Category: Safe Staffing

Extended length of stay and overcrowding in emergency departments are described internationally as one of the most comprehensive challenges of modern emergency care. An emergency department is not designed, equipped or staffed to provide care for prolonged periods of time. This context, combined with a high workload, poses a risk to patient safety, with additional medical errors and an increased number of adverse events.

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Critical reports from the Institute of Medicine in 1999 and Francis QC report of 2013 indicate that healthcare organisations, inclusive of nursing leadership, were remiss or inconsistent in fostering a culture of safety. As nurses have the highest patient interaction, and leadership is discernible at all levels of nursing, nurse leaders are the nexus to influencing organisational culture towards safer practices. A culture of safety has been exposed as a major influence on patient safety practices, heavily influenced by leadership behaviours. The relationship between leadership and safety plays a pivotal role in creating positive safety outcomes for patient care.

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The article reports on a guidance that has been published for five healthcare settings in Great Britain that covers learning disability, mental health and district nursing services, along with adult inpatient acute care and draft guidance on children and young people’s services.

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The article reports on a law requiring provision of sufficient numbers of nurses in medical and surgical wards that will take effect in Wales. Topics discussed include the Nurse Staffing Levels (Wales) Act that places responsibility on health boards to calculate and provide sufficient numbers of nurses to care sensitively for patients and the need for careful review of whether other wards and services are drained of staff.

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Patient-visitor violence (PVV) committed against nurses is a worldwide problem. Registered nurses in emergency departments (EDs) are particularly susceptible. The frequency and severity of PVV against emergency nurses (ENs) internationally is well documented. Little is known about factors that make ENs feel safe from PVV.

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A summarization of the evidence on the associations between nurse education and experience and the occurrence of mortality and adverse events in acute care hospitals, and benefits to patients and organizations of the recent Institute of Medicine’s recommendation that 80% of registered nurses should be educated at the baccalaureate degree by 2020. Overall, higher levels of education were associated with lower risks of failure to rescue and mortality in 75% and 61.1% of the reviewed studies pertaining to these adverse events, respectively.

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This review explored peer-reviewed publications that measure nurses’ preparedness for disaster response. The increasing frequency of disasters worldwide necessitates nurses to adequately prepare to respond to disasters to mitigate the negative consequences of the event on the affected population. Despite growing initiatives to prepare nurses for any disasters, evidence suggests they are under prepared for disaster response.

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This study suggests that hospitals should develop a standardized handoff checklist according to documented guidelines, promote cooperation among hospital units and departments, enhance communication, and clarify work processes to achieve safer care to create an affirmative culture that encourages reporting of errors to keep patients safe.

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Staff training effectively improves adherence to lung-protective ventilation strategies. Both interventions, which futures studies could deploy in combination, promise to improve the precision of mechanical ventilation.

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