Nursing Role in Patient Safety The nursing workforce is the biggest workforce in the health care industry. The nursing staff in hospitals is primarily tasked with patient surveillance in both ambulatory settings and care facilities (seldom termed as patient monitoring / evaluation / assessment). Patient surveillance is important for recognition of errors and evading adverse incidents. Most patient safety experts believe in cultivating an impartial system which acknowledges a system's and individual contribution to both adverse incidents and successful efforts, facilitating decreased errors. This notion is mentioned in To Err is Human, which states that prevention of error and augmenting patient's safety is cultivated when a system is developed for individual approach which will target altering the conditions of a system giving rise to errors. Since nurses are biggest workforce of healthcare industry, and largely engaged with detection, commission and evasion of such errors and accidents, they and their environment are key factors in relation to patient safety (U.S.), (2004).

Hence, in this paper we will try to highlight some of the issues that are currently major causes of concern within the nursing industry. This particular approach will help us identify some of the human aspects and flaws that exist within the system and then address these issues from the core. Patient care and safety is defined as the provision of an appropriate and ethical standard of medical care given to a patient whereby his medical concerns are aptly tackled and eradicated at the end and no other medical concerns arise due to carelessness or mistakes made. This is an extremely important issue for nursing as nurses as those medical care providers that have the most interaction with patients and know most about them; hence if nurses play their part right, the entire standard of patient care and safety improves. For this reason, the paper tackles the main issues by dividing them into aspects of historical, social/cultural, political, and ethical and barriers. The primary concern for all nurses is patient safety. In this paper we highlight why patient safety is important and the contribution or role of the nurses in its provision. The paper then moves onto the social and cultural aspects or shortcomings in the nursing industry and highlights that communication is one of the key determinants of appropriate patient care and when communication deteriorates, patient safety is compromised. Accurate reporting is recognized as another important facet of high standard patient care and safety and the role of nurses in accurate reporting is identified under the political concerns with current nursing structures. The combining of human and system errors -- and the effect that they have thereof on the reporting of the errors -- is recognized as a major ethical concern in patient care and safety. Furthermore, the paper also discusses the role of Registered Nurses (RN) in the current structure as well as the overall positive effect that they have on the provision of appropriate patient care and safety. The paper thus ends with a recognition of a further need to investigate the incorporation of technological advancements within the field of medicine and its impact on nursing in the short and long run.

Historical analysis

The safety of patients is one of the most key issues faced by healthcare, hence nurses are the primary professionals who need to detect errors and evade any possible harm on the patients. It's not just the job description of the nurses to provide patient care but their code of ethics dictates them to facilitate 'safe, competent and ethical care'. Patient safety is the top priority of the nursing department and is of valuable concern to nurses working within the community, acute care hospitals and long-term care facilities. Its of major importance in all fields of practice such as education, clinical practice, research and management / leadership positions. Agency for Healthcare Research and Quality (AHRQ) is leading a nationwide effort to curb medical errors and increase patient's safety. AHRQ has founded a research and demonstration program in order to finance research in determining sources of medical errors and create models to cut down the frequency of errors, encouraging impartial reporting, review, corrective action and lessening paperwork. But regardless, changes are important in case of accreditation, regulation, payment, policy and other such aspects which impacts healthcare delivery (Canadian Nurses Association & University of Toronto Faculty of Nursing, 2004).

Social and cultural analysis

Communication amongst health personnel is another problem which hinders patient safety. An alert from 2008 The Joint Commission (TJC) informed about rude communication between healthcare professionals being counterproductive to patient safety. The alert stated that inappropriate and unruly behavior...

Teamwork, collaboration and communication are the basis of safety and quality patient care. In order to guarantee a culture of safe practice and quality care, health care firms should deal with the behavior issue of professionals in a healthcare facility (Cherry & Jacob, 2014). The adoption of human factors approach in case of patient safety has resulted in reduction of errors in health care facilities that are liable to adverse incidents for instance the Aviation industry. It puts emphasis on relationships, tools they employ and work settings. For instance, a drug dispensing machine will be invented so medications can be given without requiring human help; in this case, the nurse's memory.
Political analysis

In order to contribute further in patient safety efforts, nurses think that their opinion must be taken in consideration, nursing management should listen to issues and information on patient safety issues in case of nursing are required. Certain nurses believe that their information might become counterproductive and hence they hesitate to reveal critical information regarding practices and patients. During years of restructuring, clinical nurse specialist, nurse manager and nurse educator positions were cut down while most chief nursing officer's positions were shut down. Due to this, most nurses weren't present in the decision making process within the healthcare facility since their leaders weren't in the management system. In case of chief nursing officers, they were branched out to different departments, nurse managers were allotted more nursing units. Hence they counter the threats which arise to patient safety in a healthcare environment (Canadian Nurses Association & University of Toronto Faculty of Nursing, 2004).

At present, data on nurse's contribution to safety of a patient and their perspective has been largely restricted due to numerous factors. The present databases take in consideration certain variables relevant to nursing and the available data from reporting isn't trustworthy. The problem arises where the definition of patient safety is conflicted. The problems start with databases and definitions on nursing and conclude at lack of solid approach to detect and track errors in any given healthcare system. It's highly recommended that lessons learnt from accidents will work hand in hand with quality care and safety of a patient rather than taking in consideration individual adverse incidents. Literature is expanding observing the patient safety outcomes which look at nurses' actions closely. The outcomes included are patient falls, medication mistakes, pressure sores and infections acquired in hospitals (White & McGillis, 2001). Continuous work in this segment will initiate an overall competitive work environment signifying patient safety issues (Canadian Nurses Association & University of Toronto Faculty of Nursing, 2004).

Nurses along with other healthcare personnel agree on the fact that teamwork and collaborating increase a patient's safety. But, in most cases, there are a lot of aspects which hinder the productive work environment. There are periods of communication breakdown detected, for instance shift rotation and transfer of patient from one ward to another (Cook et al., 2000). The nursing research and nurses are both concerned about poor communication which affects the patients. Poor decisions and communication can result in wrong evaluation of a patient, an error in judgment and diagnosis as well as insufficient patient monitoring.

Ethical analysis

For increasing patient's safety, the healthcare professionals need to conduct reporting of errors in an honest fashion. Many aspects are taken in consideration while including errors in nursing reports. Nurses have to undergo a culture of blame which occurs during investigations of adverse incidents. When error responsibility is consigned to a nurse, then honesty and openness about errors are usually not encouraged. It is the right of a patient to know about an adverse incident occurring during their care and get relevant treatment to alleviate the issue. Hence, healthcare organizations need to reinstate disclosure policies for ethical clinical practice and raise the bar of patient's safety. Nurses are mostly hesitant to talk about errors and accidents in case, the information will be used against them, especially in a court of law. In nursing history somewhere making errors and mistakes became punishable in order to guarantee proper healthcare, hence blame and punishment was initiated. The aim was to penalize the perpetrator, but the culture shifted to blame and punishment (Canadian Nurses Association & University of Toronto Faculty of Nursing, 2004).…