Institute of Medicine Archives

Patient Safety: The Basis for Nursing

Making patients safe is where nursing begins.

by Lars Plougmann/via Flickr

It doesn’t matter how or where a nurse may practice—acute care, long-term care, home health, school nursing—making sure patients are safe is where nursing begins.

In 1999, the famed Institute of Medicine (now the National Academies of Science, Engineering and Medicine) report, To Err is Human: Building a Safer Health System, woke us up to the fact that medical errors were causing thousands of deaths annually in the very places where people go to restore their health. In 2004, another report, Keeping Patients Safe: Transforming the Work Environment of Nurses, detailed nursing’s critical role in health care delivery, particularly in ensuring patient safety.

We can always do better.

While there have been significant improvements in reducing adverse events, and nurses are leading many quality improvement initiatives, we can always do better. In May 2016, I wrote the following in an editorial (“A Culture of Safety Stars With Us“):

“Nurses have always been the sentinels, the around-the-clock watchers, detecting the changes that might herald a patient’s deterioration. Nurses are the ones that the system looks to—and often blames—when there’s a failure to rescue.”

This is still true.

This week marks an emphasis on patient safety—it’s what we do every day. In honor of the week, we’ve made the following […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-03-13T07:59:37-04:00March 13th, 2018|Nursing|0 Comments

Interprofessional Collaboration and Education: Making an Ideal a Reality

Photo courtesty of Penn Medicine.

We hear a lot about interprofessional collaboration, the potentially dynamic and enlightening process of sharing knowledge across disciplines to improve patient care, but what’s being done to make this a reality?

The promotion of interprofessional collaboration is one focus of an ongoing national initiative by the Future of Nursing: Campaign for Action, as described in “Interprofessional Collaboration and Education,” an article in the March issue of AJN.

To close the gap between policy bullet points and the reality of daily work for nurses is neither impossible nor inevitable; it depends on smaller coalitions and the engagement of multiple organizations—but also, one imagines, a willingness to engage in inquiry and to try new and imperfect processes at the local level that may need refinement over time. The article is free, but here are a couple of paragraphs that give an a good overview of why it matters and where we are:

Interprofessional collaboration is based on the premise that when providers and patients communicate and consider each other’s unique perspective, they can better address the multiple factors that influence the health of individuals, families, and communities. No one provider can do all of this alone.

However, shifting the culture of health care away from the “silo” system, in which […]

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Jacob Molyneux, senior editor/blog editor2016-11-21T13:02:49-05:00March 25th, 2015|career, Nursing, nursing perspective, Patients|0 Comments

Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the U.S.: An IOM Report

[youtube=http://www.youtube.com/watch?v=CKh78vXIfis&w=640&h=360]
By Natalie McClain, PhD, RN, CPNP, clinical associate professor, William F. Connell School of Nursing, Boston College, and Barbara Guthrie, PhD, RN, FAAN, Independence Foundation Professor of Nursing, Yale University School of Nursing. The above educational video was created by the Institute of Medicine and is available on YouTube.

Each day in the United States, minors experience abuse and violence that is overlooked and unidentified. In some cases, recognition of the abuse makes these minors subject to arrest rather than assistance and care. These children and adolescents are the victims and survivors of commercial sexual exploitation and sex trafficking. A recent report from the Institute of Medicine (IOM) and the National Research Council sheds light on this serious domestic problem and underscores the critical role that nurses must play in preventing, identifying, and responding to these crimes.

Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States is the culmination of a two-year study conducted by an independent panel of experts appointed by the National Academies of Science and funded by the Department of Justice’s Office of Juvenile Justice and Delinquency Prevention. The report states that commercial sexual exploitation and sex trafficking of minors are acts of abuse and violence against children and adolescents. However, the response to these victims is often starkly different from that experienced by other victims of child abuse and neglect. In most states, for example, underage victims of commercial sexual exploitation and sex trafficking can be arrested and prosecuted.

Long-term […]

Jacob Molyneux, senior editor/blog editor2016-11-21T13:05:56-05:00December 2nd, 2013|nursing perspective|0 Comments

AJN’s March Issue: CVD Prevention in Women, Hand Hygiene, Sexuality in Nursing Homes, More

AJN’s March issue is now available on our Web site. Here’s a selection of what not to miss.

Recent surveys show that women continue to underestimate their true risk of cardiovascular disease (CVD). This prompted the American Heart Association (AHA) to update its guidelines for preventing CVD in women. To make sure you’re up to date on the latest information, read “Update on Cardiovascular Disease Prevention in Women.”

This article is open access and can earn you 2.3 continuing education (CE) credits. (The cover image to the right, a lithograph from 1830, is called A Map of the Open Country of a Woman’s Heart. For more about it, read this month’s “On the Cover.”)

Although hand hygiene is considered to be the most effective way of preventing health care–associated infections, not all health care workers adhere to the guidelines. The month’s original research article presents findings from an interventional study that showed how the introduction of gel sanitizer and informational posters improved hand hygiene at two outpatient clinics. This article is open access and can earn you 2.1 CE credits. A podcast with the author is available on our Web site, and we also feature a 1932 article on hand hygiene in our department, From the AJN Archives.

Although nurses may think of sexuality as more likely to preoccupy the young, our Sexually Speaking article, “Sexuality in Nursing Care Facilities,” points out that nursing home residents have the […]

Amy M. Collins, managing editor2016-11-21T13:08:12-05:00March 1st, 2013|nursing perspective|0 Comments

What’s So Hard to Understand: Patient Safety, Quality Care Linked to Nurse Staffing

The evidence linking nurse staffing and patient safety is strong.

The data linking nurse staffing as well as shift length with patient outcomes and satisfaction with care continue to roll in. The latest report on nurse staffing, published in the January 13 issue of Medical Care by McHugh and MA, links higher nurse–patient ratios and good work environments to reduced 30-day readmission rates. Read the abstract here.

Most nurses seem to support better nurse–patient ratios, but there’s continuing ambivalence about reducing shift length, as seen in the comments we received on a recent blog post asking whether it’s time to retire the 12-hour nursing shift.

In August, researchers reported a link between nurse staffing and hospital-acquired infections. Publishing in the American Journal of Infection Control, the authors noted a “significant association” between nurse–patient staffing ratios and both urinary tract infections and surgical site infections. Further, they noted that reducing nurse burnout was associated with fewer infections. (Read our news report on the study here.)

Health Affairs published a report in November called “The Longer the Shifts for Hospital Nurses, The Higher the Levels of Burnout and Patient Dissatisfaction.” The findings were there, loud and clear—researchers Stimpfel, Sloane, and Aiken found that “extended shifts undermine nurses’ well-being, may result in expensive turnover and can negatively affect patient care.”

And […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-03-13T10:41:13-04:00January 29th, 2013|nursing perspective, nursing research|20 Comments