This article provides a framework of strategies to support a culture of safety in the perioperative environment. 

Nursing Home Compare publicly available reports on the quality and safety of care provided by nursing homes in the United States. Prior research has found that Nursing Home Compare does not accurately capture patient safety performance. This study compared falls with injury data self-reported by nursing homes against those identified in Medicare claims data and found that falls with injury were substantially underreported by nursing homes, indicating that that the data used by Nursing Home Compare may be inaccurate.

This study looked at the impact of two different models of delivering care by nurses, team versus total care, on quality of care and adverse events. The authors found that the team nursing model reported higher frequency of adverse events when there were licensed practical nurses on the team.

… Educ Today … This commentary emphasizes how educating nursing students about human factors can help prepare them to …

… goal of determining educational interventions to prepare nursing students for practice. Participants recommended …

There is a scarcity of literature on the role nurses play in antibiotic stewardship (AS). This article describes the results of a multisite survey of nurse perceptions of AS practices. Statistical analyses of 558 survey responses indicate that nurses identify with their role in AS processes but believe hospital safety culture inhibits their work in this area.

… describes a simulated training initiative to help prepare nursing students for experiencing and responding to …

Little is known about deviations from best practices in administration of intravenous infusions that occur as a result of nurses’ clinical judgement. This study explored the ways nurses contribute to system-level resilience in relation to infusion safety. Secondary analysis of qualitative data on errors and policy deviations in intravenous infusion administration in 16 English hospitals suggest that nurses are a key source of system-level resilience.

… The Journal of nursing administration … J Nurs Adm … Suboptimal teamwork between nurses and nursing assistants was a major contributor to missed nursing care, according to this mixed-methods study. …

… potential to contribute to medication errors and missed nursing care . This position statement provides …

The value of medication reviews in reducing adverse drug events (ADEs) is now generally accepted although robust evidence of cost or clinical effectiveness of such reviews is lacking. For this pilot study of patients in a French nursing home, ADE risk scores were calculated before and six months after a pharmacist-led multidisciplinary review of each patient’s medications. Significant drops in ADE risk scores, as well as reductions in the number of patients taking at least one potentially inappropriate medication and substantial cost savings for the nursing home, are reported in this preliminary assessment.

The association between lower patient-to-nurse ratios and inpatient mortality has been demonstrated in classic studies, providing an impetus for laws in 15 states that mandate the maximum number of patients per nurse. This study explores the mechanism by which reducing patient-to-nurse ratios improves outcomes. Using a large database of patient discharges and nurse surveys from 665 hospitals in 4 states, the authors found that decreasing the number of patients per nurse improved mortality and failure to rescue predominantly in hospitals rated as having a good work environment. Hospitals with a poor work environment derived no benefit from reducing patient-to-nurse ratios. The critical role that nurses play in ensuring patient safety is discussed further in this Patient Safety Primer.

This Agency for Healthcare Research and Quality (AHRQ)–supported study discovered a need to better address safety culture in nursing homes, drawing on findings from a self-reported survey. Investigators surveyed more than 360 nurses and 630 nursing assistants on different aspects of safety. These included overall safety perception, teamwork within units, communication, actions promoting safety, and support for patient safety. Although the findings suggest areas for improvement, the authors appropriately point out that their modified tool wasn't designed specifically for nursing homes. This setting creates unique challenges but also affects elderly patients who tend to be at higher risk for adverse events, making safety initiatives critical.