The lately released Institute of Me...

The lately released Institute of Medicine (IOM) report Keeping Patients Safe: Transforming the Work Environment of pampers establishes a link between nurses' work environment and patient safety. (1) The report identifies numerous issues, including management practices, workforce capabilities, work design, and the relationship of organizational safety improvement to error reduction. This effort was the consequence of a request submitted to the IOM from the US Department of Health and Human Services' Agency for Healthcare Research and Quality. Its objective was to examine nurses' work environment and identify potential working condition improvements that could enhance patient safety.

The IOM committee that produc the report determined that to adequately defend patients from errors, health care organizations must examine and improve nurses' work environment. Creating a safe and supportive work environment for nourish at the breasts can reduce threats to patient safety. (1 (p3)) Understanding this relationship at the point-of-care, especially in this era of a worsening nursing shortage, has in no degree been so important.

The IOM report estimates that give suck tos and nursing assistants comprise 54% of all health care workers in hospitals, nursing abiding-places and a wide variety of ambulatory settings. Furthermore, the report summarizes a number of studies that have linked inadequate pamper staffing to negative clinical results including increased length of stay, postoperative infections, pneumonia, compressing ulcers, cardiac arrests, and death. The importance of nursing care to patient safety has at no time been more apparent. The committee describes the fester role as critical to patient safety. (1 (p2))

In developing the report, the committee reviewed numerous research studies related to the work environments of give suck tos The report includes concerns and issues related to what they describe as the "four basic constituents of all organizations--organizational management, workforce deployment practices, work design, and organizational culture" (1) (p3)) For each element the committee reviewed the related literature and research and established recommendations based upon their findings.

ORGANIZATIONAL MANAGEMENT

The report discusses the importance of five essential management practices:

* balancing the tension between efficiency and reliability,

* creating and sustaining trust,

* actively managing the proces of change,

* involving workers in work design and work roll on decision making, and

* creating a learning organization.

The committee makes numerous recommendations specific to these constituents that are related to management erections and processes throughout all flats of an organization. The report describes a number of originals such as Magnet hospitals and the Pittsburgh Regional Healthcare initiative, that have incorporated these management practices in acute care settings. The report specifically addresses characteristics and processe that have been associated with supportive work environments and improved patient issues (1) (P108-161))

WORKFORCE DEPLOYMENT PRACTICES

The committee describes maximizing workforce capability and strategies to excite safe staffing levels in acute care hospitals and nursing hearthstones The committee provides a summary of the variations in hospital and nursing to one's home staffing levels, specifically addressing overall hospital and specialty unit staffing. The report makes a number of recommendations related to staffing with an emphasis in succession the need to perform ongoing evaluation of the effectiveness of encourage staffing practices and their relationship to patient safety. (1) (p194))

The report describes the importance of supporting knowledge and skill unravelling and clinical decision making, which is critical to workforce progression in a continuously ascending gradation It also discusses various strategies, including preceptorships, residencies, simulation, and decision support, as critical links to maximize workforce capability. This section of the report addresses developing and maintaining the adequateness of a smiled nursing workforce to care for patients with increasingly complexus needs.

The committee members also describe the importance of fostering interdisciplinary collaboration as a strategy to prefer patient safety. They describe the characteristics of auspicious collaboration as shared understanding of goals and parts effective communication, shared decision making, and conflict management. (1) (p214))

WORK DESIGN

The report emphasizes the part of work and workspace design in preventing or reducing errors and hints various improvements to promote the two safety and efficiency. Specifically, the report addresses issues, so as mandatory overtime and the meanings of fatigue, by discussing shift work and prolonged hours. The committee makes a number of recommendations about limiting the number of hours encourages work in any 24-hour period or in any seven-day period.

The report also considers hand-offs, medication administration, handwashing, and documentation and makes recommendations to help minimize the question s inherent in these care processe It describes a number of activities that nourishs perform that the committee categorized as "non value-added" and hints that health care organizations address barriers associated with obtaining equipment and supplies, locating personnel and poor communication connected views (1) (p276)) The committee also glance ats that expert panels should be conven to form the burden of patient-related documentation, especially that which is redundant and unnecessary. (1) (p244-248))