Understanding The Importance of QSEN Competencies

female nurse working at hospital

Quality and Safety Education in Nursing (QSEN) competencies are crucial for nurses practicing at all levels. These competencies arose after the Institute of Medicine (IOM) released a report in 2000 that highlighted the pressing need to redesign healthcare systems to improve patient care. Subsequently, regulatory bodies established national initiatives designed to effect positive change within the nursing field. The QSEN competencies were part of these national initiatives.1

Established in 2005, the QSEN initiative focuses on the integration of modern knowledge and skills related to safety and quality into nursing education. Specifically, the QSEN initiative establishes six competencies of knowledge, skills and attitudes (KSAs) for pre-licensure nursing degree students.

Table of Contents:

Patient-Centered Care

The first QSEN competency is patient-centered care. This area explores the necessity of providing inclusive care that keeps patients involved in making all decisions regarding their wellness. Of course, a precursor to this is providing excellent patient education to enable patients to make informed decisions. In addition, patient-centered care acknowledges the need for a compassionate approach that takes into consideration each patient’s values and needs. Some of the KSA tasks for this competency may include:

  • Exploring the ethical and legal issues of patient-centered care
  • Understanding common barriers to patient involvement
  • Learning how to support the patient’s preferences for family involvement

Teamwork and Collaboration

Teamwork and collaboration are the second QSEN competency. This competency acknowledges that healthcare is not delivered in a bubble. In other words, multiple healthcare providers work with a single patient and in order to provide the best possible care, these providers must share in the decision-making. This QSEN competency encourages nursing degree students to acknowledge their own strengths and limitations as team members and to welcome the contributions of others with diverse skillsets. It also underscores the necessity of acting with respect when another person’s professional opinion differs. As they work to acquire this competency, students should strive to better understand their own communication style and its effect on others.

Evidence-Based Practice

The third QSEN competency is evidence-based practice. This QSEN competency builds upon the previous two. It involves the acknowledgment, interpretation and application of current medical evidence when delivering collaborative, patient-centered care. Pre-licensure nursing students will embrace this competency by learning to read and interpret clinical studies and other evidentiary findings. However, this competency acknowledges that in the nursing world, one’s education is never truly finished. Professionals are expected to continually learn about the latest evidence-based findings and to apply them in their practice. Some of the KSA tasks for this competency may include:

  • Identifying reliable sources of clinical evidence and practice guidelines.
  • Understanding the difference between clinical opinion and research summaries.

Quality Improvement

The fourth QSEN competency is quality improvement. This involves the application of evidence-based information to evaluate patient outcomes and to design, test and implement changes to the healthcare delivery model. These changes strive to continually improve the quality of care. In order to closely study the mechanisms for quality improvement, pre-licensure students may be asked to participate in a root cause analysis that explores a sentinel event.

In a healthcare setting, a sentinel event is any unexpected event that results in a severe patient outcome, including death. A root cause analysis is a standard tool that hospitals use to evaluate sentinel events, learn from them and implement appropriate quality improvement initiatives.


The next QSEN competency is safety. Although this competency focuses on the importance of patient safety, it also acknowledges the need to explore provider safety issues. Students working to acquire this QSEN competency may be asked to do any of the following KSA tasks:

  • Understand safety design principles and learn how to recognize unsafe practice, including errors of omission and inappropriate shortcuts in the workplace.
  • Explore factors that support a safety-minded work culture, such as open communication and error reporting systems.
  • Understand the benefits and limitations of healthcare technologies intended to minimize patient harm, including automatic alert systems and medication pumps.
  • Consider the theoretical and practical impacts of national patient safety initiatives and regulations.


The final QSEN competency is informatics. Healthcare informatics refers to the utilization of technology and information to manage patient care, prevent medical errors, enhance decision making and encourage collaborative communication. The importance of healthcare informatics is becoming increasingly clear as more care-oriented organizations implement advanced technologies.

This competency acknowledges that technology can play an impactful role in preventing medical errors. For example, medical healthcare records enable multiple providers to stay on top of changes to a patient’s health history. In nursing education, KSA tasks for the informatics competency may include learning how to use information management tools, navigating the electronic health record (EHR) system and understanding the need for lifelong learning in information technology. 

At Grand Canyon University, we are proud to be at the forefront of high-quality nursing education that prioritizes patient care and safety. Some of the degrees you may be interested in as an aspiring nursing student include the Bachelor of Science in Nursing (RN to BSN) degree. To learn more about earning your nursing degree at GCU, click on Request Info above.

1Retrieved from QSEN Institute, QSEN Competencies, in February 2021.

The views and opinions expressed in this article are those of the author’s and do not necessarily reflect the official policy or position of Grand Canyon University. Any sources cited were accurate as of the publish date.