Abstract
Nurses are in key positions in the healthcare system to provide, monitor, and manage the care delivered to their patients. In 2005, the Quality and Safety Education for Nurses (QSEN) initiative was launched to redefine quality and safety competencies for pre-licensure nursing education. It is imperative that nurses are graduating with the full spectrum of the QSEN competencies to practice in today's healthcare environments. The purpose of this systematic review was to evaluate the research about student nurses' perceptions of their abilities to perform the six QSEN competencies and to determine the effect of integrating the QSEN content in their courses, clinical placements, or simulation experiences. A systematic review of the literature was conducted to retrieve published studies from CINAHL, PubMed, Web of Science, and ERIC using the search terms of Quality and Safety Education for Nurses, QSEN, QSEN competencies, nursing student, and student nurse. The studies that were included in this review were assessed by both authors independently using standardized critical appraisal tools. Seven studies met the inclusion criteria: four descriptive, one quasi-experimental, and two mixed-methods designs. Overall, pre-licensure nursing students perceived patient-centered care as the most discussed and quality improvement as the competency least reviewed in their curricula. Students reported to be most prepared to perform patient-centered care skills and least prepared to perform quality improvement skills. Revisiting the integration of the quality improvement competency into nursing curricula can increase nursing students' understanding of this QSEN competency. More research with sufficiently powered sample sizes, valid and reliable tools measuring outcomes of interventional studies, and attention to quality and rigor is needed to assess graduating students' understanding of the QSEN competencies.
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