Extended and overnight shifts are associated with higher adverse event rates and burnout. This mini review summarizes the impact of overnight shifts on nurses' health, patient and public safety, and organizational costs (e.g., those related to nurse turnover). Organizational strategies to promote nurses' health and reduce errors are also summarized, ranging from low-cost measures such as breaks for physical activity during the shift to high-cost measures such as referral to sleep specialists or paid transportation home.

Clinician well-being has important implications for patient safety and quality of healthcare delivery. In this study, researchers used a concept analysis to identify attributes of nurse well-being at the individual level (e.g., satisfaction, compassion) and organizational/community level (e.g., teamwork, pride in work). These findings can support the development of a standardized definition of nurse well-being to guide future research and policy considerations around well-being and burnout.

… lower patient safety culture scores . … Montgomery AP, Patrician PA, Azuero A. Nurse burnout syndrome and work environment impact patient …

The COVID-19 pandemic has disrupted many aspects of health care delivery, including how hospitals prevent common hospital-acquired conditions such as pressure injuries. Based on retrospective data, the authors of this study did not identify a longitudinal increase in hospital-acquired pressure injuries between March and July 2020. The authors discuss how prior organizational efforts to reduce hospital-acquired pressure injuries allowed their hospital to quickly adapt existing workflows and processes to respond to the COVID-19 pandemic.

Excess workload and burnout among nurses can compromise safe patient care and lead to adverse outcomes. This survey of acute care nurses in Alabama identified high levels of nurse burnout; burnout was a significant predictor of medication administration errors. All types of burnout – personal, work-related, and client-related – were significant predictors of self-reported medication administration errors.  

… safety culture , and robust process improvement. A past PSNet interview discussed high reliability as it … health care. … Randall KH, Slovensky D, Weech-Maldonado R, Patrician PA, Sharek PJ. Self-Reported Adherence to High …

Highlighting the importance of measuring and ensuring adequate staffing levels in hospitals, this commentary describes scenarios drawn from experiences of military nurses that demonstrate how limited staffing can affect nurses, and consequently, patient safety.

… quality … J Nurs Care Qual … This commentary describes a program that provides safety and quality improvement …

… practice … J Eval Clin Pract … This commentary describes a quality and safety educational program and shares …

This study found that staff category and patient acuity were associated with medication errors and falls, but total nursing hours and census had no effect. The authors advocate for greater study of organizational factors, particularly at the unit level, to better understand clinical microsystems.

… nursing experience and skill mix was associated with a lower incidence of falls and medication errors. …

This study found that nurse work schedules were independently associated with patient mortality. In addition to known issues with staffing ratios, the authors point out an opportunity to provide safer schedules and working conditions for nurses.