Current assessments of quality and safety competencies in registered professional nurses: An examination of nurse leader perceptions

Quality and safety in healthcare is a national concern. It has been proposed that nurses and other clinicians need to develop a new set of competencies in order to make significant improvements in the quality and safety of patient care. These new competencies include: patient-centered care; teamwork and collaboration; evidence-based practice; quality improvement; safety; and informatics. There is a growing body of knowledge regarding these competencies in nursing students but there is very little understanding of how they are articulated by registered professional nurses in the practice environment. This descriptive study undertook to determine the degree to which nurse leaders are satisfied with the practice of their incumbent registered nurses with respect to the newly identified quality and safety competencies. Nurse leaders differentiated their responses based on the educational level and experience level of the nurses. Additionally, teaching and learning resources within healthcare facilities related to the domains were identified. Facilitators of and barriers to quality and safety learnings were explicated.;The study used an electronic survey for data collection followed by focus groups of nurse leaders for meaning making. One hundred ten nurse leaders responded to the survey. Differences in nurse leader satisfaction across the six domains were identified among the groups based on education and experience. The competencies rated most highly overall included: patient-centered care; teamwork and collaboration; and safety. Satisfaction with quality improvement was rated lowest regardless of nurse experience or educational level. New graduate nurses prepared at the associate degree/diploma level received the lowest satisfaction scores across all six domains. Wide variation in some but not all of the six quality and safety competencies were identified. This limited study suggests that practicing nurses have learning needs related to quality and safety particularly in the areas of quality improvement and evidence-based practice. Attention to the continued development of this new set of knowledge, skills, and attitudes is suggested.