSEN) competencies of patient‐centered care, teamwork and collaboration, evidence‐based practice, quality improvement, safety, and informatics. These include:
Developing a comprehensive plan for evidence‐based crisis care that includes input from front‐line nurses.
Creating systems of care that offer care that is safe, transparent, effective, efficient, equitable, and patient centered.
Providing nurses emotional support on the job.
Increasing administrative transparency for patient safety.
Giving front‐line nurses a place at decision‐making tables, and committing to integrating their recommendations.
While the focus of nurses and other healthcare providers is primarily on the provision of care, what these solutions highlight is the importance of paying equal attention to our systems of care delivery, providing safe working environments for people who are working in highly complex systems, and re‐examining the pre‐ and post‐licensure education of all nurses. These goals align with the December 2020 release of Safer Together: A National Action Plan to Advance Patient Safety, discussed in Chapter 1.
This volume, the third edition of Quality and Safety Education in Nursing, maintains the same laser focus on understanding and developing the six competencies that represent QSEN, but adds content reflecting the current environment. Chapter 1 covers driving forces for quality safe care and traces the two decades of progress in the current safety movement, and Chapter 2 shares policy perspectives. Chapter 3 updates the history and synergy inspired by the QSEN project. Section Two includes updated chapters on each of the six competencies with scenarios, teaching and practice strategies, and related resources. Chapters in Section 3 offer updated content and strategies to guide faculty in interactive classrooms based on unfolding case studies, reflective practice applied to narrative pedagogy, clinical education, leadership, transition to practice, and interprofessionalism.
International exemplars depicting the work and perspectives of global partners threaded throughout the book demonstrate the global imperative of collaborating to shape the way forward to improve quality and safety outcomes. Each chapter teases apart the multiple facets of quality and safety and applies the competencies to everyday components of education, care delivery, and organizational systems. The focus is on new ways to apply the competencies and related knowledge, skills, and attitudes to address contemporary challenges in health care education and practice, to improve the patient care experience, and to contribute to the well‐being of health care professionals. Each contributor is a leader in quality and safety and offers their work to stimulate all nurses and health care professionals to share and disseminate their work around the globe.
Together, we hope to ensure a high‐reliability health care system focused on safety and quality. It is our hope that the expanding story of QSEN provides motivation and will, that the expansive tool kit within these pages stimulates ideas, and that the continuing efforts of all nurses translate into execution as we develop new generations of nurses fully prepared to lead and work in health care systems based on cultures of quality and safety. In this past year, often called “a year like no other,” we have seen how these six competencies have continued to provide an evidence‐based foundation for nursing practice and education. As we move forward into the future, we anticipate that this will continue as we also tackle new challenges in health care and society, eliminating preventable harm in systems that achieve health equity and racial justice for every patient, every time.
Gwen Sherwood, PhD, RN, FAAN, ANEF
Jane Barnsteiner, PhD, RN, FAAN
References
1 Graham, J. (2020) Why Black aging matters, too. KHN, September 3. Retrieved January 13, 2021 from https://khn.org/news/why‐black‐aging‐matters‐too.
2 National Steering Committee for Patient Safety. (2020) Safer Together: A National Action Plan to Advance Patient Safety. Boston, MA: Institute for Healthcare Improvement. Retrieved June 27, 2021 from www.ihi.org/SafetyActionPlan.
3 WikiWisdom Forum. (2020) Frontline Nurses. Retrieved January 13, 2021 from https://static1.squarespace.com/static/5ae939332714e568d4990eb3/t/5f5be0b63afa8a3d70290ae3/1599856832078/WikiWisdom‐Nurses.pdf.
4 World Health Organization. (2020) State of the World’s Nursing. Geneva: WHO. Retrieved June 27, 2021 from https://www.who.int/publications/i/item/9789240003279.
About the Companion Website
This book is accompanied by a companion website:
www.wiley.com/go/qualityandsafetyinnursing3e
This hosts supplementary content that accompanies this textbook including PPT slides for use in teaching.
1 Driving Forces for Quality and Safety: Changing Mindsets to Improve Health Care
Gwen Sherwood, PhD, RN, FAAN, ANEF
Julia stashed her umbrella and looked at the overflowing waiting room of the Emergency Department (ED) where she had worked weekends for the past five years. It was summer and staffing was short even for a Sunday evening in August; several staff were on vacation and one had called in sick. A storm had pounded the area, and there was a power outage. The hospital was
