Patient Safety Is a Nurse’s Top Priority

Patient Safety Is a Nurse’s Top Priority

Nurses put a priority on keeping their patients safe and Patient Safety Awareness Week, which takes place March 10-16 this year, helps focus attention on this important part of any healthcare provider’s job. No matter how much attention nurses give to patient safety, there is always room to make improvements. swirl logo for the Center for Patient Safety

But there’s more to patient safety than knowing and following procedures and protocols, says Kathy Wire, JD, MBA, CPPS, CPHRM, FASHRM, executive director of the Center for Patient Safety. The complexities of patient safety and how it is incorporated, monitored, and managed in any healthcare organization are real. Patient safety isn’t just limited to healthcare providers–it also involves the patient and the patient’s loved ones, too.

The overall organizational culture often sets the tone around patient safety. “A culture develops as a result of attitudes and related behaviors,” says Wire. “The underlying components of safety culture are well known. Some require action from senior leadership; others fit nicely in unit-based efforts. For example, supervisors can encourage non-punitive responses to errors, focusing on addressing underlying system issues and acknowledging human fallibility.”

Nurses often look to leadership to implement processes in which questioning a decision or a process is supported. If nurses push back on something that appears unsafe, they need to know they will have a manager’s support, she says. And this kind of transparency is in the best interests of any organization as patient safety is often tied to nurse safety. “A lack of patient safety can lead to errors and near misses that any conscientious nurse will find disturbing,” says Wire. “Even minor events can trigger this ‘second victim’ phenomenon. Many provider organizations have developed programs to address this trauma in their staff, but isn’t it better to prevent the issue in the first place?” And in the high-stress situations when loved ones are concerned about the care being given, anger and fear can spark threats to nurses, so open communication is essential, she says.

A patient’s family and loved ones contribute immensely to patient safety, says Wire. As nurses need to feel comfortable about being vocal about safety, loved ones also need to be heard and feel they can raise questions safely. Nurses also can trust that those closest to the patient can be advocates and have information the nurse might not. “Helping them understand planned nursing interventions and treatments while encouraging them to ask questions will establish that relationship,” says Wire. “We must let them know that an additional, dedicated set of eyes and ears can help busy nurses provide the best care. For example, family members can often recognize subtle changes in the patient’s condition that may be more difficult for a nurse to see.”

Even the best environment can’t prevent all errors. “Good safety culture tells us that people make mistakes and can drift from the ‘standard,'” says Wire. “Reporting mistakes and errors helps the organization learn about gaps in policy and how well it is supporting its nurses, and it also helps all nurses benefit from the learning that a reported event can generate.”

The highly tuned ability that nurses have in assessing a situation and evaluating the needs in the current moment can also help reveal problems, even problems that were never there before. “It can also bring mistakes and near misses to light, avoiding unnecessary injury to patients,” says Wire. “They must know that safety is not a condition or a statistic. Patient safety is an ongoing set of activities, and a state of mind focused on recognizing risk and generating improvement. It doesn’t care what you did last week.”

Hand Hygiene Helps Patient Safety

Hand Hygiene Helps Patient Safety

Patient safety depends on many preventative steps, and many of those steps must be followed meticulously. The Society for Healthcare Epidemiology of America collaborated with several organizations to address hand hygiene and infection control in the recently released Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene: 2022 Update, one in a series of expert guidance documents known collectively as the Compendium. The report, published in the journal Infection Control & Hospital Epidemiology, reinforces how the simplest act of hand washing and proper hand hygiene can have a significant impact on patient safety.

During this year’s Patient Safety Awareness Week, Dr. Emily Sickbert-Bennett, in the Division of Infectious Diseases at UNC School of Medicine, and one of the authors of the report, provided Minority Nurse with additional insight about hand hygiene.

Healthcare workers know that hand washing helps keep them safe and helps prevent the spread of germs in the patient population. “Every episode of hand hygiene can interrupt the spread of germs between patients, between patients and healthcare personnel, and between the contaminated environment and patients,” says Sickbert-Bennett. “Healthcare personnel need to wash their hands dozens of times throughout their workday as they have complex interactions with very sick patients.”

Despite knowing how effective simple soap and water (or alcohol-based hand sanitizer) is at preventing the spread of germs, the study found that complete hand washing guidance isn’t always followed. In an intense and rushed environment, it’s not simply forgetfulness or a lack of intent that sometimes prevents proper hand hygiene. “The biggest factor is likely time – which impacts our ability to do hand hygiene often enough and thoroughly enough,” says Sickbert-Bennett. “An important way to mitigate this is to make sure that hand hygiene supplies are easily accessible in areas where patient care is occurring.”

And education about the proper techniques for keeping hands clean is essential, particularly considering that the report cites research that shows only 7% of healthcare personnel effectively clean the entire surface of their hands with thumbs and fingertips being the most frequently missed. The report also notes the potential for bacteria being difficult to remove if providers have certain fingernail polish or applications such as acrylic nails. Guidance around the need for proper cleaning practices, even if gloves are also worn, is also noted.

“Hand hygiene programs that use reminders to reinforce the habit of hand washing at the right times have been shown to be effective,” she says. “Nurses can play an important role in hand hygiene and patient safety by reminding their colleagues to clean their hands throughout the day as they take care of patients.”

Commitment from the top levels of organizations will also move the needle in the right direction. The report notes that nurses and healthcare personnel need easy access to hand-cleaning supplies and also moisturizing lotions that are in compliance with hygiene safety standards. All that hand washing takes a toll on the skin and cracks can also lead to infection. That means plenty of access to soap and water and also wall mounted pumps containing alcohol-based hand sanitizer instead of nurses carrying hand sanitizer in bottles in their pockets.

As healthcare providers, nurses can care for themselves and their patients with increased attention to an essential tool–their hands.

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