Global Survey Sheds Light on Patient Safety Challenges in Nursing

When it comes to addressing patient safety issues within a hospital, nurses want to make a difference and they assign themselves great responsibility for safe outcomes. However, the question remains whether hospitals are doing everything they can in terms of keeping patients safe. According to a recent survey of nurses in the United States, UK and China by GE Healthcare and the American Nurses Association (ANA), many nurses have witnessed errors and few call their own hospitals safe.

“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, USCAN. “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.”

Nurses cited workload, too many patients, time pressure and fatigue as factors leading to compromised safety. Additionally, nurses addressed access to technology, hospital culture and communication as the main barriers to patient safety.

Access to technology
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 name “technology/software” as a patient safety initiative that exists in their hospital and an additional 23% would like to see this in their health system. Nurses see technological innovation as key to identifying early warning signs of patient risk and alerting staff (68%) as well as improving the effectiveness of communication with regards to patient information in the hospital setting (67%).

“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 are one small part of a solution that involves participation 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 technologies, partnerships and cultural education.”

Culture
According to the survey, nurses see themselves as having by far the most responsibility for patient safety (90%), over physicians (69%) or patient safety officers (60%). Nearly all (95%) nurses believe that it is extremely or very important that hospital leadership make patient safety a priority in creating an effective patient safety culture. The vast majority of nurses (85%) agree that their hospital has a patient safety culture, and 94% report that their hospitals have programs in place that promote patient safety.

Having a culture where nurses are not penalized for reporting errors or near misses is seen as important by 90% of nurses. However, 59% agree that nurses often hold back in reporting patient errors in fear of punishment [67% US, 62% UK, 49% China], and 62% agree that nurses often hold back in reporting near misses for that reason [69% US, 65% UK, 54% China].

However, it is questionable if these programs are meeting their objectives; only 41% of nurses describe the hospital they work in as “safe” and fewer than 6 in 10 (57%) believe the patient safety programs in their hospital are effective, resulting in a great opportunity for improvement in patient safety procedures.

Communication
Among the most important aspects of creating an effective patient safety culture are communication with the patient and effective communication with the physicians. However, just 4 in 10 (37%) rate their hospital as excellent at communication with the patient and 31% say their hospital is excellent at communication between staff. Further, 33% name “poor communication among nurses at handoff” as something that has increased the risk of patient safety incidences in their hospital in the past 12 months, and 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.”

About the GE Healthcare Patient Safety Survey
The GE Healthcare Patient Safety 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). The survey took an average of 27 minutes to complete in the United States, 30 minutes in the UK and 34 minutes in China. Total as represented in this study includes respondents from the U.S., UK and China, and the U.S. is weighted down so that each of the three countries is represented equally within that total. The margin of error is +/- 5 percent with a 95 percent confidence level.

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.  Interviews lasted between half an hour and an hour and were conducted between October 12 and November 4, 2011, in the U.S., the UK and China. Subjects were recruited with the assistance of GE, the American Nursing Association and the Royal College of Nurses.