QSEN Competencies: Informatics & Quality Improvement

• Quality and Safety Education for Nurses (QSEN) has developed multiple quality and safety elements to guide nursing practice.
• QSEN has six key competencies:
  • Quality Improvement
  • Teamwork and Collaboration
  • Evidence-Based Practice

Informatics

• A patient undergoing a scheduled rhinoplasty at an ambulatory surgery clinic mentions a past allergic reaction to an antibiotic from 3 years prior, but cannot recall the name.
• After the nurse reviews the patient's Electronic Health Record (EHR), they discover the patient has a Penicillin allergy.
• Using the Electronic Health Record (EHR) to obtain trend data about medication doses and resultant lab values is an example of Informatics.

Quality Improvement (QI)

• Improving patient outcomes is the primary goal.
• A nurse recognizes their patient isn't responding to pain management, so they explore additional pain management options for patients whose pain is not controlled with the usual pain management.
• A group of emergency room nurses tasked with improving the time patients with chest pain receive an electrocardiogram (EKG) is an example of QI.
• Actions that are NOT helpful when working on a QI effort:
  • Identifying whose fault it is that the results are not very good.

Patient-Centered Care (PCC)

• Near the middle of the shift, the nurse recalls the importance of spirituality that a patient had expressed earlier in the day.
• The nurse notices that there is no consult for pastoral care in the patient's chart, so the nurse then places the consult and calls pastoral care to see the patient.
• In health care settings that are creating new models of PCC delivery, the patient should be the ultimate decision-maker regarding their care.

Teamwork and Communication (TWC)

• A nurse reminds a medical resident to sanitize their hands before touching the patient.
• Ensuring patient safety by using the handoff report, being careful to describe the situation, background, assessment, and recommendations for the patient's continued care.

Safety

• A nurse is caring for a patient with orthostatic hypotension and mild dementia with forgetfulness.
• The nurse identifies the patient as a fall risk and develops a plan of care that includes using the bed alarm setting on the patient's bed and making sure unnecessary clutter is out of the way in the room.
• Minimizing the risk of harm to patients and providers through both system effectiveness and individual performance describes safety best.
• Leadership supports safety by accepting that errors occur.
• Shift from a culture of blame to a just culture in which error is perceived as an opportunity for improvement.

Evidence-Based Practice (EBP)

• The wound care nurse is responsible for providing nursing units with necessary information regarding the latest standards of care in pressure ulcer prevention.
• A group of nurses on a medical-surgical unit identified that patients were readmitted to the hospital based on lack of understanding of discharge instructions.
• They decided to look at how they could assess every patient's health literacy level (understanding of health information).
• The group identifies three tools commonly found in the literature and systematically searched for evidence and evaluated each tool and subsequently decide on one tool that is appropriate for their medical-surgical population of patients.
• To implement the tool, they teach the nurses how to use it and document the patient's literacy level score in the chart.

Causes of error

• Common causes of errors within health care settings: Communication problems between caregivers.

QSEN Goals

• Goals of the QSEN project: to ensure that unit managers in the hospital accept full responsibility for errors.

Explore QSEN competencies with a focus on Informatics and Quality Improvement. Learn application of Electronic Health Records in identifying allergies. Discover strategies for improving patient outcomes through pain management adjustments.