Quality and Safety

Applying QSEN Strategies on the Surgical Unit

 What is QSEN?
QSEN stands for Quality and Safety Education for
Nurses.
QSEN uses three key ideas of Knowledge, Skills and
Attitudes to help educate nurses to improve quality
and safety in the workplace (QSEN, 2014).
QSEN offers ideas and competencies to define
standards for education in nursing.

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How does QSEN apply here?
We can take the QSEN competencies and apply them to
our education here on the Surgical Unit.
By applying each of these competencies we can promote
quality and safety for our unit.
The overall goal is to implement these strategies on our
unit.
 Six QSEN Competencies

1. Patient-Centered Care
2. Teamwork and
Collaboration
3. Evidence-Based Practice
4. Quality Improvement
5. Safety
6. Informatics
KSAs
Within
each competency we will evaluate
according to the KSAs:

K Knowledge What you need to know.

S Skills What you need to do.
A Attitudes How you should feel.
Patient-Centered Care
Definition: Recognize the patient or designee as the
source of control and full partner in providing
compassionate and coordinated care based on
respect for patients preferences, values, and needs
(QSEN, 2014)
Patient-Centered Care - Knowledge
We must examine how we can improve safe, quality
and cost effective care by actively involving the patient
and family, and examine barriers to doing this (QSEN,
2014).

How do we do this?
Look, think and examine the things that are going right and
the things that are going wrong. Is the patient involved?
Observe the patient and family, do they seem to be
participating in their care? Are they asking questions or
voicing their concerns to you? You must assess your patient
and family for these key elements. Know what to look for.
Patient-Centered Care - Skills
Engage your patients and/or families in active
partnerships to promote health, safety, well-being and
self care (QSEN, 2014).

How can we do this?

ASK, dont assume! Always ask the patient and family how
they want to be involved. Ask what they think or what their
concerns are. Constant communication between you and the
patient and family is key!
Encourage the patient and family to speak up and to not be
afraid to voice their thoughts or concerns about their care.
Patient-Centered Care - Attitudes
You must RESPECT your patients decision for how
involved they want to be in their care process (QSEN,
2014).
When your patient is an active member in their care,
value their participation and apply it to the nursing
process of planning, implementation and evaluation
(QSEN, 2014).

How do we do this?
Always demonstrate respect for your patient and their family no
matter their decisions.
Patient-Centered Care
Patient-centered care should do just that, center
completely around the patient and family, your
knowledge of their needs and wants, and absolute
respect for their decisions.
Teamwork and Collaboration
Definition:Function effectively within nursing
and inter-professional teams, fostering open
communication, mutual respect, and shared
decision-making to achieve quality patient
care (QSEN, 2014).
Teamwork and Collaboration - Knowledge
For teamwork to be effective there must be open
communication between patients, nurses and other
health care members. You must be able to analyze the
differences in communications styles of each team
member and individual, and your own.

How do we do this?
Dont assume you know how people communicate. Assess
communication styles as you go, on an individual basis, and
develop your response in order to have the most effective
communication.
 Teamwork and Collaboration - Skills
You must adapt your own communication style and
communicate with your team members during situations.
Demonstrating commitment to the team goals is
essential, as well as getting input from all members to
improve performance (QSEN, 2014).

How do we do this?
Practice effective communication between all team members,
including the patient.
Dont let conflict brew; address it and take action to resolve it
quickly.
Teamwork and Collaboration - Attitudes
The attitude we must have is to value
teamwork and our relationships between
each other and patients (QSEN, 2014).

How do we do this?
Value one another. Value the similarities
and the differences between our
communication styles. Always have a hand
in conflict resolution.
Teamwork and Collaboration
To function effectively as a team we must have
respect and value one another,
communicate effectively with differing
communication styles and understand our own
communication styles for the most effective
collaboration and conflict resolution.
Evidence-Based Practice
Definition:Integrate
best current evidence
with clinical expertise and patient/family
preferences and values for delivery of optimal
health care (QSEN, 2014).
Evidence-Based Practice Knowledge
You must be able to differentiate research and
evidence from clinical opinions, and be able to know
what your reliable resources are for locating evidence-
based practice guidelines (QSEN, 2014).

How do we do this?
Know where you can find the most up to date clinical guidelines
using the most reliable sources.
Understand the levels and strength of your evidence findings.
Evidence-Based Practice Skills
You must keep yourself in the know when it comes to
EBP. Locate and read reports and research that are
applicable in this area of practice (QSEN, 2014).

How do we do this?
Subscribe to nursing journals that apply to surgical care.
Research on your own when you have a question or concern
about your practice.
Evidence-Based Practice Attitudes
You must value and appreciate evidence-based
practice when you find it and value that is is an integral
part of your clinical practice (QSEN, 2014).

How do we do this?
When you find quality EBP, appreciate your finding and put
it into practice. Share your findings with others!
Evidence-Based Practice
We must know what defines quality EBP, how
to find it, and value our findings for the best
clinical practice possible.
Quality Improvement
Definition:Use data to monitor the
outcomes of care processes and use
improvement methods to design and test changes
to continuously improve the quality and safety of
health care systems (QSEN, 2014).
Quality Improvement Knowledge
Youmust recognize that health care
professions, including nursing, are a part of a
system and processes of care that can affect the
outcomes for patients and families (QSEN, 2014).

How do we do this?
Be mindful that audits of data are in place to assess
the system and process issues that affect care, not
necessarily as a punitive measure for nurses.
Quality Improvement Skills
You should participate in the quality
improvement. Use the tools provided to you,
like flow charts and diagrams, to show the
processes of care (QSEN, 2014).

How do we do this?
Participate! Play a role in data collection and
distribution. If there is a sentinel event, be a
member of the root cause analysis to assist in
discovering the issue and a solution.
Quality Improvement Attitudes
We must appreciate and value that quality
improvement must be continuously done on a
daily basis and it is an essential part of our
work as a nurse and health care professional
(QSEN, 2014).

How do we do this?
Take all data received with a positive attitude,
whether it is good or bad. Learn from the data you
receive and work to make improvements!
Quality Improvement
Qualityimprovement is a necessary component of
a health care system and each individual
member should understand, participate and
value the data in order to continuously improve
the work place.
Safety
Definition:Minimizes risk of harm to patients
and providers through both system effectiveness
and individual performance. (QSEN, 2014).
Safety Knowledge
Know and understand the benefits and
limitations of technologies built to enhance
safety, such as barcode scanning, medication
pumps, alerts and alarms, and computer provider
order entry (QSEN, 2014).

How do we do this?
You must understand the importance of using these
technologies to your benefit to prevent errors, while
also understanding the limitations they pose.
Safety Skills
use the technologies that promote
Effectively
safety and quality in order to to standardize
practice and reduce the risk of harm (QSEN, 2014).

How do we do this?
Use technology the proper way, dont use shortcuts to
get around certain steps. Every step is there for a
reason to promote safety and reduce the risk of harm!
Safety Attitudes
Value what technology contributes to
reliability and safety (QSEN, 2014).
Appreciatethat there are limitations of
human performance, both physically
and cognitively (QSEN, 2014).

How do we do this?
Try not to get frustrated with technology. Be
patient and value that it really does contribute
to safe and reliable care.
Safety
Our ultimate goal is safe care for our patient.
By each of us understanding, utilizing and
valuing the technology we are given to
standardize care and decrease risk of harm we
can increase the safety on our unit.
Informatics
Definition:Use information and technology
to communicate, manage knowledge, mitigate
error, and support decision making (QSEN,
2014).
Informatics Knowledge
Youmust be able to identify quality
information that needs to be available to you in
the electronic health record (EHR) to support
patient care as well as know the limitations
they impose (QSEN, 2014).

How do we do this?
Know what is available to you in the EHR, and also
know the limitations of the EHR.
Informatics Skills
Beable to navigate and document in the EHR
and coordinate care by using communication
technologies (QSEN, 2014).

How do we do this?
Practice using the EHR and ask if you dont know
where something is or how to use it. Use phones,
pagers and email to communicate between the
health care team and coordinate care.
Informatics Attitudes
Youmust value that these technologies can support
the health care team in clinical-decision making,
preventing errors and coordinating care, all while
protecting the patients confidentiality and
protected health information (QSEN, 2014).

How do we do this?
Always protect patients PHI, do not leave information
on computer screens, papers with information laying
around, talk about PHI with staff outside of patient
care areas.
Informatics
Technology including the electronic health
record and communication devices are essential
to promoting safe and quality care. We must
use the technology wisely and accurately to
ensure the best outcomes for our patients.
Applying QSEN Competencies
We must all apply the QSEN competencies into
our education and practice to promote safety and
quality on this unit.
Safequality care should be the ultimate goal for
each member of the health care team and for the
patient.
Usethe knowledge, skills and attitudes you
learned here today and apply them in your
practice now!
 References
QSEN. (2014). Retrieved from: http://qsen.org/competencies/pre-
licensure-ksas/