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The call to better prepare nurses in safety and quality performance resulted from the concern of the Institute of Medicine regarding egregious gaps and errors in U.S. hospitals that resulted in serious injuries and patient deaths. Quality and safety education for nursing (QSEN) competencies were set forth in 2005 to enhance nursing curricula and nursing students' preparation for practice; however, QSEN's integration and implementation have been gradual and inconsistent. This qualitative interpretive study was guided by Senge's principles of the learning organization and Benner's professional development model. Using face-to-face interviews, the perspectives of 9 full-time nursing faculty members at 2 private nursing colleges in the Northeast United States were obtained about QSEN integration into their curriculum. Data analysis employed the use of open in vivo coding, categorizing, and the formation of themes. The results indicated that QSEN integration was perceived as complex and daunting due to faculty's limited knowledge about QSEN, lack of adequate preparation to develop and employ instructional strategies, lack of adequate time to teach, and limited learning opportunities at clinical sites to develop competencies such as teamwork and collaboration and informatics. Meaningful reform in nursing education may occur as leaders engage faculty members in meaningful dialogue to better understand the complexity and challenges of QSEN integration, including faculty members' needs for successful implementation. Nursing students may then be better trained to understand the nature and consequences of human and system errors and appreciate higher standards of care that will result in a decrease in preventable injuries, medication errors, and patient deaths.

Healthcare agencies and stakeholders expect registered nurses to be competent at all times. When nurses are not confident in competencies, negative patient outcomes can occur. The purpose of this quantitative quasiexperimental with posttest only study was to investigate Quality and Safety Education for Nurses (QSEN) competency confidence levels of 2 groups of new nurses who had 5-6 months of clinical experience. Framed by the Duchscher theory and the QSEN framework, the research question was developed to examine the differences between QSEN competency confidence levels of new nurses who participated in a prelicensure program plus a residency program and nurses who only attended the residency program. Sixty-eight new nurses from 1 health facility answered the Nursing Quality and Safety Self-Inventory (NQSSI). An independent t test was used to compare each knowledge, skills, and attitudes (KSA) QSEN competency confidence levels for two groups. The results of this study demonstrated a difference between QSEN competency confidence levels between the 2 groups, but not all 18 NQSSI items reached a statistically significant difference. The 7 items that reached a statistically significant difference included the QSEN competency confidence level in knowledge and skills in evidence-based practice, quality improvement, and informatics. A statistically significant difference was also noted in the QSEN competency confidence level for patient-centered care skills. A 3-day professional development (PD) workshop was developed based on the results. Participating in the PD workshop could further increase the new nurses' QSEN competency confidence levels which can enhance patient outcomes resulting in positive social change.

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