QSEN Core Competencies Applied to Patient Safety Cases
This paper applies five QSEN core competencies to two real-world healthcare scenarios. The first section analyzes the tragic death of Josie King, examining how patient-centered care, teamwork and collaboration, evidence-based practice, informatics, and quality improvement could each have prevented her death from dehydration and central line infection. The second section identifies hospital-acquired infection control as a workplace patient safety concern, connecting it to evidence-based practice and citing research demonstrating that structured infection-control programs reduce rates and costs. Together, the two scenarios illustrate how QSEN competencies guide nurses toward safer, more responsive, and more collaborative clinical practice.
- Introduction: The Josie King Case: Overview of Josie King's preventable death
- Patient-Centered Care and Family Involvement: Ignoring family concerns as a care failure
- Teamwork, Collaboration, Evidence-Based Practice, and Informatics: Three competencies applied to Josie's case
- Quality Improvement and Communication Systems: Communication audits to prevent patient harm
- Infection Control as a Workplace Patient Safety Concern: Evidence-based infection control in clinical settings
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What makes this paper effective
- Systematically maps each QSEN competency to a specific failure point in the Josie King case, making the framework concrete rather than abstract.
- Consistently uses first-person reflection ("I would have…") to ground the analysis in professional accountability and personal practice.
- Smoothly transitions between the case study and the workplace scenario, showing that QSEN competencies apply both retrospectively and proactively.
- Supports claims with cited evidence, including a peer-reviewed source on pediatric care and an evidence-based infection control study.
Key academic technique demonstrated
The paper demonstrates applied framework analysis: it takes an established professional competency model (QSEN) and uses each competency as a structured lens to evaluate real clinical events. This technique moves beyond mere description by asking what should have been done differently and why, anchoring each answer in both the competency definition and supporting literature.
Structure breakdown
The paper is divided into two numbered sections. Section 1 works through five QSEN competencies sequentially, each tied to a specific failure in the Josie King case with a corresponding reflective corrective action. Section 2 shifts to a workplace context, identifying infection control as a patient safety concern and connecting it to the evidence-based practice competency with supporting research. References appear in APA format at the close.
Introduction: The Josie King Case
The story of Josie King is both sad and deeply compelling. It reminds us of the critical relevance of the nursing role in improving patient outcomes in a healthcare setting. Despite having healed well and being due for release from the hospital within a few weeks, Josie died of severe dehydration and a central line infection. The five QSEN core competencies each illuminate specific points at which better nursing practice could have prevented this tragedy.
Patient-Centered Care and Family Involvement
One of the QSEN competencies, patient-centered care, calls for the analysis of all dimensions of patient-centered care, with "involvement of family and friends" being one of the competency's central expectations (QSEN Institute, 2017). As one of the nurses attending to Josie, I should have taken the mother's concerns more seriously — especially given that they were raised multiple times. Those who spend the most time with a patient, namely family members, are able to notice even minor details regarding changes in behavior. Their observations must not be ignored.
There is already solid research demonstrating the importance of wholesome patient examination and the need to involve caregivers at every stage of treatment. In one such study, it was found that "because children are dependent on their caregivers, their care must be approved by parents or surrogates during all encounters" (Hughes, 2008). I would have been more attentive to all the concerns raised by Josie's mother, and I would have cross-checked her claims more actively.
Teamwork, Collaboration, Evidence-Based Practice, and Informatics
Teamwork and collaboration calls for nurses to "function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care" (QSEN Institute, 2017). Teamwork was clearly lacking in the case of Josie. As a nurse caring for her, I would have discussed her concerning behaviors with my team or with superiors — including her feverish sucking of a washcloth. I would have promptly called for assistance the moment her eyes rolled back. I would have remained aware of my own limitations and those of others working toward Josie's wellbeing, and I would have sought to initiate and sustain a stronger team effort.
Evidence-based practice, among other things, calls for the summarization of "current evidence regarding major diagnostic and treatment actions within the practice specialty" and the identification of any gaps that exist (QSEN Institute, 2017). In Josie's case, there was no assessment of the child beyond vital signs, and there was also a failure to address the mother's concerns. I would have been more attentive to all the issues the mother raised and verified her claims and concerns through available evidence.
Informatics relates to the utilization of information and technology not only for communication, but also for the management of knowledge and the mitigation of error (QSEN Institute, 2017). In Josie's case, I would have recognized the importance of maintaining all relevant information in an easily retrievable and verifiable format. A quick review of the information recorded about Josie in the system could have raised red flags — for example, her drastic weight loss in just under 24 hours. Furthermore, I would have double-checked the mother's claim that an order had been placed for no additional narcotics.
References
Hughes, R. G. (Ed.). (2008). Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality.
Nicolle, L. E. (2001). Infection control in acute care facilities: Evidence-based patient safety. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12675934/
QSEN Institute. (2017). Graduate QSEN competencies. Retrieved from http://qsen.org/competencies/graduate-ksas/#patient-centered_care
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