Key Takeaways
- QSEN defines 6 competencies: Patient-Centered Care, Teamwork, EBP, QI, Safety, Informatics
- Patient-centered care means involving patients in decisions about their care
- SBAR (Situation, Background, Assessment, Recommendation) is a standardized communication tool
- Safety culture encourages speaking up about concerns without fear of punishment
- LPN/VNs contribute to quality improvement by following protocols and reporting incidents
QSEN Competencies for Practical Nursing
The Quality and Safety Education for Nurses (QSEN) initiative identifies competencies essential for safe, quality nursing practice. While originally developed for RN education, these competencies are increasingly integrated into LPN/VN practice and may appear on the NCLEX-PN.
The Six QSEN Competencies
| Competency | Definition | LPN/VN Application |
|---|---|---|
| Patient-Centered Care | Recognize the patient as the source of control and partner in care | Respect preferences, involve patients in decisions, coordinate care |
| Teamwork and Collaboration | Function effectively within nursing and interprofessional teams | Communicate clearly, delegate appropriately, participate in team huddles |
| Evidence-Based Practice | Integrate best research with clinical expertise and patient preferences | Follow evidence-based protocols, question outdated practices |
| Quality Improvement | Use data to monitor and improve care processes | Participate in QI initiatives, report incidents, follow protocols |
| Safety | Minimize risk of harm through system effectiveness and individual performance | Use safety checks, follow procedures, report errors |
| Informatics | Use information and technology to communicate, manage knowledge, and support decision-making | Document accurately, use EHRs, protect patient data |
Patient-Centered Care in LPN/VN Practice
Key Actions:
- Elicit patient preferences before care
- Involve family as partners when appropriate
- Respect cultural beliefs and values
- Communicate in understandable language
- Advocate for patient needs
Example Scenario: A patient refuses a bed bath, preferring to shower. The patient-centered LPN/VN would assess safety, accommodate the preference if appropriate, and document the patient's choice.
Teamwork and Collaboration
The LPN/VN Role in the Team:
- Communicate patient changes promptly to RN
- Participate in shift handoff reports
- Accept delegation appropriately
- Provide feedback to team members respectfully
- Support new staff and students
SBAR Communication:
| Element | Description |
|---|---|
| Situation | What is happening right now? |
| Background | What is the clinical context? |
| Assessment | What do you think the problem is? |
| Recommendation | What do you think should be done? |
Evidence-Based Practice
How LPN/VNs Apply EBP:
- Follow facility policies based on current evidence
- Question practices that seem outdated
- Participate in education about new protocols
- Report when policies conflict with best practices
Quality Improvement
LPN/VN Contributions to QI:
- Report near-misses and errors through appropriate channels
- Participate in unit-based improvement projects
- Follow protocols designed to improve outcomes
- Collect data as assigned (e.g., fall tracking, infection rates)
Safety Culture
Creating a Culture of Safety:
- Speak up when you see unsafe practices
- Report errors without fear of punishment
- Use checklists and double-checks
- Follow the "two patient identifiers" rule
- Never take shortcuts with safety protocols
Informatics in Nursing
LPN/VN Technology Skills:
- Navigate electronic health records (EHRs)
- Document accurately and timely
- Use medication barcode scanning
- Protect patient privacy (HIPAA)
- Recognize when technology fails and use backup systems
On the NCLEX-PN
QSEN concepts are woven throughout the exam. Expect questions about:
- Patient preferences and cultural considerations
- Team communication (especially SBAR)
- Responding to errors and near-misses
- Following evidence-based protocols
- Using technology safely
According to QSEN, which action best demonstrates patient-centered care?
The LPN notices that a colleague did not scan a medication barcode before administration. What is the BEST action based on safety culture principles?
When using SBAR to communicate with the RN about a patient concern, the "A" stands for: