Strategies to Grow and Sustain a Competency Assessment Model Utilizing the Quality Safety Education for Nurses (QSEN) in the Clinical Setting

In the practice setting, a comprehensive measurement of competency assessment is essential in initial orientation and ongoing education of clinical staff. This presentation will describe how a large academic healthcare system integrated, expanded, and sustained a clinical competency assessment model utilizing the Quality Safety Education for Nurses (QSEN) framework. As the Institute of Medicine (IOM) identified criteria for nursing to provide safe quality patient care, it became apparent the use of a traditional skills checklist was not an accurate measurement of competency.  This shifted the thought process from measuring skills to a more comprehensive approach including knowledge, skills and attitudes.

 A review of the literature was completed and QSEN provided the framework for the competency assessment model. In 2011, the basic competency assessment tool utilizing the six Institute of Medicine (IOM) criteria was developed.  The new competency assessment tool included sections for learner self-assessment, method of instruction and validation of competency. This became the basic nursing competency assessment for all newly hired nurses.  Phase two was the development of what is now a three tiered comprehensive competency assessment process that includes knowledge, skills and attitudes specific to patient populations.  A formative evaluation was conducted with preceptors and new hires, which identified a knowledge gap about QSEN, as well as utilization of the new competency assessment tool.  Phase three introduced the expansion of the competency tool to disciplines outside of nursing. Phase four was the creation of the sustainability process including a three year revision cycle.

The introduction of this innovative competency assessment process was a significant cultural change for the organization and presented many challenges including educational deficits.  Ongoing education continues on QSEN, defining competency, and standardizing criteria across all three competency tiers to build on strengths of this model. Over the past four years this competency assessment work has flourished from a basic nursing assessment tool into an inter-professional framework. This work will continue to expand as we explore new opportunities.