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ABSTRACT
This article describes the redesign of the fundamentals of nursing course using an organizing framework and teaching strategies identified in the Quality and Safety Education for Nurses (QSEN) initiative. Six QSEN competencies (patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics) are essential for nursing practice. Beginning knowledge, skills, and attitudes (KSASAs) associated with each competency were identified in a preliminary Delphi survey as important to incorporate early in prelicensure nursing curricula. Redesign requires a shift in focus from task-training and psychomotor skills development to incorporation of a systems context, reflecting redefined values and interventions associated with safety, quality, and professional nursing roles. A course revision, based on the QSEN competencies definitions, selected beginning KSASAs, exemplar resources, and teaching strategies, is described. The reframing of fundamentals of nursing is essential to prepare new graduates for contemporary practice.
The traditional fundamentals of nursing course, a constant across prelicensure nursing curricula, introduces basic psychomotor skills essential for patient care. The organizing framework of fundamentals of nursing is important because it identifies priority nursing competencies and professional roles. Time-honored content and teaching approaches focusing on technical skills have lost relevance for contemporary nursing practice.
This article describes a quality and safety framework for the redesign of the traditional fundamentals of nursing course. Within a quality and safety framework, novices begin to identify with professional nursing roles that reach far beyond tasks, skills, and procedures. They develop beginning awareness of safety and quality in the context of a health care system, nurse sensitive quality indicators, and local and national safety initiatives impacting health care delivery. Nurses with a strong foundation in patient safety and quality improvement are better able to assimilate into the current complex health care environment.
Time-Honored Approach to Fundamentals of Nursing
Fundamentals of nursing textbooks often provide the organizing framework for the course content and delivery. The most common framework, which has endured for decades, is based on performance of skills and procedures, such as maintaining asepsis and administering medication (Harmer & Henderson, 1955).
A second common approach is to organize content around physiological systems. Perry and Potter (1985) introduced a dual focus, presenting essential skills of nursing practice and care for the patient's physiological needs organized around body systems. The...