Which of the following are core nursing competencies according to the Institute of Medicine?

• A. Provide legal counsel.
• B. Manage budgets and schedule staff.
• C. Apply quality improvement, identify errors, and measure quality of care.
• D. Perform all diagnostic procedures.

Answer: (C)

The main idea here is quality improvement and patient safety as central nursing competencies identified by the Institute of Medicine. Nurses are expected to engage in quality improvement by using data to identify errors or gaps in care, test changes to processes, and measure the impact on outcomes. This emphasis on systematically improving care and ensuring safety is a core part of nursing practice as outlined by the IOM.

Options that focus on providing legal advice, handling budgets and staff scheduling, or performing all diagnostic procedures fall outside these core nursing competencies. Legal counsel is outside nursing practice, administrative tasks like budgeting and scheduling pertain to management rather than the nursing scope, and performing all diagnostic procedures is not a nurse’s responsibility. Nurses contribute to diagnostics and assessments, but the comprehensive execution of diagnostic procedures is typically physician-led.

So, the choice that centers on applying quality improvement, identifying errors, and measuring quality of care best reflects the Institute of Medicine’s core nursing competencies.