Evaluation Tools

The Quality Improvement Attitude Survey

Developed by Pamela B. Dunagan

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Developed by Dawn McMeekin, MSN, RN

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Evaluation Tools

Teamwork & Collaboration

Developed by Melissa Ellis, MSN, RN

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Quality Improvement

Developed by Susan E. Ducore, MSN, RN, PHN

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Systems Thinking

Systems thinking: Advancing the Science of Continuous Quality Improvement

Goal: To develop and conduct psychometric testing of a measure of systems thinking, the Systems Thinking Scale (STS).

Systems Thinking Scale (STS)- User Manual 

Patient-Centered Care

Developed by Karen Towne, BA, BSN, RN

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Developed by Wendy Downey, BSN, RN

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QSEN Conceptual Model

“A Conceptual Model of QSEN” has been developed to assist the pre-licensure nursing student in developing ‘Information Fluency’ regarding QSEN.

Please click here to view the Conceptual Model.


Instrument Table 

*Studies with instruments measuring QSEN competencies 

Citation Year Population QSEN competency assessed Instrument Purpose of the Study/ subjects Major findings/ Comments
 Pauly-O’Neill, S.,   Prion S., Nguyen, H.,J Nurs Educ. 2013;52(9):534-538. 2013 Nursing students in Pediatric rotations (clinical site and simulation), junior –level BSN students)N=15 all Time-on-task/clinical observation tool (TOT-COT)- 6 competencies, 25 items observed all together. Do the pediatric clinical and simulation settings offerthe opportunity to practice the six competencies set forth byQSEN initiative?

Are the activities available in each setting comparable?

Three of the six QSEN competencies:patient-centered care, teamwork and collaboration, and safety in both setting were more prominent. However, students spent lessthan 10 minutes during a 3.5-hour clinical period or simulation

laboratory engaged in (a) quality improvement (2.31 and

0.62 minutes, respectively), (b) evidence-based practice (5.92

and 0.54 minutes, respectively), and (c) informatics (2.96 and

0 minutes, respectively).

Piscotty, R., Grobbel, C. M., Abele, C. Psychometric evaluation of the Nursing Quality and Safety Self- Inventory: A self-report measure of nursing quality and safety- Poster presentation 2013 N=176 pre-licensure BSN students all Nursing Quality and Safety Self-Inventory (NQSSI) 18 items measuring nurses self-rated quality and safety knowledge, skills and attitudes To develop and test an instrument that measures quality and safety competencies 2 subscales, knowledge and attitudes, which explained 53.68% of total variance. (Cronbach’s α) were 0.93 for the total inventory, and ranged from 0.88 to 0.92 for the two sub-scales.
Dycus, P., McKeon, L. using QSEN to measure quality and safety knowledge, skills, and attitudes of experiences pediatric oncology nurses: an international study.Qual Manag Health Care. 2009; 18(3): 202-8. 2009 N=37;  Pediatric Oncology Nurses from US and Latin America all Quality Improvement Knowledge, Skills, and Attitudes (QuISKA)73 items, electronic survey To develop and instrument to measure nursing quality knowledge, skills and attitudes for practicing pediatric nurses. Inter-item correlation coefficient was 0.839 (P=0.001). Lowest rated skills analysis and QI tools. Mean knowledge score 69.2 +/-11.3 (based on 100); Highest scores: safety 82.9%, lowest teamwork (48.6%). Mean skill rating 3.3 +/-0.74 (used 2-4 times)Conclusion: pediatric oncology nurses were knowledgeable in QI, but lacked skills in practice application
Bradley, K. Quality and safety assessment/ application for nurses (QSAAN); Translation of QSEN competencies in the practice setting. Poster presentation. AONE. March 2013 2013 N=668 (366 completed surveys), electronic  RNs from all areas/levels in 4 acute care facilities all Quality Improvement Knowledge, Skills and Attitudes (QUISKA2)73 items (17 knowledge, 45 skills, 11 attitude) The purpose of this study was to measure the knowledge, skills and attitudes of practicing nurses compared ti QSEN competencies; conduct psychometric evaluation of a tool to measure translation of QSEN into practice; and to provide feedback to community academic partners about QSEN competencies in the practice Chronbach’s alfa= 0.94 (Sig. < 0.001)
Citation Year Population QSEN competency assessed Instrument Purpose of the Study/ subjects Major findings/ Comments
Bertch, D. Quality and safety education in newly hired RNs and RNs in staff leadership roles 2012 Post licensure new RN All Quality Improvement Knowledge, Skills, and Attitudes (QuISKA)73 items, electronic survey To examine the potential knowledge, skills and attitudes gap regarding QSEN core competencies. 69.2% onthe knowledge portion  .The mean self-rating of skill proficiency

2.91 on a six-point Likert-type scale for both groups (1 = novice; 6 = expert).

Hensel, D. 2013 Prelicensure students- 36 BSN students All 46 QSEN attitudes survey (Q-methodology utilized) To identify pattern of professional identity arising from the QSEN attitudes among students completing their prelicensure education. Three factors or patterns of attitudes were found, that represented 66% of the variance.  The QSEN attitudes were internalized to varying degrees. The respondents were grouped into categories: The Champions, The Individualist, The Collaborators.

last updated 10/27/2014 AK