When Nurses Are Safe in the Workplace, Patients Will Also Be Safe

Safe Environment -- Patient Outcomes

What are the best practices that nurses and nursing leaders can implement to assure safe working conditions and high quality patient care? This paper delves into those issues using the available literature -- scholarly articles -- as guiding references to reach an understanding of how to assure safe working conditions for nurses and patients.

Required time and staffing for safe and effective patient care

According to author Kathy Malloch, the task of creating safe practices for nursing staff "…continues to be illusive for nurse leaders" (Malloch, 2015). The problem is that discovering the amount of time needed in order for a nurse to provide proper patient care is still a work in progress; measuring that needed time is not in the "mature stage" yet, according to Malloch. As of the publishing of this article in Nursing Economics (2015), there was as yet no "gold standard patient classification system" (PCS) in existence.

But Malloch offers a look at what she considers the four obstacles to achieving that "gold standard" patient classification system; this would be a system that can help nurses improve the delivery of quality health care in a safe environment. The first obstacle Malloch sees relates to the "quantification of nurse work, costs, and patient outcomes"; these are difficult areas of nursing to document (Malloch). However these hurdles can be overcome through the use of digital patient care needs; automated systems make the "complexity of healthcare systems more manageable" (Malloch). It appears to be just a matter of hospitals and clinics investing in these technologies -- then manual documentation will be a thing of the past.

The second obstacle that Malloch sees is that traditional motion and time measurements are limited in their scope and not as accurate as they should be. Too many strategies in the past have focused on the simple economics of "…matching demand with supply" and have given short shrift to the "multifaceted nature of patient care" (Malloch). Malloch's third obstacle is what she calls "conceptual blurring"; for example patient care needs and the actual intervention by the nurse are sometimes considered "one concept" rather than the two "distinct concepts" that are actually involved. Checking for hypertension is the issue and measuring the blood pressure is the intervention; hence, these are two concepts, not one, as some measurements would view this procedure.

And the fourth obstacle to a patient classification system is the fact that "…much of nursing is relational" and it requires "critical thinking" along with the need to crunch data, and this is difficult to measure. That said, Malloch believes that because digital technology continues to evolve in the healthcare field, in time data will be available for nurses to "associate the interventions and labor costs with patient outcomes"; this in turn will offer essential guidance and clarity, leading to a "safe patient care environment" (Malloch).

Nurses' safety is as important as patient safety

Another article in the peer-reviewed journal Nursing Economics reports that about 12% of nurses leave the field because of injuries to their backs. Of those who stay, 52% complain of "chronic back pain and injuries" (Hunter, et al., 2010). And while a culture of safety for patients is what Hunter calls "a win-win for nurses and patients," that culture of safety also means realizing that "what is good for nurses is also good for patients" (Hunter).