Quality and Safety in Nursing. Группа авторов

      Preface

      2020 was declared the Year of the Nurse and Midwife by the World Health Organization (WHO) and the International Council of Nurses, heightened by the first State of the World’s Nursing report (WHO, 2020). Indeed, nurses were on the front lines of news organizations the world over, but in unexpected ways. We have been writing the third edition of Quality and Safety Education in Nursing as we are in the throes of two cataclysmic events: the COVID‐19 pandemic and the recognition of profound systemic racism in our institutions. Health care organizations across the continuum of care were besieged with critically ill people, a situation compounded by shortages of supplies and equipment to deliver care, often leaving front‐line clinicians forced to deliver care with insufficient staffing and personal protection equipment. As of June 2021, the pandemic has claimed more than 602,917 lives in the United States and more than 3,973,000 worldwide. More than ever, nurses are the heart of health care; stories of overwork, too few resources, and risks are countered with resilience, innovation, compassion, and dedication to keeping patients safe. More than ever, quality and safety are defining aspects of care. Indeed, providing safe quality care begins with adequate resources and system leadership committed to safety culture.

      Simultaneously, the disproportionate numbers of deaths of Black and Brown people from COVID‐19 underscore the inequity in health care delivery. Throughout their lives, people of color lack equal access to health care and often receive services of lower quality than the general population. Judith Graham (2020) points out how social and economic disadvantage, reinforced by racism, plays a significant part in unequal health outcomes, all of which threaten quality safe care and the moral fiber of health care.

      The need for systemic change in health care and in the education of our future clinicians to ensure safety and quality has become even more apparent. The recently released report Frontline Nurses (WikiWisdom, 2020) poignantly describes the experiences of nurses working at the front lines of the COVID‐19 pandemic. The authors propose solutions to improving health care settings that align with the Quality and Safety Education for Nurses (QSEN) competencies of patient‐centered care, teamwork and collaboration, evidence‐based practice, quality improvement, safety, and informatics. These include:

While the focus of nurses and other healthcare providers is primarily on the provision of care, what these solutions highlight is the importance of paying equal attention to our systems of care delivery, providing safe working environments for people who are working in highly complex systems, and re‐examining the pre‐ and post‐licensure education of all nurses. These goals align with the December 2020 release of Safer Together: A National Action Plan to Advance Patient Safety, discussed in Chapter 1.

      This volume, the third edition of Quality and Safety Education in Nursing, maintains the same laser focus on understanding and developing the six competencies that represent QSEN, but adds content reflecting the current environment. Chapter 1 covers driving forces for quality safe care and traces the two decades of progress in the current safety movement, and Chapter 2 shares policy perspectives. Chapter 3 updates the history and synergy inspired by the QSEN project. Section Two includes updated chapters on each of the six competencies with scenarios, teaching and practice strategies, and related resources. Chapters in Section 3 offer updated content and strategies to guide faculty in interactive classrooms based on unfolding case studies, reflective practice applied to narrative pedagogy, clinical education, leadership, transition to practice, and interprofessionalism.

      International exemplars depicting the work and perspectives of global partners threaded throughout the book demonstrate the global imperative of collaborating to shape the way forward to improve quality and safety outcomes. Each chapter teases apart the multiple facets of quality and safety and applies the competencies to everyday components of education, care delivery, and organizational systems. The focus is on new ways to apply the competencies and related knowledge, skills, and attitudes to address contemporary challenges in health care education and practice, to improve the patient care experience, and to contribute to the well‐being of health care professionals. Each contributor is a leader in quality and safety and offers their work to stimulate all nurses and health care professionals to share and disseminate their work around the globe.

      Together, we hope to ensure a high‐reliability health care system focused on safety and quality. It is our hope that the expanding story of QSEN provides motivation and will, that the expansive tool kit within these pages stimulates ideas, and that the continuing efforts of all nurses translate into execution as we develop new generations of nurses fully prepared to lead and work in health care systems based on cultures of quality and safety. In this past year, often called “a year like no other,” we have seen how these six competencies have continued to provide an evidence‐based foundation for nursing practice and education. As we move forward into the future, we anticipate that this will continue as we also tackle new challenges in health care and society, eliminating preventable harm in systems that achieve health equity and racial justice for every patient, every time.

       Gwen Sherwood, PhD, RN, FAAN, ANEF

       Jane Barnsteiner, PhD, RN, FAAN

References