United States and abroad. What originally began as an initiative to teach faculty the IOM safety competencies has been transformed into an interprofessional, international movement that is bringing passionate advocates together with far‐ranging interests to improve quality and safety. This section will describe what has evolved within the nursing education arena. It will also provide a brief overview of where the movement is now heading: to improving clinical practice through academic–clinical partnerships; to promoting interprofessional education and practice; and to spreading the word to, and learning from, our international colleagues.
Education
Faculty in schools of nursing continue to integrate the QSEN competencies, with the requisite KSAs, into curricula, and share innovative strategies for use in the classroom, simulation laboratories, and clinical settings. As of June 2016, Google Scholar indicated that the QSEN publication (Cronenwett et al., 2007) describing the QSEN initiative with the competencies and requisite KSAs had been cited in 684 publications. Many of the articles describe how the competencies are being demonstrated in innovative teaching strategies across programs and how outcomes are measured. The first edition of the current book (2012) received the American Journal of Nursing first place award for Leadership in 2013 and has been translated into Swedish, Korean, and Chinese.
Hundreds of articles and editorials have been written on the competencies and their implementation. Authors who have numerous QSEN publications include Gwen Sherwood, Mary Dolansky, Joanne Disch, Pam Ironside, Gail Armstrong, and Amy Barton. In addition to those previously published, a number of professional nursing journals published special topic issues on quality and safety and the QSEN project, including the following:
Archives of Psychiatric Nursing: October 2012.
Nursing Clinics of North America: September/October 2012.
Journal of Professional Nursing: March/April 2013.
The home of QSEN has successfully transitioned from UNC at Chapel Hill to Francis Payne Bolten School of Nursing at Case Western Reserve University. This includes the QSEN Institute, which is the annual meeting that serves as a focal dissemination point for educators, researchers, and increasingly clinicians to present the latest innovations in quality and safety; the QSEN website; and the consultation service for incorporating the QSEN competencies into nursing curricula.
Expanding Focus
The QSEN work under the leadership of Mary Dolansky has expanded from an essentially educational focus to one that seeks to improve the quality and safety of care by promoting stronger academic–practice partnerships. The expanded network includes nurses from academia and practice, other health care professionals, nursing professional organizations (American Nurses Association [ANA], Association of Operating Room Nurses [AORN], American Nurses Credentialing Center, National Council of State Boards of Nursing [NCSBN], AACN, Association of Nurse Executives [AONE]), and interprofessional organizations (IHI, American Association of Medical Colleges [AAMC], and VA).
These networks are enabling clinicians to apply the latest evidence and best practices. One example is the QSEN partnership with ANA. A QSEN pre‐conference, QSEN Quality Competencies: Connecting Academic and Nursing Practice, was held at the 2016 annual ANA staffing conference and also at the 2015 AONE. Examples of application in clinical settings include the use of the QSEN framework for orientation at the Children’s Hospital of Denver, the University of Pennsylvania Health System, the University of Alabama Birmingham hospital, and the ProMedica Health System. The University of Pennsylvania Health System and Denver Children’s Hospital are also using the QSEN framework for their clinical advancement programs.
Numerous statewide initiatives have been developed. Two examples are the Florida Statewide Initiative Integrating QSEN through Academic/Clinical Partnerships to Improve Health Outcomes; and the Michigan Academic Practice Partnership. In Ohio, Dr. Dolansky worked with the Ohio Organization of Nurse Executives to develop a white paper calling for the QSEN framework to be used in all nursing education programs and in the practice arena. In the Michigan example, former Dean Mary Mundt worked with deans and chief nursing executives to foster academic–clinical partnerships based on the QSEN competencies.
The direction is also spreading from a largely nursing focus to an interprofessional one that is influencing how all health professions’ students are improving quality and safety together. Successful examples include the collaborative partnership among health professions’ schools, IPEC, which was spearheaded by the AACN to offer annual quality and safety workshops to develop interprofessional academic/clinical teams doing safety and quality improvement work. The VAQS Fellowship Program brings together researchers to work together through interprofessional learning and scholarly inquiry about quality and safety.
The work of QSEN has also moved into the international arena. In addition to numerous international publications, partnerships have been developed between the QSEN Institute and the Swedish Society of Nursing and collaborators in Canada, Japan, and China. QSEN experts have been working with colleagues in Sweden, Saudi Arabia, Spain, the United Kingdom, Finland, Japan, France, China, and Thailand. These partnerships are assisting faculty and clinicians in countries other than the United States to learn the competencies and integrate them into nursing education and practice.
Moving forward there is a need to continue to stay focused on QSEN’s purpose; that is, ensuring that nurses and other health care professionals have the requisite knowledge to provide the highest‐quality, safest care by delivering person‐ and family‐centered care as members of an interprofessional team, emphasizing evidence‐based practice, safety, quality improvement approaches, and informatics.
QSEN: 2018–2022
As I write this update for the third edition, the planet is in the throes of the COVID‐19 pandemic, while the United States is also grappling with how to come to terms with systemic racism that touches every area of health care. Both cataclysmic events have significantly affected the incorporation of the six QSEN competencies into education and practice. How do health care professionals deliver person/family‐centered care when people are quarantined at home, and hospitals and long‐term care facilities are closed to family members? How do health care providers stay current with the latest evidence for a virus that is not fully understood and for which new interventions are being trialed daily; a form of building the bridge as we walk on it? How do front‐line providers practice safety for themselves and their patients in the face of insufficient personal protective equipment, intensive care unit beds, and ventilators? What are the barriers to and outcomes from the significant use of telehealth? How are big data being used as an informatics lever to understand the COVID‐19 virus and assess progress during the pandemic? And how do we continue quality improvement and measuring the outcomes of our work even as nurses and other health professionals are stretched to the limits? How do health care providers begin to recognize implicit biases and recognize the disparities in health care? How do we provide equitable health care to populations that have been historically marginalized? These are but a few of the challenges we face as we attempt to educate nurses and other health care providers to deliver high‐quality, safe care to individuals and their families.
In spite of these challenging circumstances, nurses were often reported as leaders in redesigning care to accommodate people with COVID‐19. Safety and quality became even more important in this crisis time, with daily leadership rounds to touch base, modeling teamwork and collaboration outside silos and hierarchies, leading evidence‐based practice synthesis panels, and demonstrating patient‐centered care despite widespread no‐visitors policies.
Significant Accomplishments
