Safety quality | Nursing homework help

199The Journal of Continuing Education in Nursing · Vol 50, No 5, 2019

The Quality and Safety Education for Nurses
(QSEN) Collaboration formed in response to the
call from the Institute of Medicine (now the Na-

tional Academy of Medicine) to improve the quality and
safety of health care. That call to action identified five com-
petencies required by all health care providers to transform
the health care system, shifting the emphasis to include
patient-centered care, teamwork and collaboration, use of
evidence-based practice, quality improvement skills, and
the integrated use of informatics in the care provided for
patients (Institute of Medicine, 2003). Shortly afterward
in 2005, the QSEN collaboration, funded by the Robert
Wood Johnson Foundation and led by Linda Cronenwett,
adopted those five requisites, added safety as a sixth com-
petency, and the newly developed QSEN competencies
became the blueprint for nurse educators working to re-
channel the focus of formal nursing education programs
(Cronenwett et al., 2007). The QSEN competencies pro-
vided a clear structure designed to change the identity of
nursing from that of a task-oriented role to one driven by
the knowledge, skills, and attitudes (KSA) that underpin
quality and safety concepts.

What followed was 13 years of transformation as the
QSEN competencies were integrated into curriculum
plans and accreditation standards for schools of nursing.
QSEN provided resources and partnered with national
nursing organizations to support the implementation of
the competencies in nursing academia. In 2009, graduate-
level QSEN competencies that demonstrated enhanced
leadership KSAs were developed, but through all this, prac-
tice was slow to embrace the QSEN competencies. Dur-
ing this same time, practice saw the introduction of the
Hospital Value-Based Purchasing program implemented
by the Centers for Medicare & Medicaid Services (2018).
This program reimbursed hospitals based on quality of
care rather than quantity, thus driving efforts to improve
quality and safety within health care systems. The Joint
Commission Accreditation Standards supported hospitals
in meeting the regulatory requirements and Magnet® stan-

dards drove excellence. Through it all, the aims have always
been congruent between nursing practice and academia,
but the two have not always shared a common language or
understanding.

The work of Lyle-Edrosolo and Waxman (2016) has
been significant in bridging academia and practice. Us-
ing crosswalk methodology, they aligned the six QSEN
competencies, the Magnet® standards, and the Joint Com-
mission Accreditation Standards. This work demonstrates
the relationship among these three driving forces and how
nursing education framed in quality and safety aligns with
expectations for excellence in nursing practice. Although
the QSEN competencies were originally designed for nurs-
ing education, this work validates the QSEN competencies
as an effective framework to drive excellence and buttress
the lifelong learning required by nursing professionals to
ensure that the best care is provided to those who access
the health care system.

Nurses are the linchpin in achieving quality and safety
outcomes, and they are frequently viewed as the last de-
fense between the patient and potential errors (Sherwood
& Zomorodi, 2014). In order to champion for safer health
care for patients and to make an appreciable difference,
nurses need to be informed and educated about quality
and safety competencies (Sherwood & Zomorodi, 2014).
QSEN competencies serve as an appropriate framework
for education to address common issues confronting nurs-
ing practice, such as medication errors, pressure injuries,
and falls.

Why Quality and Safety Education for
Nurses (QSEN) Matters in Practice

guest editorial

Dr. Altmiller is Professor, Director of Quality and Safety Education
for Nurses (QSEN) Institute Regional Center at The College of New Jersey,
Ewing, New Jersey; and Ms. Hopkins-Pepe is Director, Nursing Education
and Professional Development, Einstein Healthcare Network, Philadelphia,
Pennsylvania.

The authors have disclosed no potential conflicts of interest, financial or
otherwise.

Address correspondence to Gerry Altmiller, EdD, APRN, ACNS-BC,
FAAN, Professor, Director of Quality and Safety Education for Nurses
(QSEN) Institute Regional Center at The College of New Jersey, 2000 Pen-
nington Road, Ewing, NJ 08628; e-mail: [email protected].

doi:10.3928/00220124-20190416-04

Authors: Gerry Altmiller, EdD, APRN, ACNS-BC, FAAN; and Loraine Hopkins-Pepe, MSN, RN, CCRN-K

Continuing education and professional development
educators play a vital role in enhancing quality and safe-
ty in the practice setting. To improve care delivery and
achieve quality and safety goals, continuing education pro-
grams for nurses must be transformed to include expanded
content focused on quality and safety competencies (Sher-
wood, 2017). Integrating the QSEN competencies into
educational initiatives provides a standardized structure for
content development and clearly delineates objectives to
enhance the clarity of the material delivered. The QSEN
competencies provide an effective foundation for nurses to
influence and promote high-quality safe care.

QSEN competencies have served as the underpinning of
transition-to-practice programs but why not as the frame-
work for continuing education? Integrating the QSEN
competencies enables continuing education and profes-
sional development educators to emphasize the “why”
behind nursing interventions while also highlighting the
evidence driving care. Additionally, framing educational
offerings in the QSEN competencies allows all educators
to promote the universal language of quality and safety.

Finally, and perhaps most significantly, integrating the
QSEN competencies into practice-based education pro-
grams challenges educators to update and revitalize course
content. Continuing education and professional develop-
ment educators are often tasked with repeatedly teaching
the same required courses containing content that becomes
stagnant over time. By critically evaluating existing courses
and revising them to integrate the QSEN competencies,
these educators may begin teaching from a different lens,
shifting their focus from teaching tasks to teaching concepts
about how to influence and promote high-quality safe care.

Continuing education and professional development edu-
cators are influential in enhancing the quality and safety
of care delivery, and The Journal of Continuing Education
in Nursing will support QSEN competency implementa-
tion in practice through the Teaching Tips column, begin-
ning with this issue, by sharing strategies and ideas with
educators so that they may perform this work effectively.
Reframing continuing education programs in the QSEN
competencies supports the work of continuing education
and professional development educators as they work to
better highlight the critical impact of the nursing profes-
sion on quality care and patient outcomes.

REfERENcES
Center for Medicare & Medicaid Services. (2018). Hospital value-based

purchasing. Retrieved from https://www.cms.gov/Medicare/Quality-
Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/
HVBP/Hospital-Value-Based-Purchasing.html

Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J.,
Mitchell, P., . . . & Warren, J. (2007). Quality and safety education for
nurses. Nursing Outlook, 55, 122-131.

Institute of Medicine. (2003). Health professions education: A bridge to
quality. Washington, DC: National Academies Press.

Lyle-Eldrosolo, G.L., & Waxman, K.T. (2016). Aligning healthcare safety
and quality competencies: Quality and Safety Education for Nurses
(QSEN), The Joint Commission, and American Nurses Credential-
ing Center (ANCC) Magnet® Standards Crosswalk. Nurse Leader, 14,
70-75.

Sherwood, G. (2017). Driving forces for quality and safety: Changing
mindsets to improve health care. In G. Sherwood & J. Barnsteiner
(Eds.), Quality and safety in nursing: A competency approach to improv-
ing outcomes (2nd ed., pp. 1-20). Hoboken, NJ: Wiley Blackwell.

Sherwood, G., & Zomorodi, M. (2014). A new mindset for quality and
safety: The QSEN competencies redefine nurses’ roles in practice. Ne-
phrology Nursing Journal, 41, 15-22.

Editor’s Note: This special guest editorial is presented as a beginning to a series in the Teaching Tips
column that focuses on QSEN (Quality and Safety Education for Nurses). This new emphasis is designed to
support nurses in practice as they enrich their knowledge, skills, and attitudes in addressing quality and safety
issues.

As The Journal of Continuing Education in Nursing celebrates our next half-century of editorial
excellence, we welcome manuscripts that describe the ways continuing education/professional development
educators prepare nurses with competencies for ensuring quality and safety in nursing care and demonstrate
the link to improved patient outcomes.

~ Patricia S. Yoder-Wise, RN, EdD, NEA-BC, ANEF, FANOL, FAAN

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July 1, 2023

89. Profit margin is defined as:

A. Revenues divided by net sales.

B. Net sales divided by assets.

C. Net income divided by net sales.

D. Net income divided by assets.

E. Net sales divided by net income.

90. A company earned $2,000 in net income for October. Its net sales for October were $10,000. Its profit margin is:

A. 2%.

B. 20%.

C. 200%.

D. 500%.

E. $8,000.

91. All of the following statements regarding profit margin are true except:

A. Profit margin reflects the percent of profit in each dollar of revenue.

B. Profit margin is also called return on sales.

C. Profit margin can be used to compare a firm's performance to its competitors.

D. Profit margin is calculated by dividing net income by net sales.

E. Profit margin is not a useful measure of a company's operating results.

92. A company had $9,000,000 in net income for the year. Its net sales were $13,200,000 for the same period. Calculate its profit margin.

A. 17.5%.

B. 28.0%.

C. 62.5%.

D. 160.0%.

E. 68.2%

93. On June 30 Apricot Co. paid $7,500 cash for management services to be performed over a two-year period. Apricot follows a policy of recording all prepaid expenses to asset accounts at the time of cash payment. On June 30 Apricot should record:

A. A credit to an expense for $7,500.

B. A debit to an expense for $7,500.

C. A debit to a prepaid expense for $7,500.

D. A credit to a prepaid expense for $7,500.

E. A debit to Cash for $7,500.

94. On June 30 of the current calendar year, Apricot Co. paid $7,500 cash for management services to be performed over a two-year period. Apricot follows a policy of recording all prepaid expenses to asset accounts at the time of cash payment. The adjusting entry on December 31 for Apricot would include:

A. A debit to an expense for $5,625.

B. A debit to a prepaid expense for $5,625.

C. A debit to an expense for $1,875.

D. A debit to a prepaid expense for $1,875.

E. A credit to a liability for $1,875.

95. Accrued revenues:

A. At the end of one accounting period often result in cash receipts from customers in the next period.

B. At the end of one accounting period often result in cash payments in the next period.

C. Are also called unearned revenues.

D. Are listed on the balance sheet as liabilities.

E. Are recorded at the end of an accounting period because cash has already been received for revenues earned.

96. An account linked with another account that has an opposite normal balance and that is subtracted from the balance of the related account is a(n):

A. Accrued expense.

B. Contra account.

C. Accrued revenue.

D. Intangible asset.

E. Adjunct account.

97. The total amount of depreciation recorded against an asset or group of assets during the entire time the asset or assets have been owned:

A. Is referred to as depreciation expense.

B. Is referred to as accumulated depreciation.

C. Is shown on the income statement of the final period.

D. Is only recorded when the asset is disposed of.

E. Is referred to as an accrued asset.

98. The periodic expense created by allocating the cost of plant and equipment to the periods in which they are used, representing the expense of using the assets, is called:

A. Accumulated depreciation.

B. A contra account.

C. The matching principle.

D. Depreciation expense.

E. An accrued account.

July 1, 2023

89. Profit margin is defined as:

A. Revenues divided by net sales.

B. Net sales divided by assets.

C. Net income divided by net sales.

D. Net income divided by assets.

E. Net sales divided by net income.

90. A company earned $2,000 in net income for October. Its net sales for October were $10,000. Its profit margin is:

A. 2%.

B. 20%.

C. 200%.

D. 500%.

E. $8,000.

91. All of the following statements regarding profit margin are true except:

A. Profit margin reflects the percent of profit in each dollar of revenue.

B. Profit margin is also called return on sales.

C. Profit margin can be used to compare a firm's performance to its competitors.

D. Profit margin is calculated by dividing net income by net sales.

E. Profit margin is not a useful measure of a company's operating results.

92. A company had $9,000,000 in net income for the year. Its net sales were $13,200,000 for the same period. Calculate its profit margin.

A. 17.5%.

B. 28.0%.

C. 62.5%.

D. 160.0%.

E. 68.2%

A. A credit to an expense for $7,500.

B. A debit to an expense for $7,500.

C. A debit to a prepaid expense for $7,500.

D. A credit to a prepaid expense for $7,500.

E. A debit to Cash for $7,500.

A. A debit to an expense for $5,625.

B. A debit to a prepaid expense for $5,625.

C. A debit to an expense for $1,875.

D. A debit to a prepaid expense for $1,875.

E. A credit to a liability for $1,875.

95. Accrued revenues:

A. At the end of one accounting period often result in cash receipts from customers in the next period.

B. At the end of one accounting period often result in cash payments in the next period.

C. Are also called unearned revenues.

D. Are listed on the balance sheet as liabilities.

E. Are recorded at the end of an accounting period because cash has already been received for revenues earned.

96. An account linked with another account that has an opposite normal balance and that is subtracted from the balance of the related account is a(n):

A. Accrued expense.

B. Contra account.

C. Accrued revenue.

D. Intangible asset.

E. Adjunct account.

97. The total amount of depreciation recorded against an asset or group of assets during the entire time the asset or assets have been owned:

A. Is referred to as depreciation expense.

B. Is referred to as accumulated depreciation.

C. Is shown on the income statement of the final period.

D. Is only recorded when the asset is disposed of.

E. Is referred to as an accrued asset.

98. The periodic expense created by allocating the cost of plant and equipment to the periods in which they are used, representing the expense of using the assets, is called:

A. Accumulated depreciation.

B. A contra account.

C. The matching principle.

D. Depreciation expense.

E. An accrued account.

July 1, 2023

89. Profit margin is defined as:

A. Revenues divided by net sales.

B. Net sales divided by assets.

C. Net income divided by net sales.

D. Net income divided by assets.

E. Net sales divided by net income.

90. A company earned $2,000 in net income for October. Its net sales for October were $10,000. Its profit margin is:

A. 2%.

B. 20%.

C. 200%.

D. 500%.

E. $8,000.

91. All of the following statements regarding profit margin are true except:

A. Profit margin reflects the percent of profit in each dollar of revenue.

B. Profit margin is also called return on sales.

C. Profit margin can be used to compare a firm's performance to its competitors.

D. Profit margin is calculated by dividing net income by net sales.

E. Profit margin is not a useful measure of a company's operating results.

92. A company had $9,000,000 in net income for the year. Its net sales were $13,200,000 for the same period. Calculate its profit margin.

A. 17.5%.

B. 28.0%.

C. 62.5%.

D. 160.0%.

E. 68.2%

A. A credit to an expense for $7,500.

B. A debit to an expense for $7,500.

C. A debit to a prepaid expense for $7,500.

D. A credit to a prepaid expense for $7,500.

E. A debit to Cash for $7,500.

A. A debit to an expense for $5,625.

B. A debit to a prepaid expense for $5,625.

C. A debit to an expense for $1,875.

D. A debit to a prepaid expense for $1,875.

E. A credit to a liability for $1,875.

95. Accrued revenues:

A. At the end of one accounting period often result in cash receipts from customers in the next period.

B. At the end of one accounting period often result in cash payments in the next period.

C. Are also called unearned revenues.

D. Are listed on the balance sheet as liabilities.

E. Are recorded at the end of an accounting period because cash has already been received for revenues earned.

96. An account linked with another account that has an opposite normal balance and that is subtracted from the balance of the related account is a(n):

A. Accrued expense.

B. Contra account.

C. Accrued revenue.

D. Intangible asset.

E. Adjunct account.

97. The total amount of depreciation recorded against an asset or group of assets during the entire time the asset or assets have been owned:

A. Is referred to as depreciation expense.

B. Is referred to as accumulated depreciation.

C. Is shown on the income statement of the final period.

D. Is only recorded when the asset is disposed of.

E. Is referred to as an accrued asset.

98. The periodic expense created by allocating the cost of plant and equipment to the periods in which they are used, representing the expense of using the assets, is called:

A. Accumulated depreciation.

B. A contra account.

C. The matching principle.

D. Depreciation expense.

E. An accrued account.

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