American Nursing Competencies and Education

Table of Contents


Nursing plays a crucial role in the treatment of patients. In 2005, an educational project for nurses about healthcare quality and safety was created to build a bridge between education and practice. The Robert Wood Johnson Foundation funded the project. The Quality and Safety Education for Nurses (QSEN) was developed in the second phase of this project. QSEN competencies are aimed to give nurses all knowledge, skills and attitudes needed for their everyday work.

In the meantime, the National League for Nurses created a list of competencies for nursing education. NLN competencies include detailed instructions for the curricular development. In addition to the previous two types, AONE competencies were created specifically for preparing nurse executives to lead organizations. The purpose of this review is to analyze QSEN, NLN, and AONE competencies in the context of nurses’ practicum projects.

QSEN competencies are aimed at teaching nursing students to provide quality and safe patient care. According to Hunt (2012), “there are six QSEN competencies that were developed for pre-licensure and graduate nursing programs: patient-centered care, teamwork and collaboration, evidence-based practice (EBP), quality improvement (QI), safety, and informatics” (p. 1). The majority of these competencies are already in practice, but students require additional education to know how to address them in their work. To achieve the needed level of healthcare proficiency, students have to acquire particular knowledge, skills, and attitudes about every competency.

There are several ways to address and promote QSEN competencies in the nursing practice. Members of the safety and quality committees can directly influence and enhance the level of patients’ care. Nurses can create projects on particular clinical issues that occur regularly in their work. Specialists organize meetings and discussions to enhance the collaboration of all healthcare workers.

The organization of the teaching-learning process is crucial for the further professional growth of nursing students. In 2005 and 2012, the National League for Nursing has published eight Core Competencies of Nurse Educators (Billings & Halstead, 2015).

The NLN competencies aim to eliminate the lack of educators in the healthcare sphere. They cover all aspects and activities needed for the nursing educational process including teaching, research, and practice. The preparation of nurse leaders is important for the development of global healthcare. AONE presents core competencies needed for an effective combination of professional communication, leadership, and business planning in the nursing practice (Carlson, Kline, & Zangerle, 2016). Leaders with the profound knowledge of AONE competencies can represent their organizations and manage care delivery.

QSEN Competencies: Follow-up Blog

In 2001, the Institute of Medicine (IOM) proposed a reform in the education of healthcare specialists to enhance the quality and safety of nursing practices (Billings & Halstead, 2015). The report issued by IOM contained five core competencies of a modern health professional including the collaboration of medical workers, close attention to the needs of patients, evidence-based practice, and the improvement of safety and quality of all provided services.

The following QSEN project aimed to provide all necessary knowledge and skills to nurse students about the quality and safety requirements in their practice. The project corrected the curriculum of nursing educational programs to include courses about all five core competencies. The established QSEN website provided online resources for teachers and students to support the educational process.

The implementation of QSEN competences in nurse practices can greatly influence and enhance the overall care delivery process. Patient-centered care includes the provision of nursing services with close attention to the needs and preferences of patients and their relatives. According to Sherwood and Zomorodi (2014), a nurse should “recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’s preferences, values, and needs” (p. 18).

For example, a nurse can allow children to accompany their relatives during the treatment if their presence does not disturb the work of the staff. The teamwork and collaboration of professionals will help to designate workers according to their strengths and limitations and develop a productive communication. Moreover, this approach recognizes patients and their relatives as active members of the treatment process. People tend to tell much more to their family members than to healthcare professionals.

Spouses and children know about typical reactions of patients to specific medicaments and procedures. Therefore, close collaboration between nurses and relatives is crucial for the positive outcome of the treatment. Evidence-based practice ensures the best approach to the treatment according to the gathered and evaluated facts about the case. For example, if evidence proves the positive effect of the reduced amount of medication, the course of the treatment should be changed accordingly. Quality and safety improvement identifies the hindrances in the treatment and improves the care delivery by introducing new practices. Informatics make use of the modern digital technologies to record all evidence and improve the search of information needed for the treatment.

NLN and AONE Competencies: Follow-up Blog

The lack of nurse educators and leaders presents a major hindrance to the enhancement of the global healthcare. Only recently modern education of nursing professionals started to develop in these two directions. According to Leonard, McCutcheon, and Rogers (2016) “this is reflected in a position statement from the US National League for Nursing which emphasizes the importance of lifelong learning for nurse educators, with an emphasis on learning about education as well as clinical” (p. 150).

The NLN published eight core competencies that can help to redesign the curriculum in order to prepare nurse educators. Using the acquired competencies, a nurse educator will be able to enhance the learning process and the learner’s development, assess and evaluate correctly the educational activities and difficulties, design a curriculum and evaluate the outcomes of the teaching program. The NLN competencies also allow nurse educators to act as leaders for their students, design new activities and initiatives and collaborate with other members of the academic community.

Nursing students need to learn how to speak up for the benefit of their patients. Young professionals are generally hesitant in the discussion of the treatment appointed by their senior colleagues what might lead to a variety of errors. Nevertheless, a leadership course can help students to defend their opinion more confidently. The results of the study conducted by Kent, Anderson, Ciocca, Shanks, and Enlow (2015) “showed a statistically significant improvement in confidence in speaking up, from the beginning to the end of the senior practicum and leadership course, even though none of the demographic variables had any relationship to confidence scores” (p. 14).

AONE presents five key competencies that can help nurse students become prominent leaders in the healthcare sphere. Learning AONE competencies, nurse professionals enhance their communication skills, knowledge of the global healthcare structure, visionary thinking, and understanding of business processes at their work. The appearance of new nurse educators and leaders is crucial for the global development of healthcare.


Billings, D. M., & Halstead, J. A. (2015). Teaching in nursing: A guide for faculty. St. Louis, MO: Elsevier Health Sciences.

Carlson, E., Kline, M., & Zangerle, C. M. (2016). AONE competencies: Preparing nurse executives to lead population health. Nurse Leader, 14(2), 108-112.

Hunt, D. (2012). QSEN competencies: A bridge to practice. New Rochelle, NY: Wolters Kluwer Health.

Kent, L., Anderson, G., Ciocca, R., Shanks, L., & Enlow, M. (2015). Effects of a senior practicum course on nursing students’ confidence in speaking up for patient safety. Journal of Nursing Education, 54(3), 12-15.

Leonard, L., McCutcheon, K., & Rogers, K. M. (2016). In touch to teach: Do nurse educators need to maintain or possess recent clinical practice to facilitate student learning? Nurse Education in Practice, 16(1), 148-151.

Sherwood, G. & Zomorodi, M. (2014). A new mindset for quality and safety: The QSEN competencies redefine nurses’ roles in practice. Nephrology Nursing Journal, 41(1), 15-23.

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