Project Overview

Overview

The Robert Wood Johnson Foundation (RWJF) has funded the Quality and Safety Education for Nurses (QSEN) project for three phases to date. The overall goal through all phases of QSEN is to address the challenge of preparing future nurses with the knowledge, skills and attitudes (KSA) necessary to continuously improve the quality and safety of the healthcare systems in which they work.

In order accomplish this goal, six competencies were defined in Phase I of the project. These competencies included five from the Institute of Medicine (IOM) -patient centered care, teamwork and collaboration, evidence-based practice, quality improvement and informatics- as well as safety. In addition to these definitions, sets of knowledge, skills and attitudes for each of the six competencies were created for use in nursing pre-licensure programs (Cronenwett, et. al., 2007).

Pilot schools integrated the six competencies in their nursing programs in Phase II of QSEN. The pilot schools have shared their work on the QSEN website (www.qsen.org), contributing teaching and development strategies as well as other collaborative resources.

Phase III was funded in November, 2008 and will

  • Continue to promote innovation in the development and evaluation of methods to elicit and assess student learning of KSA of the six IOM/QSEN competencies and the widespread sharing of these competencies;
  • Develop faculty expertise necessary to assist the learning and assessment of achievement of quality and safety competencies in all types of nursing programs;
  • Create mechanisms to sustain the will to change among all programs through the content of textbooks, accreditation and certification standards, licensure exams and continued competence requirements.

PRESS RELEASE
November 2005, Phase I

Robert Wood Johnson Foundation funds national study to educate nursing students on patient safety and healthcare quality

CHAPEL HILL -- In an effort to prepare future nurses with the knowledge and skills necessary to improve patient care and the health care environments in which they work, the Robert Wood Johnson Foundation has awarded the University of North Carolina at Chapel Hill School of Nursing a $590,000 grant to evaluate and enhance nursing school curricula on the topics of quality and safety.

"It is an honor to partner with the Robert Wood Johnson Foundation on a project that will change what and how we teach future health professionals," said Dr. Linda Cronenwett, School of Nursing dean and project director. "In the end, we expect these changes to make a difference in the quality and safety of health care everywhere."

The multi-phase project, Quality and Safety Education for Nurses (QSEN) began in October, 2005. In the first18-month phase, Cronenwett is leading a panel of 17 national nursing leaders to outline the core knowledge, skills and attitudes that should be mastered by prelicensure nursing students. Dr. Gwen Sherwood, UNC School of Nursing Associate Dean and Professor, serves as the project co-investigator. Comprising the QSEN team include: Pamela Mitchell PhD, RN,FAAN, Associate Dean for Research, University of Washington; Susan Grant RN, MS, Chief Nursing Officer at the University of Washington Medical Center; Joanne Disch PhD, RN,FAAN, Professor and Director at the University of Minnesota School of Nursing; Dori Taylor Sullivan PhD, RN, CNA, CPHQ, Chair and Associate Professor of Nursing at Sacred Heart University, Fairfield Connecticut; Judith Warren, PhD, RN,BC,FAAN,FACMI, Associate Professor at the University of Kansas; Jean Johnson PhD, RNC, FAAN, Senior Associate Dean of Health Sciences, George Washington University; Jane Barnsteiner PhD, RN, FAAN, Professor and Director of Nursing Translational Research, University of Pennsylvania; Shirley Moore, PhD, RN, FAAN, Associate Dean for Research, Case Western Reserve University; Pamela Ironside, PhD, RN, Assistant Professor, University of Wisconsin at Madison; Carol Durham, MSN,RN, Clinical Associate Professor, University of North Carolina at Chapel Hill School of Nursing, and Lisa Day, PhD, RN, Assistant Clinical Professor at the University of California at San Francisco. The faculty are supported in their work by an interprofessional advisory board.

The expert panel will examine key content areas including: patient-centered care, professional communication, teamwork and collaboration, evidence-based practice, informatics, systems-thinking and improvement, and error reduction, human factors theory and safety. A range of strategies for clinical, classroom and simulation-based learning will be developed, including options aimed at interprofessional student groups .Additionally, the QSEN team will develop an electronic compendium of patient safety and quality related resource materials and support a website dedicated to the grant's accomplishments.

In subsequent project phases, the QSEN project team will partner with leading professional associations to disseminate information, support faculty development and address the same challenges for graduate nursing education.

"We know that there are significant problems related to safety and quality in the U.S. health-care system," said Cronenwett. "To improve, health professionals need to be able to determine what constitutes good care from the scientific evidence, identify the gaps between good care and local actual care, and know what activities are necessary to close any gaps."

QSEN aims to assist Nursing educators who are eager to discover effective ways to promote student learning that will prepare them for becoming full partners in the work of improving patient safety and healthcare systems.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 30 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org.

PRESS RELEASE
April 2007, Phase II

Principal Investigator Linda Cronenwett received $1,094,477 from the Robert Wood Johnson Foundation to fund Phase II of the Quality and Safety Education for Nurses (QSEN) project. The award will enable Cronenwett and project co-investigator Gwen Sherwood to continue work on Phase I that has been in progress since October, 2005. The long-range goal of QSEN is to reshape professional identity formation in nursing to include commitment to quality and safety competencies recommended by the Institute of Medicine (IOM). To date, QSEN faculty have defined quality and safety competencies for nursing and proposed targets for the knowledge, skills, and attitudes to be developed in nursing pre-licensure programs for each competency: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. They also completed a national survey of 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, the level of satisfaction with student competency achievement, and the level of faculty expertise in teaching the competencies. A website - www.qsen.org - was launched in April, 2007, to feature teaching strategies and resources.

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. Phase II also includes work with 15 pilot schools who commit to active engagement in curricular change to incorporate quality and safety competencies.

Other project staff from UNC-Chapel Hill include:

  • Denise Hirst, project manager
  • John Carlson, statistician
  • Jean Blackwell, from the UNC Health Sciences Library.

The following are QSEN content and pedagogical specialists:

  • Deborah Ward from the University of Washington - Patient-centered Care
  • Joanne Disch from the University of Minnesota - Teamwork and Vollaboration
  • Dori Taylor-Sullivan from Duke University in Durham, North Carolina - Evidence-based Practice
  • Judith Warren from the University of Kansas - Informatics
  • Jean Johnson from George Washington University - Quality Improvement
  • Jane Barnsteiner from the University of Pennsylvania - Safety
  • Shirley Moore from Case Western Reserve University - Interprofessional Learning
  • Pamela Ironside from Indiana University - Narrative Pedagogies
  • Carol Durham from the SON - Simulation
  • Lisa Day from the University of California-San Francisco - Clinical Site Teaching.

QSEN Advisory Board members include:

  • Paul Batalden from the Dartmouth Medical School
  • Geraldine Bednash, executive director of the American Association of Colleges of Nursing
  • Karen Drenkard, Robert Wood Johnson executive fellow and chief nursing executive of Inova Health System of Falls Church, VA
  • Leslie Hall from the University of Missouri-Columbia
  • Mary (Polly) Johnson, (former) executive director of the North Carolina State Board of Nursing
  • Maryjoan Ladden from Harvard Medical School
  • Audrey Nelson, director of the Patient Safety Research Center at the Veterans Administration in Tampa, Florida
  • Joanne Pohl from the University of Michigan and National Organization of Nurse Practitioner Faculties
  • M. Elaine Tagliareni from the Community College of Philadelphia and National League for Nursing
  • Jeanne Floyd, executive director of the American Nurses Credentialing Center

PRESS RELEASE
February 2009, Phase III

The American Association of Colleges of Nursing (AACN) and the University of North Carolina School of Nursing today announced that the two institutions have been awarded grants from the Robert Wood Johnson Foundation totaling $4.25 million to conduct an innovative and far-reaching project aimed at preparing future nurses to continuously improve the quality and safety of the healthcare systems in which they work.

The grants – $2.45 million for AACN and $1.8 million for the UNC School of Nursing – will support the third phase of the multi-year Quality and Safety Education for Nurses (QSEN) initiative. The overall goal of Quality and Safety Education for Nurses (QSEN) initiatives is to prepare nurses who have the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems within which they work, based on the six quality and safety competencies. In the first two phases of the project, begun in 2005, QSEN faculty – experts drawn from institutions across the nation – defined a comprehensive set of quality and safety competencies for nursing and proposed training targets for each. QSEN faculty then surveyed nursing colleges to gauge the extent to which these competencies are already included in curricula, whether faculty are sufficiently expert to teach them, and how well nursing students are learning them.

In Phase III, the UNC School of Nursing and AACN will work to develop the faculty expertise necessary for the nation's nursing schools to teach the competencies; focus on instilling the competencies in textbooks, licensing, accreditation and certification standards; and promote continued innovation in teaching the competencies.

The six competencies are patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics.

Linda Cronenwett, Ph.D., F.A.A.N., dean of the University of North Carolina at Chapel Hill School of Nursing, is the project's principal investigator. She leading the project with Geraldine P. Bednash, Ph.D., R.N., F.A.A.N., executive director of the American Association of Colleges of Nursing.

"Our health care system has significant safety and quality problems," Cronenwett said. "To fix that, we need to redesign what and how we teach the next generation of nurses and other healthcare professionals so that they understand what goes into ensuring good and safe care, and can identify and bridge the gaps between what is and what should be. In the first two phases of this project, we've tried to identify what's out there now, what's missing, and what's wrong. One conclusion we reached is that our nursing schools need to equip the next generation of nurses to help drive change in health care. So in this phase of the project, we're going to promote innovation in the way we teach, test, and certify."

"Our healthcare system faces a number of critical problems," said Bednash. "The financing system is broken, too many patients lack access to care, a severe nursing shortage looms, and safety and quality are suffering. Nurses – particularly the next generation of nurses – can make important contributions on all these fronts but we need to be sure they are prepared for the challenge. We're delighted to participate in this important initiative, and eager to move forward with this third phase of the project."

The project will:

  • Promote continued innovation in the development and evaluation of methods to promote and assess student learning of the knowledge, skills, and attitudes of the six competencies and the widespread sharing of those innovations
  • Develop the faculty expertise necessary to assist the learning and assessment of achievement of quality and safety competencies in all types of nursing programs
  • Create mechanisms to sustain the will to change among all programs through the content of textbooks, accreditation and certification standards, licensure exams and continued competence requirements.

Faculty development will be supported with curricular resources developed and disseminated through regional conferences, a QSEN Speaker's Bureau, QSEN National Forums, web-based modules, and the QSEN website: www.qsen.org. In addition, QSEN will partner with the VA National Quality Scholars Fellowship Program (created by the Veteran's Health Administration) to support nursing pre- and post-doctoral students in an inter-professional program of training in quality improvement and safety.

In addition to UNC's Cronenwett and AACN's Bednash the project's steering committee will include Gwen Sherwood, UNC-Chapel Hill; Jane Barnsteiner, University of Pennsylvania; Joanne Disch, University of Minnesota; Pamela Ironside, Indiana University; Jean Johnson, George Washington University; and Shirley Moore, Case Western Reserve University.