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Background
Professional nurses play a critical role in protecting
patient safety and providing quality health care.
In fact, an expert committee formed by the Institute
of Medicine (IOM) found that "how we are cared
for by nurses affects our health, and sometimes can
be a matter of life and death … nurses are indispensable
to our safety" (IOM, 2004). This finding has
been confirmed by an emerging body of research showing
that nurses are much more likely than any other health
professional to recognize, interrupt and correct errors
that are often life threatening (Rothschild et al.,
2006), that higher levels of baccalaureate-prepared
nurses in hospital settings reduce mortality and failure
to rescue rates (Aiken, et al, 2004), and that inadequate
nurse staffing levels may lead to a higher incidence
of complications and inadequate care (Aiken et al.,
2002, JCAHO, 2002; Needleman et al., 2002).
Calls from the Institute of Medicine, the Robert Wood Johnson Foundation, Agency on Healthcare Research and Quality, and other authorities to address patient safety issues are growing louder and must be addressed by all health disciplines, including nursing. In the report titled Health Professions Education: A Bridge to Quality (2003, p. 1), the IOM found that nurses and other health professionals are not adequately prepared to provide the highest quality and safest care possible. The authors concluded that "education for the health professions is in need of a major overhaul."
In response to the urgent calls to
transform health care delivery and better prepare
today's nurse for professional practice, the American
Association of Colleges of Nursing (AACN) convened
a task force on the essential patient safety competencies
and charged this group with identifying the essential
baccalaureate core competencies that should be achieved
by professional nurses to assure high quality and
safe patient care. The AACN Board of Directors instructed
the task force to consider what knowledge the professional
nurse must have related to quality and patient safety,
as well as the leadership and communications skills
needed to address quality and patient safety issues
effectively within the context of an interdisciplinary
team. The following competencies are the result of
the work of the task force. This preliminary work
will continue as the Essentials of Baccalaureate Education
for Professional Nursing Practice (AACN, 1998) are
revised in 2007. The Patient Safety Task Force recommends
that baccalaureate programs begin to evaluate current
curricula to determine where these competencies are
being taught as well as where opportunities exist
for further integration of these competencies into
curricula. The following competencies are organized
according to selected categories of the conceptual
framework used in the Essentials of Baccalaureate
Education for Professional Nursing Practice.
Hallmarks
of Quality and Patient Safety
in Baccalaureate Nursing Education
Critical Thinking