Applying Graduate-Level QSEN Competencies to Clinical Quality and Safety Issues

Application Focus

The graduate-level QSEN competencies can be used as a practical framework for examining clinical quality and safety issues. In the indexed AACN material, application involves using data, evidence, teamwork, patient partnership, safety principles, and informatics to understand care problems and improve outcomes. Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

Using Quality Improvement to Frame a Clinical Issue

When approaching a clinical quality or safety issue, the Quality Improvement competency directs the nurse to describe strategies for improving outcomes, align aims, measures, and changes, review benchmarks and outcome data, and use change management and small tests of change such as Plan-Do-Study-Act. This means a clinical issue is not only identified; it is translated into measurable improvement work. Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

• Use outcome data and benchmarks to identify gaps.
• Compare current performance with accepted measures.
• Design, implement, and evaluate small tests of change.
• Consider the effect of context, including work environment, team functioning, and community or social factors.

Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

Applying Safety Principles

The Safety competency guides analysis of how harm occurs and how risk can be reduced. The indexed material emphasizes culture of safety, just culture, best practices that protect patients and providers, and attention to human factors and unsafe practices such as work-arounds and risky behavior. Application to a clinical issue therefore includes examining system conditions, not just individual mistakes. Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

• Look for system contributors to harm.
• Use safety resources and research-based strategies.
• Integrate risk-reduction practices for patients, self, and others.
• Value a systems approach rather than blame.

Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

Role of Teamwork and Collaboration

Clinical quality and safety issues often require coordinated interprofessional action. The Teamwork and Collaboration competency emphasizes open communication, mutual respect, and shared decision-making. Applied to a clinical problem, this means improvement work should involve nursing and interprofessional teams rather than isolated action. Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

Role of Patient-Centered Care

The Patient-Centered Care competency requires that patients or designees be treated as full partners in care. Applied to a clinical issue, this means the problem and proposed changes should be considered in relation to patient preferences, values, and needs, not only system efficiency. Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

Role of Evidence-Based Practice

The Evidence-Based Practice competency supports selecting responses to clinical issues by integrating best current evidence with clinical expertise and patient/family values. In application, this means proposed interventions should be informed by evidence rather than habit alone. Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

Role of Informatics

The Informatics competency supports communication, knowledge management, error mitigation, and decision-making. For a clinical quality or safety issue, informatics can support outcome review, data comparison, communication of findings, and monitoring of change efforts. Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

Important Graduate-Level Themes in Clinical Application

• Systems thinking: Analyze how the environment, team functioning, and larger context shape quality and safety.
• Measurement: Use accepted quality indicators, benchmarks, and public reporting data where relevant.
• Leadership: Lead improvement efforts and influence planned change.
• Accountability and transparency: Commit to measurement, accountability, and the responsible use of quality information.
• Risk reduction: Promote safety through proactive design and practice improvement.

Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes

Study Takeaways

• Apply QSEN by linking a clinical issue to data, benchmarks, and measurable outcomes.
• Use safety culture, just culture, and systems thinking to analyze causes of harm.
• Ground changes in evidence, teamwork, patient partnership, and informatics.
• Remember that graduate-level QSEN application requires leadership and evaluation of change, not only problem identification.

Reference: AACN Graduate-Level QSEN Competencies: Knowledge, Skills and Attitudes