The Importance of Quality and Safety Education in Nursing

The present-day healthcare provision is progressively dynamic due to the rising need for quality and safe healthcare service delivery. Nursing training and practice should be geared towards promoting quality and safety to improve health outcomes. Pauly-O’Neill and Cooper (2013) state that QSEN focuses on the delivery of patient-centered care, implementation of evidence-based practice (EBP), promotion of teamwork among nurses, quality assurance and nursing informatics in the delivery of care. EBP competency is a fundamental QSEN among nurses as it supports the implementation of nursing practice based on scientific rationale obtained from research. Fisher, Cusack, Cox, Feigenbaum, and Wallen (2016) note that the incorporation of research to guide nursing practice also contribute to effective decision making in the management of patients as opposed to traditional practice which was guided by intuition. Nurses should be equipped with the appropriate knowledge, skills and attitude (KSA’s) which are significant for effective implementation of EBP in the clinical setting.

Quality and Safety Education for Nurses (QSEN)

Introduction

Nurses contribute significantly to the delivery of healthcare services. Nurses bear the task of ensuring that health services meet the set quality standards. Additionally, healthcare service delivery by nurses should promote safety for both the patient and the nurse. Pauly-O’Neill and Cooper (2013) draw attention on the role of QSEN as an approach to train nurses on effective knowledge, skills and attitude (KSA’s) to promote the delivery of quality and safe nursing services targeted at improving the health outcomes of patient care. QSEN focuses primarily on the KSA’s required for the promotion of patient-centered care, quality improvement, teamwork and collaboration, evidence-based practice (EBP) implementation, and nursing informatics (Nygårdh, Sherwood, Sandberg, Rehn, & Knutsson, 2017). The following task aims to highlight the KSA’s necessary for the positive impact of EBP and its effective implementation in the clinical setting.

EBP Competency

According to Theofanidis (2015), EBP is an approach that focuses on the utilization of best scientific evidence from research and clinical expertise to improve clinical practice. EBP is based on the identification of existing gaps in the provision of quality care, sourcing for the best practice commendation with scientific rationale and the implementation of the practice in the clinical setup. Additionally, nurses should address the practice to other team members through nurse education session and during actual practice. The purpose of EBP is to shift nursing practice from the traditional practice that involved the use of intuition in the provision of care to the use of a contemporary best practice that is guided by scientific rationale in the provision of patient care (Bjuresäter & Athlin, 2016). EBP should also identify and address the needs and preferences of the patient and the family in service delivery. Nurses need to be equipped with the effective KSA’s relevant for the effective implementation of EBP in the clinical setup.

Knowledge, Skills and Attitudes (KSA’s) for EBP Implementation

Knowledge Required for EBP Implementation

QSEN Institute (2018) suggests that nurses should be knowledgeable on the scientific research methodologies and approaches to promote proficient identification of research information, guidelines and recommendations of care which are relevant to fill the identified gaps service provision in the actual clinical setting. An acquaintance on the identified concern enables nurses to efficiently collect information from various data sources and comparatively identify the best research material which is effective in improving the outcome of patient care in the actual practice. According to Sherwood and Barnsteiner (2017), understanding research methodology is also relevant as it equips nurses with the competency to match the effectiveness of the research guidelines in relation to the available resources in the actual health care system.

Nurses should demonstrate an understanding of the appropriateness of the research evidence in addressing the care needs of the patient and the family. QSEN Institute states that EBP should focus on prioritizing patient and family desires in the delivery of care (2018). Research guidelines on best practices address a variety of concerns which may focus on various groups on basis of age, ethnicity, and socioeconomic factors (Theofanidis, 2015). Therefore, the nurse can comparatively source for best practice guidelines which align to the patient’s age, identified special needs, and comorbidity to promote improved health outcome.

Nurses should demonstrate comprehension of the reliable sources of information and guidelines of best practices (QSEN, 2018). In the contemporary health sector, there are numerous collection of health-related information from the internet, journals, medical libraries, health publications, websites, and blogs. Nurse’s need to recognize that some sources of information may not offer reliable information on best practice. The nurse is tasked with proficiency in the identification of reliable information from sources approved by recognized health institutions and organizations (Bjuresäter & Athlin, 2016). Consistency in sourcing for EBP research evidence also promotes quick access to information during the implementation of EBP for patients with different conditions.   

Skills Required for EBP Implementation

The implementation of EBP in the clinical setting requires the nurse to be active in the collection of research evidence which guides best practice. Service providers should possess the ability to prioritize the requirements of the Institutional Review Board (IRB) in the collection of data (QSEN, 2018). The clinical nurse should competently indulge in data collection process through selectively identifying information sources such as health journals, medical websites and materials from the medical library. Nygårdh et al., (2017) suggest that competency in the identification of research evidence promotes efficiency in the identification of best and current rationale-guided procedures for the provision of care.

Application of the research evidence in the actual clinical set up to meet the patient and family needs is an essential skill for the implementation of EBP to improve health outcomes of nursing care (Fisher et al., 2016). Upon identification of evidence-based guidelines, the nurse should efficiently conduct the patient assessment, identify expected patient outcomes, implement the appropriate nursing intervention, and provide a scientific rationale guiding the intervention. The nurse should also evaluate the outcomes of the implemented EBP to determine whether it meets the expected patient outcomes. Theofanidis (2015) outlines that the ability of the nurse to meet the patient and family needs during the implementation of EBP significantly promotes quality healthcare.

QSEN Institute suggests that professional consultation and open-mindedness throughout the identification of research evidence for implementation of EBP enables the nurse to accurately distinguish between reliable and unreliable information from the diverse sources of information (2018). Identification of reliable information is crucial in guiding justifications for a specific practice. Also, the nurse should collaborate with other healthcare providers for effective implementation of EBP.  The nurse should participate in educating other team members about the identified EBP and relevance of the practice in improving healthcare outcomes (Bjuresäter & Athlin, 2016). The creation of a suitable work environment for nurses promotes the implementation of the EBP by team members.

Attitude Required for EBP Implementation

Valuing the importance of EBP in improving the quality of healthcare is necessary to promote the realization of best practice in the clinical area (QSEN, 2018). Nurses to develop a positive attitude and enthusiasm to study available information on health and care. Also, caregivers should appreciate the strengths and weaknesses of identified guidelines from research sources and focus on the implementation of best practice. QSEN Institute (2018) also suggests valuing the need for continuous improvement of medical practices and procedures on the basis of scientific evidence are also significant for the implementation of EBP. Health care providers should acknowledge the existing gaps in the provision of quality care owing to old practice (Bjuresäter & Athlin, 2016). Appreciating and addressing discrepancies in the healthcare sector promotes the enthusiasm to identify and implement EBP. Failure to develop a positive attitude toward the implementation of EBP is a major setback towards the implementation of best practice in service delivery among nurses.

Implementation of KSA’s in Nursing Profession to Promote EBP

According to Pauly-O’Neill and Cooper (2013), promoting the implementation of EBP requires the identification of gaps in the provision of quality care in the facility as the initial step. Application of the knowledge on research methodology and data collection techniques is relevant for the effective identification of evidence-based guidelines from empirical studies to provide a solution to the identified problem (QSEN, 2018). Understanding the appropriateness of the best practice is relevant in improving the health care outcomes of the implemented EBP. The in-depth comparison should be done on the available research evidence to ensure that it promotes best practice.

Knowledge of the needs and preferences of the patient and the family is also essential during the implementation of the EBP.  Fisher et al., (2016) recommend that EBP guidelines should be selected comparatively to ensure they align to the needs of the patient and the family members. Also, the identified evidence-based guideline should align with the available resources at the health facility. Identification of patient needs is attained through assessing the patient’s expectations of the outcome of care (Sherwood & Barnsteiner, 2017). Additionally, factors such as age and available comorbidity should be considered during the identification of best practice for patient care.

Pauly-O’Neill & Cooper (2013) outline that patient assessment and identification of the expected outcomes of care should be conducted prior to the implementation of EBP. Upon implementation, it is essential to develop a rationale for the practice and evaluation plan for the outcome of the practice towards improving the wellbeing of the patient. The evaluation should focus on whether the practice meets the expected healthcare outcomes and the needs of the family. QSEN Institute (2018) recommends that it is essential for the nurse to maintain collaboration with team members in the implementation of EBP. Building rapport with other nurses and educating them on the scientific rationale for EBP facilitates in building interest among team members to adopt best practices of care. Liaising with the administration is relevant for the acquisition of research resources and the development of institutional policies which promote EBP among staff members.

Conclusion

EBP competency in QSEN is an effective strategy to support quality and safety standards in the provision of health services. Nurses should be educated on the importance of EBP in the contemporary health setting during their training as well as practice. Emphasis should be placed on the development of the required KSA’s for effective implementation of EBP. Recent scientific research should provide the rationale for nursing practice. As a nurse facilitator, influencing other team members to adopt EBP and liaising with the hospital administration also contribute towards the overall improvement of healthcare services.  

Reference

Bjuresäter, K., & Athlin, E. (2016). Improvement of nursing care by means of the evidence-based practice process: The facilitator role. Journal of Nursing Education and Practice, 6(11), 61.

Fisher, C., Cusack, G., Cox, K., Feigenbaum, K., & Wallen, G. R. (2016). Developing competency to sustain evidence-based practice. The Journal of Nursing Administration, 46(11), 581.

Nygårdh, A., Sherwood, G., Sandberg, T., Rehn, J., & Knutsson, S. (2017). The visibility of QSEN competencies in clinical assessment tools in Swedish nurse education. Nurse Education Today, 59, 110-117.

Pauly-O’Neill, S., & Cooper, E. E. (2013). Addressing gaps in quality and safety education during pre-licensure clinical rotations.

QSEN Institute (2018). QSEN Competencies, Quality and Safety Education for Nurses. Accessed on 10/23/2018 Retrieved from http://qsen.org/competencies/pre-licensure-ksas/

Sherwood, G., & Barnsteiner, J. (Eds.). (2017). Quality and safety in nursing: A competency approach to improving outcomes. John Wiley & Sons.

Theofanidis, D. (2015). Evidence based practice and evidence based nursing education. J Nurs Care, 4(279), 2167-1168.