Keeping Patients Safe : Transforming the Work Environment of Nurses

Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform — monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis — provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care — and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety. Table of ContentsFront MatterExecutive Summary1 Nursing: Inseparably Linked to Patient Safety2 A Framework for Building Patient Safety Defenses into Nurses' Work Environments3 Nurses Caring for Patients: Who They Are, Where They Work, and What They Do4 Transformational Leadership and Evidence-Based Management5 Maximizing Workforce Capability6 Work and Workspace Design to Prevent and Mitigate Errors7 Creating and Sustaining a Culture of Safety8 Implementation Considerations and Needed ResearchAppendix A: Committee Membership and Study ApproachAppendix B: Interdisciplinary Collaboration, Team Functioning, and Patient SafetyAppendix C: Work Hour Regulation in Safety-Sensitive IndustriesIndex