A national Delphi to determine developmental progression of quality and safety competencies in nursing education

doi:10.1016/j.outlook.2009.08.003

Nursing Outlook

Volume 57, Issue 6, November–December 2009, Pages 313-322

https://doi.org/10.1016/j.outlook.2009.08.003 Get rights and content

Quality and Safety Education for Nurses (QSEN) faculty outlined 6 competency domains: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. In this study, 18 subject matter experts participated in a web-based modified Delphi survey between October 2008 and February 2009 to determine whether there was consensus on the developmental progression of knowledge, skill, and attitude elements within the QSEN competencies. Support for creation of curricular threads to facilitate student progressive achievement of the QSEN competencies was validated. Competency development related to the individual patient was emphasized early in the curriculum, whereas teams and systems were emphasized later. Complex concepts such as teamwork and collaboration, evidence-based practice, quality improvement, and informatics were emphasized in advanced courses. Experts outlined a developmental approach in curriculum design, which would potentially encourage practice, reinforcement of learning, and recognition of context of care.

Section snippets

National Trends

In response to the complexity of patient care needs and the changing nature of the role of the professional nurse, the American Association of Colleges of Nursing (AACN) recently endorsed a new set of guidelines to direct the preparation of baccalaureate nurses to provide safe, high-quality patient care. The Essentials of Baccalaureate Education for Professional Nursing Practice⁵ provides specific standards for designing and assessing baccalaureate educational programs. Congruencies between the

Traditional Nursing Curricula

A sequential approach to knowledge and skill acquisition is common in nursing education. A simple-to-complex developmental progression with leveled learning experiences results in an initial focus on discrete skills and nursing care of an individual, with increasing complexity to families, communities, and then systems. Patricia Benner's seminal work of the 1970s explicated the developmental nature of nurses' clinical development from novice to expert.⁶ Nursing students enter a new clinical

Colorado's Experience

The University of Colorado, Denver College of Nursing participated in Phase II of the QSEN Initiative as one of 15 pilot schools. The first Colorado QSEN gathering targeted nursing faculty, clinical instructors, and representatives of partnering clinical agencies to engage in dialogue about the potential impact of QSEN on Colorado's nursing curricula. This group quickly asked the question of how to appropriately level the 51 knowledge elements, 65 skill elements, and 46 attitude elements of the

Conclusion

A major objective of Phase III of the QSEN work is to provide ongoing support and development to faculty innovators who are committed to continued development, testing, and dissemination of teaching and assessment strategies, all of which need to be considered in terms of leveled curricular placement. The findings from this Delphi study may be used to inform that work.

Amy J. Barton, PhD, RN, is an Associate Professor and Associate Dean for Clinical and Community Affairs, University of Colorado Denver, College of Nursing, Denver, CO.

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Providing quality and safe nursing care is considered the cornerstone of the healthcare system globally. However, there are no comprehensive evaluation indicators of nursing students' quality and safety competencies in China.
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Citation Excerpt :
In addition, educators may need assistance in determining ways to integrate the QSEN competencies in assessment tools. The six competencies are defined by 162 objective statements of the knowledge, skills and attitudes required, which can be daunting for faculty (Barton et al., 2009). Lastly, there needs to be an emphasis on the integration of the QSEN competencies across nursing schools (Barnsteiner et al., 2013) to underscore the significance of the competencies in helping improve patient quality and safety outcomes.
Prospective nurses need specific and sufficient knowledge to be able to provide quality care. The Swedish Society of Nursing has emphasized the importance of the six quality and safety competencies (QSEN), originated in the US, in Swedish nursing education.
To investigate the visibility of the QSEN competencies in the assessment tools used in clinical practice
A quantitative descriptive method was used to analyze assessment tools from 23 universities. Results and Conclusion: Teamwork and collaboration was the most visible competency. Patient-centered care was visible to a large degree but was not referred to by name. Informatics was the least visible, a notable concern since all nurses should be competent in informatics to provide quality and safety in care. These results provide guidance as academic and clinical programs around the world implement assessment of how well nurses have developed these essential quality and safety competencies.
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Amy J. Barton, PhD, RN, is an Associate Professor and Associate Dean for Clinical and Community Affairs, University of Colorado Denver, College of Nursing, Denver, CO.

Gail Armstrong, ND, RN, is an Assistant Professor, University of Colorado Denver, College of Nursing, Denver, CO.

Gayle Preheim, EdD, RN, is an Associate Professor and Director, Baccalaureate Education, University of Colorado Denver, College of Nursing, Denver, CO.

Sherril B. Gelmon, DrPH, FACHE, is a Professor of Public Health and Chair, Division of Public Administration, Mark O. Hatfield School of Government, Portland State University, Portland, OR.

Lynne C. Andrus, MSN, RN, is a PhD Student, University of Colorado Denver, College of Nursing, Denver, CO.

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ArticleA national Delphi to determine developmental progression of quality and safety competencies in nursing education

Section snippets

National Trends

Traditional Nursing Curricula

Colorado's Experience

Conclusion

Institute of Medicine. To err is human: Building a safer health system

Institute of Medicine. Crossing the quality chasm

Institute of Medicine. Health professions education: A bridge to quality

Institute of Medicine. Keeping patients safe: Transforming the work environment of nurses

Article
A national Delphi to determine developmental progression of quality and safety competencies in nursing education