Friday, December 4, 2009

Nurses: The Crucial Link for Patient Safety

To Err Is Human Blog Series Logo

This post is part of our two-week series commemorating the 10-year anniversary of the seminal IOM Report "To Err Is Human." To see all posts in the series, please click here.

This post is by Terri Schmitt of Nurse Story, a blog that is full of thoughts on nursing, nurse practitioners, service to others and life in general. Terri Schmitt is a nurse practitioner who is currently finishing up her PhD at the University of Missouri-Kansas City (UMKC).

In the past, nurses such as Florence Nightingale, Dorthea Dix, Lillian Wald, Margaret Sanger, and Mary Breckenridge provide a legacy for improving patient access and quality in health care. Nursing has readily embraced this foundation, developing nurse-run clinics, advanced practice models of care, and preventative education. For the current profession of nursing, the publication of To Err is Human brought to light new needs for standards and methods of patient care.

For nurses, frequently the first and last health care professionals to interact with patients in any health care setting, being the crucial link to patient safety has long been a focus of care, making our ability to clearly communicate and translate science crucial to patient safety. As health care cost, technology, complexity, and revenue have expanded, the need for examination of errors and safety were readily embraced by nursing and pushed to the forefront of nursing organizations like the American Nurses Association, where initiatives such as the Safe Staffing Save Lives campaign have served to protect patients from medical errors (

The examination of preventable deaths and health care errors at the bedside and beyond, has found a close companion in nursing. Since the To Err publication, nursing has expanded educational and practice activities. Nurses now develop and head workplace safety through occupational health programs such as the graduate program at the University of California at San Francisco ( Nurse-run pediatric helmet and seatbelt programs help save lives through community safety programs such as Safe Kids USA. Likewise, nurses are actively engaged in developing new models to prevent medication errors such as the ‘Good Catch’ model or collaborative professional teams that evaluate medication interactions in home health patients (Aston & Young, 2009; Frey & Rahman, 2003).

Nurses influence patient safety throughout all aspects of the nursing process, assessment, planning, implementation of care, and continuous evaluation. Nurses have been essential in the evolution of patient safety and continue to work on researching, translating, and implementing patient safety initiatives. However, challenges still remain.

With an aging population that has expanding health care needs, an aging and dwindling nursing workforce, and less insurance coverage of preventive education, the safety of patients is in jeopardy. Nurses will need to expand their knowledge base even more to include; being well versed in health policy, understanding epidemiology, evidenced based practice, use of communication and technology, and accountability for our performance and autonomous practice. Nurses will need to work with state and federal agencies, as well as with other health care disciplines, to prevent further development of these patient safety risks. This multidisciplinary model of patient care and safety cannot be emphasized enough in matters of patient safety. Likewise, schools of nursing need to be preparing future nurses to be well versed in two-way communication, translation of science to practice, and multidisciplinary problem solving models. Nursing accounts for more than half of the health care workforce and is based in primary practice areas of holistic care and patient education, making nurses well equipped to meet the upcoming challenges and to continue with a legacy of improved access, quality, and care.

Anston, E. & Young, T. (2009). Enhancing the reporting of “near miss” events in a children’s emergency department. Clinical Nurses Forum; 35(5), 451-452.

Frey, D. & Rahman, A. (2003). Medication management: an evidence-based model that decreases adverse events. Home Healthcare Nurse; 21(6), 404-412.

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