| Level 1: Entry-Level | 5.1a Recognize nursing’s essential role in improving healthcare quality and safety. | Identify key concepts of quality and safety in healthcare. Describe nurses' responsibility in maintaining healthcare quality and safety. Explain the nurse's role in preventing patient harm. | Identify nursing-specific quality indicators and safety initiatives to address clinical improvement needs. Identify nursing-related system-level factors contributing to patient safety issues. Articulate the importance of the nurse as the last line of defense. | 
| 5.1b Identify sources and applications of national safety and quality standards to guide nursing practice. | Identify key national safety and quality standards relevant to nursing practice. Identify key organizations that set national safety and quality standards. | Select national safety and quality standards to analyze clinical situations and guide nursing practice. Recommend opportunities to improve patient safety based on national safety and quality standards and new evidence. | 
| 5.1c Implement standardized, evidence-based processes for care delivery. | Identify standardized processes used in nursing practice. Follow standardized processes for patient care. | Adapt standardized processes to meet the needs of individual patients. Analyze patient situations/characteristics and act to mitigate patient risks. | 
| 5.1d Interpret benchmark and unit outcome data to inform individual and microsystem practice. | Identify key trends in unit-level data. Recognize the relationship between unit-level data and national benchmarks. | Analyze unit- and system-level data to identify areas for improvement in patient care. Use data to support evidence-based practice decisions. | 
| 5.1e Compare quality improvement methods in the delivery of patient care. | Describe the basic principles of various quality improvement methods. Compare the strengths and limitations of quality improvement methods. | Select relevant quality improvement methods to support care improvement. | 
| 5.1f Identify strategies to improve outcomes of patient care in practice. | Explain the role of patient engagement in improving patient outcomes. Use communication and collaboration strategies to improve patient outcomes. | Select evidence-based practice strategies to improve patient outcomes. Recommend protocols essential to improve the outcomes of patient care. | 
|  | 5.1g Participate in the implementation of a practice change. | Gather relevant data to support the need for a practice change initiative. Identify potential barriers to implementing quality improvement initiatives. Communicate the rationale for the proposed change to colleagues and patients. | Develop quality improvement projects. Model a practice change and serve as a resource for peers. | 
|  | 5.1h Develop a plan for monitoring quality improvement change. 
 | Describe methods for collecting and analyzing data. Analyze key data to monitor the effectiveness of a practice change. | Develop a monitoring plan. Justify the selection of a particular quality improvement method to address a clinical issue. | 
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| Level 2: Advanced-Level | 5.1i Establish and incorporate data driven benchmarks to monitor system performance. | Determine the specific aspects of system performance that need to be monitored. | Choose methods and frequency of data collection and reporting. Use data to inform the development and implementation of targeted interventions to improve system performance. | 
| 5.1j Use national safety resources to lead team-based change initiatives. | Use national safety resources to develop a framework for addressing a patient safety or system performance issue requiring improvement. Consider relevant stakeholders for the proposed change. | Lead team development, implementation, and evaluation of a comprehensive safety action plan. | 
| 5.1k Integrate outcome metrics to inform change and policy recommendations. | Choose outcome, process, and efficiency metrics to provide a comprehensive strategy to assess change. Use outcome data to propose policy recommendations. | Present findings to decision-makers to advocate for policy change. Conduct a thorough evaluation of practice change to determine effectiveness. | 
| 5.1l Integrate outcome metrics to inform change and policy recommendations. | Analyze data for a process improvement initiative. Identify patterns and trends in data relevant to improvement initiatives.  Contribute relevant information and insights based on knowledge, experience, and evidence. | Collaborate in establishing a plan for monitoring and evaluating outcomes of process improvement initiatives. | 
| 5.1m Lead the development of a business plan for quality improvement initiatives. | Define the scope and objectives of the quality improvement plan. Lead collection of relevant data to inform the improvement initiative. | Lead prioritized intervention and evaluation strategies for the quality improvement initiative. | 
| 5.1n Advocate for change related to financial policies that impact the relationship between economics and quality care delivery. | Analyze the impact of financial decisions and policy on quality care delivery and patient outcomes. Propose cost-effective initiatives to improve quality care delivery. | Use data and evidence-based strategies to advocate for financial policy changes to improve quality care delivery.
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|  | 5.1o Advance quality improvement practices through dissemination of outcomes. | Construct relevant dissemination strategies for outcome dissemination. | Disseminate quality improvement process outcomes. |