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Nursing Education: Quality, Safety and Systems Thinking

How would you prioritize the competencies in Hunt’s (2012) article?

In her article, Hunt (2012) discusses the Quality and Safety Education for Nurses (QSEN) competencies. She emphasizes that those nurses who are taught these six competencies can improve care delivered to clients and improve their health outcomes in this way. However, they are yet rather new and rarely approached. It would be advantageous to prioritize them so that learners realize how to allocate their attention.

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In fact, Hunt (2012) enumerates all competencies, which allows presupposing that she prioritizes them herself in the way they are put in the article. However, the text provided by AACN (2012) that discusses the same QSEN orders them differently. Personally, I believe that patient-centered care should be in the first place because it reveals the main focus of nursing. It is critical to do the best for the patient, and then to discuss how to do this.

Thus, I would put the evidence-based practice in the second place. In this way, patients will be treated with the help of those methods that are proved to be effective. Teamwork and collaboration will be in the third position, as nurses cannot treat clients themselves and interaction with other professionals are critical. Then I would focus on quality improvement, as many innovations and interventions can improve care. Safety would be in the fifth position, as it is already partially considered in previous competencies. Finally, informatics would allow enhancing performance using up-to-date technology.

How are QSEN competencies incorporated into your local nursing education programs and/or facility new graduate nursing orientation?

QSEN competencies are incorporated in the facility new graduate nursing orientation, which can be seen when considering the goals of the program and its expected outcomes. Mainly, there is a focus on the transition to competent professionals, engagement in professional development, a creation of a support network, and a decrease in turnover rates. In this framework, I am encouraged to be involved in various experiences that are aligned with QSEN competencies.

For instance, evidence-based practice is connected with the necessity to be up-to-date with the professional literature and prove knowledge through action, as it discusses a lot of innovative interventions and their outcomes, defining how I can use them and when. I am taught to treat colleagues with respect and ask questions, which enhances teamwork and collaboration (Heuninckx, 2014). They say it is normal to make mistakes in the beginning, as focusing on quality improvement I can perform better soon. It is claimed that the nurse’s main concern is a patient, which emphasizes the necessity to ensure patient-centered care and safety. Dealing with reports and protocols, I also resort to informatics.

Discuss how QSEN competencies impact your practice as a nurse educator? How have QSEN competencies impacted your practice setting?

The development and implementation of QSEN competencies influenced my practice as a nurse educator greatly and made nurses in my practice setting act differently. Firs of all, they provided me with an opportunity to identify gaps in the current curriculum. Using them as a tool, I received an opportunity to incorporate changes observed in quality and safety education (Sherwood & Zomorodi, 2014).

With the help of the QSEN website, I also obtained a chance to find contemporary teaching strategies prepared by other nurses with the focus on these competencies. Unfortunately, the QSEN competencies are mainly integrated at the individual level of care within my practice setting rather than at the level of the system of care. However, even in this way, nurses tend to act according to them, improving the quality and safety of care.

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Dolansky and Moore (2013) believe that the emphasis on teaching critical thinking and systems thinking skills can enhance this situation because nurses in all roles, including those who act as educators, need to be able to assess the way they apply QSEN competencies and at what levels, determining if improvement is needed and defining how it can be maintained. My practice setting, for instance, is currently encouraging nurses to communicate more and discuss decisions they make with one another so that they can analyze various cases.

Reflect on your role (nurse educator) competency development as a result of your practicum project. How has your knowledge, skills, or attitudes changed?

Due to my practicum project, my competency development streamlined substantially. As a nurse educator, I pay enormous attention to the changes connected with my knowledge, skills, and attitudes, because they also affect my learners and their perceptions. I have previously realized that, as a nurse, I am to act as a patient’s advocate. But now, I feel more responsible for speaking up against unsafe practices and other issues that can affect client’s health.

I also started paying more emphasize on this problem when dealing with nursing students, because I understood that they needed to improve their confidence to be able to share their opinion with others, especially seniors. Unfortunately, I still believe that it is much easier for me, as well as for others, to approach peers and those colleagues who are approximately in the same position than the representatives of the authority.

Still, I believe that even in this way, I can improve much knowledge greatly because I discuss various issues with those people who can understand what is wrong and critically assess my decision. I can also gain some recommendations and advice, which can benefit my patients indirectly. Thus, it is impossible to deny that there is an improvement in my communication and critical thinking skills.


AACN. (2012). Graduate-level QSEN competencies: Knowledge, skills and attitudes. Web.

Dolansky, M., & Moore, S. (2013). Quality and safety education for nurses (QSEN): The key is systems thinking. Quality and Safety Education for Nurses, 18(3), manuscript 1.

Heuninckx, M. (2014). Want a successful orientation? 10 tips for new graduate nurses. Web.

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Hunt, D. (2012). QSEN competencies: A bridge to practice. Philadelphia, PA: Lippincott, Williams & Wilkins.

Kent, L., & Shanks, L. (2015). Effects of a senior practicum course on nursing students’ confidence in speaking up for patient safety. Journal of Nursing Education, 54(3), 12-15.

Sherwood, G., & Zomorodi, M. (2014). A new mindset for quality and safety: The QSEN competencies redefine nurses’ roles in practice. Nephrology Nursing Journal, 41(1), 15-22, 72.

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StudyCorgi. (2020) 'Nursing Education: Quality, Safety and Systems Thinking'. 4 December.

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