Background:Nurses are in key positions in the healthcare system to provide, monitor, and manage the care delivered to their patients. Their constant presence and surveillance make nurses the first line of patient care to prevent adverse events and improve patient outcomes.In 2005, the Quality and Safety Education for Nurses (QSEN) initiative was launched to redefine quality and safety competencies for pre-licensure nursing education. It is imperative that nurses are graduating with the knowledge, skills, and attitudes (KSAs) of all six QSEN competencies—patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics—to practice in today’s healthcare environments.
Problem Statement: After reviewing the literature, several studies were identified evaluating student nurses’ perceptions of their KSAs related to all six QSEN competencies. However, no existing reviews were found in the literature evaluating and summarizing the research about student nurses’ perceptions of their KSAs within all six QSEN competencies.
Purpose: The purpose of this systematic review was to evaluate the research about graduating student nurses’ perceptions of their abilities to perform the six QSEN competencies and to determine the effect of integrating the QSEN content in their courses, clinical placements, or simulation experiences.
Methods: A systematic review of the literature was conducted to retrieve published studies from CINAHL, PubMed, ERIC, and Web of Science using the search terms: Quality and Safety Education for Nurses, QSEN, QSEN competencies, nursing student, and student nurse. The inclusion criteria were: (1) original peer-reviewed research published in English, (2) consisting of senior nursing students as the study sample, and (3) assessing senior nursing students’ perceptions of their KSAs within all six QSEN competencies.
Results: Among 671 records screened, seven studies met the inclusion criteria: four descriptive, one quasi-experimental, and two mixed-methods designs. All the studies were found to be low quality except one, which was graded as medium quality. Overall, pre-licensure nursing students perceived patient-centered care as the most discussed and quality improvement as the competency least reviewed in their curricula. Students reported to be most prepared to perform patient-centered care skills and least prepared to perform quality improvement skills. All six QSEN competency skills were perceived as being of high importance to practice nursing after graduation. In three interventional studies, the researchers reported improvements in students’ perceptions of their KSAs after the integration of the QSEN content in courses and simulations.
Conclusion: Revisiting the integration of the quality improvement competency into nursing curricula can increase nursing students’ perceptions of their knowledge and skills related to this QSEN competency. This review indicates that classroom settings were reported to be most used in teaching the QSEN competencies compared to other venues. However, as suggested by the QSEN faculty and advisory board members, these competencies should be taught with a combination of classroom content, clinical education, simulations, reflective papers, and case studies with the involvement of every faculty member. More research with attention to quality and rigor is needed to assess graduating students’ understanding of their abilities to perform the QSEN competencies.