NR 451 WEEK 5 DISCUSSION, CORE COMPETENCIES FOR NURSES

Week 5: Core Competencies for Nurses . Explore the website for the Quality and Safety Education for Nurses (QSEN) initiative at (Links to an external site.)Links to an external site.. How can the QSEN competencies for nurses be implemented into your workplace or professional nursing setting? If you are not currently employed as a nurse, consider a previous work setting that would have benefited from implementation of the QSEN competencies. In the beginning nursing classes in my pursuit for BSN, is when I became aware of the QSEN Core Competencies. It seems fitting that we touch on this subject again in the final nursing course. Maintaining competency is an ongoing responsibility for the registered nurse as well as monitoring competency of those with whom we work with. The Institute of Medicine reported gaps in education that can be addressed by making the core competencies of patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics the curricular framework for all educational programs for healthcare professionals (Greiner & Knebel, 2003). At my facility, there is a program for new graduate nurses. This program consists a 4-hour class that meet once a month, for 12 months. I am told the classes review the QSEN competencies, discuss barriers, ways to overcome, and include a change quality improvement project to be presented to the class. The QSEN project focuses on preparing future nurses and states “the nurse of the future will function effectively within nursing and interdisciplinary teams, fostering open communication, mutual respect, shared decision making, team learning, and development (QSEN, 2018). I do not recall learning these competencies when perusing my associates degree 5 years ago. At my facility there are a significant amount of associate degreed nurses who do not plan to further their education to the BSN level, who would benefit from such classes. It may encourage more participation in shared governance in making changes in practice. One of the QSEN core competencies, teamwork and collaboration, is a constant work in progress. A simple breakdown of communication can have detrimental effects for the patient. For example, not reporting abnormal vital signs to the nurse by the PCT. Abnormal vital signs were not acted upon by the nurses in a timely manner and sometimes resulted in the patient being transferred to a higher level of care. It was identified by our unit-based council that there were unclear vital sign parameters. The solution was to identify parameters and include them on the vitals machine. It is important that we proactively find ways to prevent error by improving practices, and communication methods, resulting in the safer care of our patients. One area we are currently working on is improvement of bed side shift report. It is understood that effective handoff results in improved patient safety by promoting the transfer of patient information, as well as continued care and treatment. One of the barriers identified for the nurse in getting out on time, is the time it takes for shift report. When you have six patients and average time for report ends up being 10 minutes, it causes nurses to stay past their shift. According to AHRQ (2013), conduction of bedside shift report should be no longer than 5 minutes. In addition nurses have reported less time spent on shift report and better time management because they have seen all of their patients at the start of the shift and can prioritize patient needs and concerns (AHRQ,2013). I think one of the problems is determining what is critical information, not the whole patient history. Meeting a patient for the first time, we want to know all about them. What has brought them here. Results of tests performed. What progress has been made. Current condition and concerns. My facility has added more information to the in room white boards. A quick glance identifies diet, how a patient ambulates, how often they have ambulated, physicians consulted, goal pain level, and last pain medication given, so all of that does not need to be verbalized. I would be interested in knowing what tools your facility uses to facilitate a fast, safe, and effective handoff? References Greiner, A. C., & Knebel, E. (Eds.). (2003). Health professions education: A bridge to quality. Washington, DC: National Academics Press. Retrieved from Quality and Safety Education for Nurses. (2018). Graduate QSEN Competencies Agency for Healthcare Research and Quality. (2013). Nurse Bedside Shift Report Implementation Handbook; A Guide to Patient and Family Engagement.