Quality improvement engagement and competence: A comparison between frontline nurses and nurse leaders

•As the largest, most consistent provider of care, nurses play a pivotal role in improving care and patient outcomes at the frontline.•The Nursing Quality Improvement in Practice tool can be used to determine current levels of QI competence (e.g. knowledge, skills, and attitudes) and engagement of nurses in QI.•Strategies for increasing QI competence and engagement of nurses must be created and deployed in order to improve quality and safety.