QSEN Competency #6: Quality Improvement


QSEN Competency #6: Quality Improvement

The content emphasizes the key elements of quality improvement that the pre-licensure graduate should be competent in upon graduation. Nurses are part of the system of care and their actions affect outcomes for patients and families. Small unit changes can improve patient care. It does not always have to be an institutional change.

QSEN 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.


Clinical Teaching Strategy: Infusing Quality Improvement into Clinical Education

Learning Objectives

  1. Faculty and students will “seek information about quality improvement projects in the care setting” (Knowledge).
  2. Students will identify the potential impact of quality improvement measures on patient care (Knowledge).
  3. Students will evaluate evidence based practice with observed practice (Skills).
  4. Students will gain an appreciation “that continuous quality improvement is an essential part of the daily work of all health professionals” (Attitudes).
  5. Students will “value vigilance and monitoring (even of own performance of care activities) by patients, families, and other members of the health care team” (Attitudes).

Strategy Overview

This strategy may be used to educate students on how patient safety may be improved through quality improvement audits and the Plan-Do-Study-Act (PDSA) cycle. The audit subjects were chosen in collaboration with several nurse managers and administrators at clinical facilities utilized by our nursing program.

  1. Provide each clinical faculty member the Quality of Care Audit instructor guide (Attachment #1) and a set of audits (Attachment #2): Computer screen; Fall precautions; Hand hygiene; Hourly rounds; IV labeling; and Pain medication reassessment.
  2. Have clinical faculty member assign students an audit to complete (Attachment #2). Have students read the directions and perform the audit.
  3. Have students discuss their findings and reflections in post conference. Invite the unit manager or charge nurse to participate or provide them a copy of the findings. If the facility allows have the students create a PDSA plan and implement it. Then complete the audit again at a later date and compare the findings to determine if the plan improved care.


Author: Donna B. Lupinski, MSN, RN
Title: Faculty
Institution: Lorain County Community College


Classroom Teaching Strategy: The Influence of Human Factors in Medication Errors: A Root Cause Analysis

Learning Objectives


  1. Examines the human aspect of nursing practice which influences the delivery of safe patient care.
  2. Identifies individual components within a health system and its impact on quality patient outcomes.


  1. Demonstrates the use of root cause analysis in identifying human influences in medication errors.
  2. Differentiates best practice and local practice in examining nursing medication errors.


  1. Values individual responsibility for safety and quality when providing patient care.

Strategy Overview

Healthcare organizations strive to provide safe, quality care in every patient setting. The complexities of the healthcare environment however, allows prospective errors. Medication related errors are the most common type of error and also account for a sizable increase in healthcare costs (IOM, 2000). Medication errors account for lost wages, disability, and productivity, and are responsible for over 7000 deaths annually (IOM, 2000). The Joint Commission mandates healthcare systems demonstrate strong leadership which creates a fair and just culture of safety. This approach holds both the organization and individual accountable for safe, quality patient care (Joint Commission, 2017). This accrediting body recognizes that individuals human and capable of mistakes in an often flawed system. This case study examines the human factor in a fatal medication error using a root cause analysis.


Author: Robyn B. Caldwell, DNP, FNP-BC, CNE
Title: Assistant Professor
Institution: Auburn University Montgomery


Classroom Teaching Strategy: Understanding and Acceptance of Grief and Loss

Learning Objectives

  1. Utilize the nursing process to provide care which supports psychosocial health related to loss and grief.
  2. Students examine the role as a patient advocate in meeting the psychosocial, cultural, and spiritual needs of assigned patients and their families.
  3. Students examine the responsibility in caring for a dying patient and his/her significant other.
  4. Discuss the coping behaviors when supporting the grieving individual/familyStrategy OverviewProvide an overview of palliative care and the important and unique roleStudent’s play in providing quality care. As a nurse, they will likely witness the major deficiencies in current systems of care for patients and their families facing serious illness, particularly at the end of life. Examine what details that are needed in order to inform/teach about nursing care planning for patients with different disease processes and reinforce the importance of various assessments.

Adrienne Donaldson-Steverson PhD(c), MBA, BSN,RN-BC, BCC, CEKGT – Nursing Faculty, Dallas College, adonaldson-steverson@dcccd.edu