Applying QSEN

Competencies in the ICU

A presentation for SICU RNs
Courtney R Pringle, BSN RN
Quality & Safety Education for Nurses
(QSEN)
Who are they?
An institute that prepares nurses with
the knowledge, skills, and attitudes
QSEN Mission:
necessary to continuously improve the
The QSEN Institute is a collaborative of healthcare professionals
quality and safety of the healthcare focused on education, practice, and scholarship to improve the quality and
safety of healthcare systems.
systems within which they work.
QSEN Vision:

Our vision is to inspire healthcare professionals to put quality and

safety as core values to guide their work.
Quality & Safety Education for Nurses
(QSEN)
Define quality and safety competencies for
nursing and proposed targets for the
knowledge, skills, and attitudes to be
developed in nursing pre-licensure programs
Perform nation-wide assessment of beliefs
about the extent to which the competencies are
included in current curricula, the level of
satisfaction with student competency
achievement, and the level of faculty expertise
in teaching the competencies
Partner with representatives of organizations
that represent advanced practice nurses and
propose knowledge, skills, and attitude targets
for graduate education.
Fund work with pilot schools committed to
active engagement in curricular change to
incorporate quality and safety competencies
Patient-Centered Care
Goals for ensuring patient-centered care in the SICU
Patient-Centered Care

Patient-Centered Care- recognize the

patient or designee as the source of
control and full partner in providing
compassionate and coordinated care
based on respect for patients
preferences, values, and needs.
Patient-Centered Care

1. Elicit patient values,

preferences, & expressed needs
as part of the nursing
assessment, implementation of
care plan, and evaluation of
care.
RNs will perform shift report at
the patient bedside and involve the
patient in the care plan.
Patient-Centered Care

2. Assess presence and extent of pain

and suffering.
RN will assess and document pain <
Q1H.
Patient-Centered Care

3. Remove barriers to presence of

families and other designated
surrogates based on patient
preferences
ICU will have open visiting hours
except when limited per patient.
Teamwork and Collaboration
Goals for ensuring teamwork and collaboration within the SICU
Teamwork and Collaboration

Teamwork and collaboration-

Function effectively within nursing
and inter-professional teams,
fostering open communication, mutual
respect, and shared decision-making
to achieve quality patient care.
Teamwork and Collaboration

1. Follow communication practices

that minimize risks associated
with handoffs among providers
and across transitions in care.
ICU RN will provide verbal and
written report in SBAR format.
Teamwork and Collaboration

2. Initiate plan for self-development

as a team member.
Each RN will submit 5 CEUs related
to stroke care per year.
Each RN will be certified in critical
care nursing within 2 years of hire
date.
Teamwork and Collaboration

3. Communicate with team members,

adapting own style of communicating
to needs of the team and situation.
Each ICU RN will take the
Strengthsfinder 2.0 assessment and
communicate findings to team
members during quarterly meeting.
Evidenced-based Practice
Goals for incorporating evidenced-based practice in the SICU
Evidence-based Practice (EBP)

Evidence-based Practices (EBP)-

Integrate best current evidence with
clinical expertise and patient/family
preferences and values for delivery of
optimal health care.
Evidence-based Practice (EBP)

1. Read original research and

evidence reports related to area
of practice
An ICU RN will present 1 article
per year to the ICU Journal Club.
Evidence-based Practice (EBP)

2. Participate effectively in
appropriate data collection and other
research activities
All ICU RNs will successfully pass
the NIH modules for protecting
human subject research
participants
Evidence-based Practice (EBP)

3. Question rationale for routine

approaches to care that result in less-
than-desired outcomes or adverse
events.
Each nursing procedure will have
documented evidence for support.
Quality Improvement
Goals for quality improvement in the SICU
Quality Improvement (QI)

Quality Improvement (QI) - 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.
Quality Improvement (QI)

1. Seek information about outcomes

of care for populations served in
care setting.
ICU RN will know standard
treatment protocol for the acute
stroke patient.
Quality Improvement (QI)

2. Use quality measures to understand

performance.
ICU performance on stroke care
will be measured quarterly using
the AHAs GWTG-Stroke database.
Quality Improvement (QI)

3. Design a small test of change in

daily work (using an experiential
learning method such as Plan-Do-
Study-Act)
All changes in process or
procedures in the ICU will be
tested on a small-scale before
making unit-wide change
Safety
Goals for ensuring safety in the SICU
Safety

Safety - Minimizes risk of harm to

patients and providers through both
system effectiveness and individual
performance.
Safety

1. Demonstrate effective use of

technology and standardized
practices that support safety and
quality.
All ICU RNs must be checked off in
3 separate incidences before
being considered competent to
perform a function alone.
Safety

2. Use organizational error reporting

systems for near miss and error
reporting.
All near misses will be reported
using the intranet tool.
All incidents will be reported to
the Charge RN immediately &
submitted to the Nurse Manager
before end of shift.
Safety

3. Use appropriate strategies to

reduce reliance on memory
ICU RNs will use a checklist for all
bedside procedures that require a
Time-Out procedure.
Informatics
Goals for incorporating informatics in the SICU
Informatics

Informatics - Use information and

technology to communicate, manage
knowledge, mitigate error, and
support decision making.
Informatics

1. Apply technology and information

management tools to support
safe processes of care.
ICU RNs will scan all medications
using the BMV system prior to
administration of any medication
to a patient.
Informatics

2. Employ communication
technologies to coordinate care for
patients
ICU RNs will use the spectra link
phone system for communicating
patient care with other healthcare
providers; not use cell phones.
Informatics

3. Use information management tools

to monitor outcomes of care processes
ICU RNs will review, set, & update
all patient alarms Q4Hs.
Summary

The goal is to continuously improve

the quality and safety of the ICU.