Patient Safety in nursing is about preventing patient harm. Nurses play the role of patient Advocate, Educator, and End- Users to implement the organizational protocol and to promote patient safety. Also, it is essential to incorporate patient safety into nursing practice to facilitate positive outcomes.
The principles of patient safety are based on Just Culture which promotes professional accountability and high reliability. For example, nurses obtain appropriate training to provide safe care to their patients. The Joint Commission publishes national patient safety goals to promote patient safety culture in the healthcare industry. Thus, healthcare leaders can develop safety initiatives to improve patient outcomes.
Healthcare Regulations In Patient Safety
The Joint Commission develops the National Patient Safety Goals – NPSG according to healthcare trends identified during the compliance surveys. The federal government establishes regulations to protect patients while under the care of healthcare professionals. For instance, CMS regulates the practice of private healthcare organizations and state facilities.
The government funds quality initiatives programs and supports agencies that prioritize patient safety culture. Besides, the Agency for Health Research and Quality-AHRQ is a government agency that promotes patient safety programs across the United States. Healthcare professionals should receive training about patient safety culture. Thus, many activities will promote patient safety in nursing.
Patient Safety Culture In The Healthcare Industry
The clinical documentation audits, training simulation, walking rounds, performance improvement projects are examples of patient safety initiatives. When healthcare organizations develop a patient safety program, it validates their commitment to preventing patient harm and adverse outcomes. Therefore, their engagement validates the importance of patient safety in nursing.
Patient safety can affect patient outcomes. Nurses obtain knowledge in school to provide safe care to their patients. It can be challenging for nurses to manage multiple patients’ tasks while promoting safe care. Thus, healthcare organizations should support adequate nurse staffing to promote safe nursing care.
Nurses Role as Advocate In Patient Safety
Nurses are responsible to coordinate patient care in collaboration with multidisciplinary team members. Therefore, it is vital for nurses to communicate clinical assessment findings and changes in patient status to the primary team. Nurses also advocate for patient safety during team meetings.
Nurse Advocate: In this role, nurses collaborate with team members to discuss the safest treatment plan for the patients. Thus, nurses review the patients’ plan of care and identify safety concerns to discuss with team members. For example, nurses maintain effective communication with team members and patients to facilitate positive outcomes.
As a patient advocate, nurses maintain transparency and professionalism during the delivery of care. Nurses use clinical knowledge and training to identify preventable errors and avoid patient harm. Therefore, the role of nurses in patient safety culture can prevent adverse patient outcomes.
The Role Of Nurses As Educator In Patient Safety
Some healthcare institutions standardize team rounds to prevent medical errors associated with communication issues. For instance, nurses and providers can validate current orders and treatment plans. Nurses can also discuss the patients’ needs with discharge planning.
Nurses should understand that patients rely on nursing expertise to promote health and wellness. Besides, patients tend to comply with care when they are active participants in their plan of care. The involvement of nurses in patient care rounds will promote safer outcomes.
Nurse Educator: The nursing staff also have the ability to empower patients to make better decisions about their health. Thus, nurses play a vital role in promoting patient safety. The transparency in the patients’ care validates engagement in a culture of safety.
Nurses receive advanced education in disease management so that they can guide patients with decision making. Besides, nurses assume the role of clinical educators in different healthcare settings. Some nurses also develop training objectives to disseminate clinical information to their peers.
Nurses Play The Role Of End-Users In Patient Safety
It is evident that nurses spend a significant amount of time at the patients’ bedside. Thus, they are the End-Users in their organizations who often implement safety initiatives. They receive training and have access to resources to implement safe patient care.
Patient Safety Initiatives As End-Users
Falls Prevention: Healthcare organizations should adopt strategies to prevent patients’ falls while under the care of healthcare professionals. CMS does not reimburse for conditions or harmful events that occur in healthcare facilities. Nurses should assess all patients for fall risks and implement a falls prevention bundle to maintain patient safety.
Pressure Injury Prevention: Nurses play a vital role in preventing harm associated with pressure injury or pressure sores. For instance, nurses identify patients at risk for pressure injury on admission. A preventive measure bundle should be activated for all at-risk patients.
The bundle should include a turning schedule, skincare, patient hygiene, protection of pressure points, nutrition, and mobility initiatives. Nursing leadership should adopt quality control strategies to monitor compliance with the pressure injury prevention bundle.
Nurses Role In National Patient Safety Goals
Prevent Medication Errors: It is an NPSG – to use medicines safely. Nurses should follow their facilities’ policies during medication administration to prevent medication errors. For example, nurses should identify patients correctly, follow the 10 medication Rights during medication review, and educate all patients about the side effects of each medication and expected outcomes.
Prevent Infection: All healthcare organizations should establish guidelines to protect patients from hospital-acquired infections. For example, hand hygiene campaigns, central line care bundle, peripheral lines and drains care, invasive devices ( urinary catheters, suprapubic catheters, ET tubes, and others). Nurses should follow their facilities’ infection prevention bundle to eliminate preventable injuries.
Prevent Nursing Burnout: This is a Patient Safety Concern because staff wellbeing affects patient care. Healthcare facilities should adopt safe staffing to promote positive patient outcomes.
Implications For Nurses
Organizations that adopt a safety culture also value staff development and professional accountability. Thus, nurses will benefit from patient safety training. Additional nursing training will promote professional accountability and reinforce clinical knowledge.
Nurses play a vital role in patient safety culture and should advocate for patient safety. It is beneficial for nurses to participate in patient safety activities. For example, they should obtain evidence-based knowledge to promote safe delivery of care.
Electronic barcoding during medication administration is a patient safety initiative that most organizations implemented to prevent medication errors. Besides, nursing leadership monitors nursing compliance with medication scanning. When nurses comply with medication scanning, they are promoting safe medication administration.
Adaptation To Technology
Medication scanning enables nurses to identify incorrect medication, incorrect patient, incorrect dose, expiration date, incorrect time and additional features. Thus, the scanning system is able to display safety alerts on high-risk medications that require a second nurse verification or special handling. As End-Users, nurses will be able to give feedback to leadership about system failures and make recommendations for improvement.
Nurses should strive to participate in different patient safety initiatives because they spend more time with the patients in comparison with other disciplines. Nursing leadership also expects nurses to adapt to technological innovation to improve patient delivery of care.
Follow Standards Operating Policies
Another aspect of patient safety is the standards of care. This measure involves the standardization of every process. Nursing leadership establishes step by step instructions to guide nursing staff during the implementation phase. Nurses will follow the clinical standards during nursing care to prevent errors and harm to patients.
When leadership develops standards, the process becomes consistent for staff to follow. Thus, nurses will be able to prevent errors when they implement policies for guidance during patient care. Therefore, the role of nurses in patient safety is significant.
Safe patient care can prevent harmful events. As a nurse, I worked in a busy medical-surgical ward and the workload was stressful and heavy. Thus, the patient turnover was high along with acuity. The nursing unit was full most of the time, and the nursing staff often reported burnout.
Despite the unit workload, I was responsible for monitoring all my patients and for participating in team meetings. I remember that the unit was short staff in most days. Therefore, the nurses often voiced frustrations and often call out to recover from the physical burden of the work.
It is evident that nurses play a vital role in patient safety. They provide direct care to patients and can successfully identify patient care issues to address with nursing leadership and team members. Nurses play the role of advocate, educator, and end-users in patient safety culture.
Professional behaviors affect patient safety. Therefore, healthcare organizations rely on nurses’ professional accountability to promote compliance with patient safety activities. Also, many organizations adopted the principle of just culture to maximize positive patient outcomes.
When leadership allocates appropriate resources to support nurses, the nursing staff will successfully fulfill the safety culture of the organization. Thus, nurses will comply with initiatives when they have access to supplies and resources. Nurses are essential team members who often implement patient safety projects. Therefore, leadership values their opinions and clinical observations.
Nurse Sophie has been a registered nurse for over a decade. I have a Master's degree in nursing, and my clinical experiences include staff nurse, clinical nurse supervisor, and manager, and most recently, nurse consultant in Patient Safety and legal nursing. I was always passionate about system operations and practice standards.
I have completed over 2000 hours of medical chart reviews. I am an expert in clinical investigations, and I also develop event timelines. I can assist the legal team with the Discovery process: Deposition, Interrogatories questionnaire, event timelines, locate expert witnesses, and more. I provide and formulate clinical opinions based on the investigative summary.
Nurse Sophie, MSN, RN, LNC
Legal Nurse Consultant
Patient Safety Specialist
Email: [email protected]