Establishing a safe environment
According to a report released by the National Academies of Sciences, Engineering, and Medicine, 44,000 to 98,000 people die every year as a result of a medical error. The number of deaths caused by medical errors is ranked 8th, followed by Acquired Immune Deficiency Syndrome (AIDS), breast cancer, and traffic accidents. The most frequent problems threatening patient safety are diagnosis errors, medication errors, hospital infections, bedsores, complications during and after surgery, errors induced by breakdown of equipments, falls, and ventilator-related errors.
The facilities of the health care system can also pose serious risks in terms of medical errors which can be threatening to patient safety. For example, in the ICU where patients are in serious condition requiring constant monitoring and many advanced technological life-saving equipment is used, it's more common for patients to face a life-threatening error during hospitalization.
Nurses working in ICUs have a crucial role in establishing a safe and qualified care environment. ICU nurses are the personnel who give constant care, apply complicated medications, use various technological equipments, and provide advanced life support. For this reason, nurses have a responsibility to adopt, defend, and have a critical perspective on the issue of patient safety.
Safety event reporting plays an important role in safety management. Managers find strategies to prevent safety events from occurring by analyzing reported events. When an event threatens patient safety, nurses have an ethical obligation to report and disclose it. To improve error reporting, better understandings of nurses’ behaviors, reporting barriers, and possible ways to increase reporting are necessary.
Nurses are shown to be more likely than other health care providers to report safety incidents and are more likely to take primary responsibility for error reporting in organizations through interprofessional training, according to the Journal of Nursing Care Quality. They prefer to share events with a nurse manager through informal processes. Nurse managers play key roles during the safety event reporting procedure. The managers’ awareness and attitude toward incident reporting directly influenced the reporting practices of their staff. Therefore, it is important to improve the nurse managers’ attitudes regarding safety event reporting.
Nurses who perceived more supervisor or manager expectations, feedback and communications about errors, teamwork across hospital units, and hospital handoffs and transitions had more frequency of events reported and a better overall perception of patient safety. Furthermore, nurses who had more years of experience and were working in teaching hospitals had more awareness of patient safety.
Implications for nursing policy
Continuing education, hospital management support, supervisor/manager expectations, communication about errors, and teamwork are all found to be major patient safety culture predictors. Investing in practices and systems that focus on improving these aspects is likely to enhance the culture of patient safety in hospitals.
Strategies to nurture patient safety culture in hospitals should focus upon building leadership capacity that support open communication, blame-free culture, team work, and continuous organizational learning.
Through more frequent in-service trainings, patient safety awareness should be raised and nurse training should be kept up-to-date.
How does your organization cultivate a culture of safety? Leave us a comment.
Using evidence to support safety
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