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Patient Safety Challenges in Nursing Identified in Global Survey

Nurses

Nurses often face the conflict between patient safety culture vs. fear of reporting. To see a larger image click here

Healthcare

Healthcare information technology has become increasingly important in handling vast amounts of patient data. To see a larger image click here

The

The majority of nurses agreed that communication is key to resolving challenges. To see a larger image click here

A survey has revealed that many nurses in the US, UK and China have witnessed errors made whilst caring for patients. The survey also reveals that a significant number of nurses do not believe their own hospitals to be a safe place in which to carry out their work.

The survey—carried out by GE Healthcare and the American Nurses Association—also questions whether hospitals are doing everything they can in terms of keeping patients safe as well as provide a number of recommendations based on these results. The findings are a cause of concern for hospital managers, who are already dealing with a raft of cost-cutting measures to hospital budgets as well as impending reforms to healthcare policy.

 

Patient Safety

The survey first tackles the subject of patient safety in which nurses say they feel responsible for patient safety but cite workload, too many patients, time pressure, and fatigue as factors leading to compromised safety. In addition, nurses identify hospital culture, communication and access to technology as the main impediments to patient safety.

The results of the survey also saw nurses identify themselves as shouldering most of the burden of patient safety (90%), more so than physicians (69%) or patient safety officers (60%). The vast majority of (95%) nurses believe leadership in the hospital is ‘extremely’ or ‘very important’ in placing patient safety as crucial in order to cultivate an effective patient safety culture. Eighty-five percent of nurses agree that their hospital has a patient safety culture, and 94% report that their hospitals have programs in place that promote patient safety.

The majority of nurses (90%) felt that there should be a culture in which they were not penalized for reporting errors or near misses. However, the percentage of nurses (67% US, 62% UK, 49% China) surveyed stated they would be reluctant to report patient errors for fear of punishment.

Only 41% of nurses identify their hospital surroundings as “safe”. In addition, only 57% state the patient safety programs put in place in their hospital are effective, recognizing a large scope for future improvement.

“Our goal in initiating this survey with the ANA was to get to the root causes of what is driving patient safety issues in today’s hospital, by surveying those who know the hospital best – nurses,” said Rob Reilly, Chief Marketing Officer, GE Healthcare Americas.

“It is clear from the results of this survey that nurses place much of the responsibility of patient safety on their own shoulders. However, with the challenges facing today’s hospital, it is almost impossible for a nurse to shoulder this entire burden, and this survey provides valuable information on how we can work to improve the situation.”

According to the World Health Organization patient safety has become an endemic concern with healthcare errors impacting 1 in every 10 patients around the world.

 

Patient Communication

The results of the survey found only 4 in 10 (37%) rate their hospital as ‘excellent’ at communication with the patient. Communication between staff was equally disappointing with only 31% stating their hospital as excellent at this. Communication among nurses at handoff fared little better with 33% stating this as ‘poor’ while 31% say “poor communication with doctors” has also increased the risk of patient safety incidents.

“It’s no surprise that communication is a challenge for nurses today, given heavy patient loads and the time that they are able to spend on patient care is constantly decreasing,” said Cheryl Peterson, MSN, RN, director of nursing practice & policy of ANA.

“Where we can help is increasing the quality of communication, and arming nurses and front-line staff with the information they need to effectively communicate on behalf of the patient.”

 

Technology to aid Patient Care

“Through the survey we found a lot of information about the challenges facing today’s nurses including workloads, too many patients, time pressure, less than ideal nurse ratios and fatigue, but what we were also able to identify is some potential areas for improvement, with one significant area being technology to report errors,” said Reilly. “This survey is only one small part of the picture, and our efforts one small part of a solution that involves efforts from the individual hospital on up to national programs like the Partnership for Patients. GE and ANA are committed to helping healthcare systems tackle some of their toughest challenges, including addressing patient safety concerns through innovative technology, partnership and cultural education.”

According to a study by RAND Health, the US healthcare system could save more than $81 billion annually, reduce adverse healthcare events, and improve the quality of care if health information technology (HIT) is widely adopted. The adoption of technology is hindered by mainly cost despite the advantages patients gain in health and lower costs.

When surveyed, 59% of nurses agree that although patient safety data is collected and reported, there is no follow-up or feedback given to the nurses. Three quarters (74%) of nurses identified “technology/software” as a patient safety initiative that exists in their hospital. A further 23% would like to see this in their health system. Nurses viewed technological innovation as core to flag early warning signs of patient risk and alerting staff (68%). A further 67% see this innovation as also improving the communication of information to patients within the hospital surroundings.

 

The GE Patient Safety Organization

As nurses continue to face these challenges, GE Healthcare has been proactive in finding solutions to help address these issues.

The GE Patient Safety Organization (PSO) was created to improve patient safety by disseminating insights/information derived from analysis and evaluation of the qualitative and quantitative data submitted to the GE PSO to members on a monthly basis.

All members of the GE PSO use the MERS-TH medical event reporting system. Web-based and user-friendly, MERS-TH gives members a powerful tool to record and analyze adverse events and near-misses with single-click functionality that encourages high utilization. It’s flexibility means it will also accept data from other event reporting systems. In addition, the GE PSO recently launched the Global Patient Safety Network (GPSN) that operates under the GE PSO. The GPSN provides the ability for members to work on the “how” to improve patient safety by discussing, collaborating and sharing best practices in a live, secure and private environment.

GE Healthcare’s AgileTrac RTLS technology was been developed to track mobile assets and patients to better manage hospital operations. The technology uses small sensor tags and a dedicated infrastructure to track the location and identify meaningful workflow events. The technology has now been deployed as part of a recent hand hygiene compliance program to detect and report whether clinicians washed their hands upon entering and leaving patient rooms, as specified by hospital protocol.

 

About the Survey

The study was conducted by research firm Edelman Berland as an online survey among a total of 900 practicing registered nurses (500 in the United States, 200 in the United Kingdom, and 200 in China). Edelman Berland also conducted 14 in-depth interviews with nurses from a wide spectrum of facilities, organizations and fields with similarly varied backgrounds with patient, teaching and administrative responsibilities.