Nursing Qsen Essays

Evidence-Base practice (EBP) is defined as: “based on problem identified from the practitioner’s area of practice; a combining of best evidence and professional expertise and an integration of this into current practice; about ensuring patients receive quality care, being part of quality improvement processes; about collaboration and requiring a team approach” (French, 1999). Scott and Mcsherry (2008) supported the French’s assertion, proposing the key elements of EBP are that it is a theory-driven process, which involves the use, evaluation and application of research; identification of best evidence; evaluation of care; problem solving; decision-making; clinical expertise; and requires patient involvement. Evidence-based practice is made of evidence, clinical expertise, patient preference, the context of care (Barker, 2013). In brief, evidence-based practice is the parameter in the nursing practice that it requires that the nurses gather and use clinical evidence to make decision for the patients so that in the nursing process they can deliver the quality of care for the patients (Ellis, 2013). In the other words, in the nursing practice all the nursing procedures performed by the clinical evidence supported.

Evidence based practice is an integral part of nursing care. According to the Academy of Medical-Surgical Nurses, evidence based practice is defined as, “the conscientious use of current best evidence in making decisions about patient care.” (AMSN) The use of evidence based practice has drastically improved patient outcomes, increased quality and safety of healthcare, and reduced costs for facilities. (Melnyk, 2016) In this paper I will provide the history of evidence based practice, how it has already been incorporated and impacted healthcare, and why it is important to nursing and healthcare as a whole.

Quality and Safety Education in Nursing (QSEN) was started around 2005 by the Robert Wood Johnson Foundation. QSEN's main goal is to “prepare future nurses with knowledge, skills and attitudes (or KSAs) necessary to continuously improve the quality and safety of the healthcare system,” (QSEN, 2017). “Integration of clinical skills with the intellectual capacity to safely manage the complexity of nursing work in key to quality care in a time of diminishing resources,” ( Dolansky, 2013). “It is vital for schools of nursing to meet the needs of today's complex health care systems by including principles of quality and safety throughout the curriculum,” (Lewis, 2016). Within the KSAs are six main categories; patient-centered care, teamwork

The overall goal through all phases of The Quality and Safety Education for Nurses (QSEN) is to address the challenge of preparing future nurses with the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems in which they work. In order to accomplish this goal, six competencies were defined. These competencies from the Institute of Medicine (IOM) are patient centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics and safety. Over a decade has passed since the Institute of Medicine’s reports on the need to improve the American healthcare system. The Quality and Safety Education for Nurses

Over time the health care industry has become more complex. Health care is rapidly evolving and continuing to complicate our delivery of care, which in turn has the same effect on quality of care. This steady evolution and change results in nursing shortages and an increase in the prevalence of errors being made. In hopes of preventing these errors and creating safe and high quality patient care, with the focus on new and improved ways of thinking, The Quality and Safety Education for Nurses (QSEN) initiative was developed. The QSEN focuses on the following competencies: patient-centered care, quality improvement, safety, and teamwork and collaboration. Their initiatives work to prepare and develop the knowledge, skills, and attitudes that are necessary to make improvements in the quality and safety of health care systems (Qsen.org, 2014).

Dolansky and Moore (2013) argued that the development and integration of QSEN competencies into nursing education had not have the outcomes intended. They stated "over a decade has passed since the Institute of Medicine (IOM) report, To Err Is Human: Building a Safer Health System" and national initiatives to improve quality, especially QSEN, have been futile in significantly improving quality and safety. "QSEN is a national movement that guides nurses to redesign the "what and how ' they deliver nursing care so that they can ensure high-quality, safe care" (Dolansky & More 2013).

QSEN is quality and safety in nursing. It is designed for nurses to continuously improve the quality and safety of patient care delivered. Interdisciplinary friction can threaten the delivery of quality patient care. In addition to ineffective communication and teamwork which can be very detrimental and result in adverse effects in patient care. These adverse reactions lead to the need for incident reports to be filled out, however, some reports end up incomplete or overlooked. The implementation of new skills can change the outcomes in patient safety.

Itroduction: Evidence-based practice is an approach to medicine that uses scientific evidence to determine the best practice (Beyea & Slattery, 2006). As nurses perform their daily tasks they must continually ask themselves, “What is the evidence for this intervention?”. Nurses are well positioned to question current nursing practices and use evidence to make care more effective. In order to improve patients’ outcomes it is the responsibility of the nurse to transition evidence-based practice into the norm, through application of daily practice (Flynn Makic, Rauen, Watson & Will Poteet, 2014). Continual evaluation of current practice must be performed to ensure the use of evidence-based practice opposed to practice based upon tradition. The implementation of evidence-based practice standardizes healthcare practices and diminishes groundless variations within care. These variations lead to the production of uncertain health outcomes (Stevens, 2013).

The Quality and Safety Education for Nurses (QSEN) Institute developed six core competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (Quality and Safety Education for Nurses Institute, 2017). At my facility, it is clearly evident that they have adopted these six core competencies to improve patient quality and safety. My facility created the Office of Patient Experience which supports care that is safe, of high quality and high value. Patient satisfaction is a top priority which is why our guiding principle is known as “Patients First”. Through teamwork and collaboration, we deliver care that is patient-centered by working together in multidisciplinary rounds on the inpatient units. Also, the nursing education department supports quality, safety and consistent nursing care through a database of policies and procedures developed using evidence-based research. Lastly, the nursing informatics department is working towards making our EPIC system more patient-centered. They are doing this by decreasing the redundancy in charting for the nursing staff and finding ways to improve processes which automate tasks. This in turn will reduce the time that the nursing staff spends with their computer and increase the time that the nursing staff can spend with their patients.

The second week of my preceptorship brought many new experiences for me, and I can honestly say that each day I spend with my preceptor is better than the last. This week I focused on time management of a full patient load with continued documentation practice as well as admission and discharge procedures. I’ve had brief experiences in my past rotations assisting with discharge teaching and admission assessments however I have never been able to fully take charge and complete the process from start to finish, so this was a great learning opportunity for me.

“Advanced nursing practice is the deliberative diagnosis and treatment of a full range of human responses to actual or potential health problems.” (Calkin, 1984). Advanced nurse practitioners attempt to maximize the use of knowledge and skills and improve the delivery of nursing and health care services. The field of advanced nursing practice differs from basic practice as the former requires clinical specialization at the master’s level. At this level, nurses become expert practitioners whose work includes direct and indirect patient care. Direct patient care involves caring for patients and their families; this is the focus of my section on nurse clinicians. Indirect patient care includes work as an educator, researcher, and a

Teamwork is vital in healthcare.  When all participants are engaged in a program, goals are successfully achieved. Being able to communicate and work collectively as a team requires an appreciation for each other’s area of practice.  Every team member has an important role and being acknowledged provides a sense of responsibility and accountability. Essentially, inter-professional collaboration helps ensure that the patient is getting care that is not only accessible but also comprehensive.  The plan of a patients’ care includes active participation by all health care professionals working interdependently in accordance to the patient’s preferences, values and beliefs. The health care team accomplishes the goal of meeting the patient’s medical needs by delivering evidence-based practice.   To deliver quality care, the patient should always be involved.

Teamwork and communication are very important in providing good quality care, especially in the healthcare field. A team is described as a group of people that works together and cooperatively, between each member of the group to reach a common goal (Sullivan, 2013). For a team to function, communication is essential. A report by McKay and Crippen (2008), as stated by Alfaro-LeFevre, (2013) showed that when collaboration is in place, hospitals can decrease their mortality rate by 41%. When mortality rate is lower, hospitals does not only decreased cost, but it also means that patients are receiving good quality care.

This assignment will present a nursing care study of a patient on a cardiac ward. The patient will be referred to as Ann to maintain confidentiality (NMC, 2008). Ann’s consent was gained prior to starting this care study. The care study will be developed using the Nursing process and the Roper, Logan and Tierney model. These will both be outlined. The assignment will focus on the assessment process and one problem identified during the assessment and the nursing care which followed this.

Evidence-based practice (EBP) in nursing means making decisions about patient care on the basis of best, current, standardized practice and guidelines. According to an article, written by Dr. Kathleen Stevens, the development of evidence-based practice (EBP) is fueled by the increasing public and professional demand for accountability in safety and quality improvement in health care (Stevens, 2013). The author also mentioned in her article that the intended effect of EBP is to standardize healthcare practices to science and best evidence and to reduce illogical variation in care,