Hiring more nurses and fostering a no-blame atmosphere are two ways to increase patient safety, according to the National Quality Forum's Safe Practices for Better Healthcare-2009 Update: A Consensus Report, released in March. The report lists 34 practices shown to reduce the incidence of adverse events in health care facilities. Many directly concern nurses.

For example, "Safe Practice 8: Care of the Caregiver" advocates counseling nurses when errors occur and, instead of accusing them, including them in the evaluation process. "Nobody goes to work thinking, 'Hmm, today I'm going to harm a patient!!'" said Rita Munley Gallagher, senior policy fellow at the American Nurses Association. "A bad mistake is probably because of a system failure and not purposeful," said National Quality Forum senior advisor Peter Angood.

When it comes to system failures, the forum said one big culprit is understaffing, an issue addressed in "Safe Practice 9: Nursing Workforce." This practice advocates "a nurse staffing plan [that is] adequately resourced and actively managed." "Having enough RNs really does make a difference," said Gallagher. "Deep in their souls, hospitals know this. It's a conundrum in these tough economic times, but having enough staff is to their benefit." Some institutions skirt the issue by skimping on support workers to keep RN numbers adequate. The result is nurses stretched thin with nonnursing tasks, a problem "Safe Practice 10: Direct Caregivers," with its mandate to "ensure that nonnursing direct care staffing levels are adequate," is written to counter. Taken together, the practices are a reminder that, said Gallagher, "nurses have the central and most critical role in patient safety." To read the report, go to http://bit.ly%2fGkgNn.

Bunny Wong