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 […]

2018-03-13T07:59:37-04:00March 13th, 2018|Nursing|0 Comments
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The 1918 Influenza Epidemic’s Long Reach in Time

“It would be impossible to relate all the sad and terrible scenes . . . all night long . . . witnessing death scenes, seeing weeping relatives and trying to take care of emergencies . . . “

A mother’s death remembered.

Litter carriers at Red Cross Emergency Ambulance Station in Washington, D.C., during influenza pandemic of 1918.

When my grandfather was six years old, his mother went to sleep one night and never woke up. She was one of the nearly 700,000 Americans who died during the 1918–1919 influenza pandemic, which killed an estimated 50 million people worldwide. The rest of her young family—my grandfather and his twin brother, their seven-year-old sister, and my great-grandfather—survived. The shock of losing his mother so suddenly was still evident when my grandfather talked about her 70 years later. She was 29 years old and healthy, and then she was gone.

High mortality, even among healthy young adults.

My family was not alone as it mourned. The CDC estimates that one-third of the world’s population was infected by what’s become known as the “Spanish flu.” (The origin of this name is unclear: some sources suggest it’s due to a misunderstanding about […]

2018-03-07T09:08:45-05:00March 7th, 2018|infectious diseases, Nursing, Public health|1 Comment
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Strong Nursing Management Empowers the Why

“Our managers are effective leaders because they care for us, which empowers us to care for others, and for this we are indescribably grateful.”

I recently had the opportunity to speak at the American Association of Critical-Care Nurses (AACN) UCLA Chapter 2018 Leadership Symposium, which centered around AACN’s current theme, “Guided by Why.” Along with AACN president Christine Schulman, other nurses and I explored the importance of staying connected to our “Why” in the midst of considerable challenges in and to our profession.

I found myself considering not only my original answer to “Why do I want to become a nurse?” but also “Why do I stay in nursing?” I found that a significant part of my answer to the second question has to do with the managers I am privileged to work under. It is their strong management that continually fuels my underlying “Why.”

Genuine care for staff well-being.

Our managers demonstrate to us time and again that they see and value us as people, not just cogs in a wheel that needs to keep turning at all costs.

Self-scheduling allows for flexibility. In our unit, we have self-scheduling: all nurses determine their own shifts, so long as every shift is staffed with the minimum required number of nurses and everyone […]

2018-03-05T08:23:27-05:00March 5th, 2018|Nursing, nursing career|1 Comment
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Is It Time to Relax Food Restrictions on Women in Labor?

Three years ago, I went into labor in the middle of the night, 10 days before my expected due date. Things ramped up fast, and by the time I got to the hospital an hour later, I was almost ready to have the baby. However, when my son’s heart rate suddenly dropped and wouldn’t recover with medication, I was told I had to have an emergency C-section immediately.

As I hadn’t planned on surgery, or labor, that night, I had eaten a full three-course meal earlier in the evening. The nurses asked me if I had eaten, and I had to admit yes, and then some! I did feel nauseous as the procedure began, but luckily the wonderful anesthesiologist quickly helped, when I told him how I felt, with some miracle medication in my IV. The surgery proceeded without incident.

Nil by mouth? New research questions a tradition.

It was with interest, then, that I read AJN’s March original research CE feature, “An Investigation into the Safety of Oral Intake During Labor.” In this article, the authors compared maternal and neonatal outcomes among laboring women permitted ad lib oral intake with those permitted nothing by mouth except for ice chips. Restriction of oral intake in laboring women has traditionally been, as AJN’s editor-in-chief […]

2018-03-02T08:27:46-05:00March 2nd, 2018|nursing research, patient experience|1 Comment
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Late in a High Anxiety Season, Some Flu and Vaccine Basics

After what has seemed like constant media scrutiny for months, influenza hasn’t been in the news as often in recent days. Still, CDC data indicate that flu activity remains “widespread” across the country, so it’s still too early to eliminate flu from your list of “differential diagnoses,” at work or at home.

Maybe it’s the general state of our national psyche, but this year the “flu” seems to have caused more than its usual share of anxiety. This is not a pandemic; there are no brand-new strains of flu in circulation to which no one is immune. But the H3N2 strain that has been predominant this year does tend to lead to a harsher-than-usual season. (The 2014-2015 season was also severe, but the public heard relatively little about it because media were focused on the Ebola outbreak.)

Influenza surveillance basics.

How do we know how bad a flu season really is? Since the 1997–1998 flu season, lab data and clinical reporting have facilitated real-time flu surveillance in the U.S. Public health laboratories in every state, in collaboration with National Respiratory and Enteric Virus Surveillance System laboratories, track the types (A or B) and subtypes (H3N2, H1N1, etc.) of flu in circulation.

To complement these data, the U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) tracks the percentage of […]

2018-02-28T12:20:28-05:00February 28th, 2018|infectious diseases, Nursing, Public health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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