1. Michele Gilmore Julie Saladin Kelly Vogt Sandra Wernstrom Ferris State University

2. QSEN Michele Gilmore Developed to prepare nursing students with the knowledge to improve quality and safety in Nursing (QSEN, 2013). Mainly funded by the Robert Wood Johnson Foundation (QSEN, 2013). Funds used to educate nursing students on patient safety and improved quality (QSEN, 2013). Began in 2005 by the American Association of Colleges of Nursing (AACN, 2013). Goal was to develop quality and safety competencies among nursing students to improve healthcare practices (AACN, 2013).

3. Phase 1 Michele GIlmore Developed from 2005-2007 to focus on 6 key areas that pre licensure nursing students must pass competencies in: 1. Patient centered care Patient is in charge of their care and their preferences, values and needs should be respected (QSEN, 2013). 2. Teamwork and collaboration To achieve the best patient care, teams should have open communication, mutual respect and shared decision making (QSEN, 2013). 3. Evidence based practice Nurses use current best evidence based care in addition to the patients values to provide the best patient care possible (QSEN, 2013).

4. Phase 1 cont. 4. Quality improvement Continue to monitor and evaluate changes to ensure the best practices are being used in the healthcare system (QSEN, 2013). 5. Safety Utilizes ways to minimize harm to patients and employees including system and self-evaluations (QSEN, 2013). 6. Informatics Uses information and technology to minimize error and improve communication (QSEN, 2013).

5. Phase II- Kelly Vogt Developed in April 2007. Principal investigator Linda Cronenwett received $1,094,477 from Robert Wood Johnson Foundation to fund phase II (QSEN, 2013). In Phase II, QSEN will partner with representatives of organizations that represent advanced practice nurses to draft proposed knowledge, skills, and attitude targets for graduate education (QSEN, 2013). Phase II also includes work with 15 pilot schools committed to active engagement in curricular change to incorporate quality and safety competencies (QSEN, 2013).

6. Phase II continued- Kelly Vogt QSEN.org was launched in April 2007 to feature teaching strategies and resources (QSEN, 2013). QSEN faculty completed a national survey if baccalaureate program leaders and a state survey of associate degree educators to assess beliefs about the extent to which the competencies are included in current curricula.

7. Phase II continued- Kelly Vogt  Defined graduate-level quality and safety competencies for nursing education and proposed targets for the knowledge, skills, and attitudes (KSAs) for each competency.  The 6 competencies are: 1. Quality improvement (QI) 2. Safety 3. Teamwork and Collaboration 4. Patient-centered Care 5. Evidence-based practice (EBP) 6. Informatics

8. Phase II Project Leaders  Linda Cronenwett, PhD, Dean of the University of North Carolina at Chapel Hill School of Nursing, is the project Principal Investigator with Gwen Sherwood as the project Co-investigator (QSEN, 2013).  National Advisory Board  17 leaders from 11 professional organizations representing advanced nursing practice

9. Phase III – Sandra Wernstrom Robert Wood Johnson Foundation  awarded $4.25 million to the American Association of Colleges of Nursing (AACN) and the University of North Carolina School of Nursing to continue to research and educate nurses on quality and safety of the healthcare system in 2009. (QSEN Institute, 2013)  Phase III collaborates with colleges to ensure that educators are competent in training quality and safety to nursing students. (QSEN Institute, 2013)  The money will help develop programs within the colleges to introduce the six competencies as defined in phase I. (QSEN Institute, 2013)

10. Phase III Project Leaders Linda Cronenwett, PhD, FAAN is the principle investigator for Phase III.  Cronenwett identifies the importance of developing and implementing training based on the six competencies. (QSEN Institute, 2013)  Goal for phase III is to “’…promote innovation in the way we teach, test, and certify’” (QSEN Institute, 2013).  Cronenwett stresses that to move health care forward, we must train the next generation of nurses to continue to promote quality and safety (QSEN Institute, 2013) Geraldine P. Bednash, PhD, RN, FAAN also leads the project.  Bednash stresses the importance of improving the nursing profession by implementing the following: 1. “’…Assess student learning of the knowledge, skills, and attitudes of the six competencies…’” (QSEN Institute, 2013). 2. Ensure that nursing faculty is competent in the six competencies (QSEN Institute, 2013). 3. Focus on promoting high standards with initial training and continuing education (QSEN Institute, 2013).

11. Faculty Development and Support Information can be found through the following sources: 1. Conferences 2. QSEN.org 3. QSEN National Forums 4. QSEN Speaker’s Bureau QSEN Partners with the VA National Quality Scholars Fellowship Program to ensure high quality training for doctoral students (QSEN Institute, 2013).

12. Continued Commitment  QSEN has committed to the safety, quality, and advancement of the nursing profession. Goals have been clearly identified through the leadership team.  Gordon and Betty Moore Foundation (GBMF) provided money to implement initiative and evaluate outcomes. (Barnsteiner, & McGuinn, 2013)  Initial evaluation reveals that many schools have implemented the six competencies into their curriculum. (Barnsteiner, & McGuinn, 2013)  GBMF stress that it is too soon to evaluate outcomes. (Barnsteiner, & McGuinn, 2013)

13. QSEN - Phase IV Julie Saladin Development of new program in March of 2012 to support the Institute of Medicine (IOM) in their recommendation to have more nurses pursue higher level degrees (QSEN, 2013). Leading the Program is the Tri-Council of Nursing which consists of the American Association of Colleges of Nursing, National League for Nursing, American Nurses Association, and the American Organization of Nurse Executives (AONE) (QSEN, 2013). Funding the program is the Robert Wood Johnson Foundation who will fund $4.3 million for phase 1 of this 2 year program, with the intent to fund another 2 years at the conclusion of phase 1 for those states who have met or exceeded the goals set forth in phase 1 (QSEN, 2013).

14. QSEN - Phase IV continued In 2010, IOM recommended that 80 percent of nurses acquire the minimum of a bachelors degree by 2020 (QSEN, 2013). In Phase IV, RWJF advances these recommendations by supporting The Future of Nursing: Campaign for Action (QSEN, 2013). The Campaign for Action is a collaborative effort to find ways to assist the nursing profession to improve care and is responsible for the Academic Progression in Nursing (APIN) initiative to help support academic progression (QSEN, 2013). According to the Campaign for Action website, the states that are progressing with this initiative are CA, WA, MT, NM, TX, NY and NC (http://campaignforaction.org/apin).

15. QSEN - Phase IV continued Funding will be used towards working on at least one academic strategy and one employment strategy for BSN or higher level nurses (QSEN, 2013). Strong working relationships between community colleges and universities are vital to making the transition to BSN a smooth one (QSEN, 2013). APIN will provide up to $300,000 over two years to each of the nine state Action Coalitions who have made progress towards IOM’s goal of 80 percent of nurses obtaining bachelors degrees or higher by 2020 (QSEN, 2013).

16. QSEN - Phase IV continued Phase IV of the QSEN project is a collaborative effort to ensure that nurses acquire the advanced skills required to provided high-quality patient-centered care (QSEN 2013). Goals of program include: “ensuring that nurses have critical competencies, including leadership, cultural competence, interprofessional collaboration, and quality and safety, and to increase the diversity of the nursing workforce” (QSEN, 2013). The Robert Wood Johnson Foundation mission statement: “To improve the health and health care of all Americans” (Robert Wood Johnson Foundation, 2013). The progression of the QSEN project and the efforts to advance the education of the nursing workforce is advantageous to RJWF’s mission (QSEN 2013).

17. QSEN - Julie Saladin QSEN’s initiative to nurses to improve quality and safety in Healthcare is becoming the standard of practice and the higher level education for nurses, the expectation. Healthcare is becoming more and more challenging and to keep up with the demands of the aging and diverse population, along with the competitive workforce, I needed to return to school to earn a higher level degree. Despite my 16 years as a Registered Nurse and 12 years as a nurse manager, I have found that I am not as marketable as a nurse with a Bachelors Degree in Nursing. I have found that I need to pursue a higher level degree so that I can grow both academically and professionally. How QSEN’s practice standards influence my personal nursing practice.

18. How the Practice Standards Influence My Nursing Practice QSEN continues to promote quality and safety in the nursing profession, which directly impacts my daily practice. QSEN promotes a higher education, which directly affects the quality of my patient care. QSEN provides resources, which directly affects my continued education. QSEN promotes the “’…innovation in the way we teach, test, and certify”’ (QSEN institute, 2013), which directly affects the upcoming generation of nurses. Sandra Wernstrom

19. How QSEN has helped in our individual practice. When starting at Hurley Medical Center in 2011, all needle systems were still being used. There were a lot of employee bodily fluid exposures to used needles, either with a trauma patient or a combative patient. That placed the healthcare providers at a risk of contracting Hepatitis B, C or even HIV. I did the research and presented the information to my educator as well as the quality control board on an all needleless system. And, at the beginning of 2013 Hurley Medical Center has went to a mostly needless system to provide more safety for the healthcare providers as well as the patients. -Michele Gilmore

20. How QSEN has helped in our individual practice. QSEN promotes patient safety. This is evidenced in my workplace by the scanning of the wrist bands, medications, and laboratory slips. This is also evidenced by the double checking of certain medications that are a high risk for medication error. This includes insulin, heparin, TPN, and when programming medications on IV pumps. Another patient safety initiative is the fall risk identifiers. We assess whether the patient is at risk for falls due to medications, delirium, previous falls, impulsiveness, and confusion. Kelly Vogt

21. References Barnsteiner, J. (2011). Teaching the Culture of Safety. Retrieved from http://www.medscape.com Disch, J., Barnsteiner, J., McGuinn, K. (2013). Taking a “deep dive” on integrating QSEN content in San Francisco Bay area schools of nursing. Journal of Professional Nursing, 29(2), 75-81. doi: 10.1016/j.profnurs.2012.12.007 Future of Nursing Campaign for Action. (2013). Retrieved from http://www.campaignforaction.org/apin Mitchell, P. (2008). Defining Patient Safety and Quality Care. Retrieved from http://www.ncbi.nlmh.nih.gov/books/NBK2681 Robert Wood Johnson Foundation. (2013). Retrieved from http://www.rwjf.org The American Association of Colleges of Nursing. (2013). Quality and Safety Education for Nurses. Retrieved from http://www.aacn.nche.edu/faculty/qsen QSEN Institute. (2013). Pre-licensure KSAS. Retrieved from http://qsen.org/competencies/pre-licensure-ksas/ QSEN Institute. (2013). Press release: Phase II. Retrieved from http://qsen.org/about-qsen/project-overview/press-release-phase-ii/ QSEN Institute. (2013). Press release: Phase III. Retrieved from http://qsen.org/about-qsen/project-overview/press-release-phase-iii/ QSEN Institute. (2013). Press release: Phase IV. Retrieved from http://qsen.org/about-qsen/project-overview/press-release-phase-iv/