Brief updates state of nursing and patient safety

A new brief from the Robert Wood Johnson Foundation (RWJF) follows up on an Institute of Medicine patient safety report and recommendations on how hospitals could change to reduce errors.

The initial recommendations constituted a transformation of nurses' work environment. Keeping Patients Safe: Transforming the Work Environment of Nurses found that hospitals and other healthcare organizations did a poor job of managing the high-risk nature of the healthcare enterprise. “The typical work environment of nurses is characterized by many serious threats to patient safety,” according to the report.

The new brief, Ten Years After Keeping Patients Safe: Have Nurses’ Work Environments Been Transformed?, details a series of programs designed by and for nurses that have “spurred the creation of work environments that foster healthcare quality and patient safety.”

“We’ve made important gains in the past decade, but we have a lot more work to do,” said RWJF Senior Program Officer Maryjoan D. Ladden, PhD, RN. “Some of the changes needed are systemic, and will require collaboration among nurses, doctors, educators, policymakers, patients and others. But nurses also have a critical responsibility to transform their individual workplaces, asserting leadership at the unit level and beyond to help identify and solve problems that affect patient safety.”

Government agencies, professional associations, the public service sector and credentialing organizations all have worked to advance patient safety and transform nurses’ work environments, according to the brief. The paper also includes an “emerging blueprint for change” that urges providers, policymakers and educators to follow through on the following:

• Monitoring nurse staffing and ensuring that all healthcare settings are adequately staffed with appropriately educated, licensed, and certified personnel;
• Creating institutional cultures that foster professionalism and curb disruptions;
• Harnessing nurse leadership at all levels of administration and governance; and
• Educating the current and future workforce to work in teams and communicate better across the health professions.