Health care is one of the fastest-growing fields in the US economy. Nurses are one of the main medical workers that promote development and growth. They create standards, improve the environment, and promote the importance of health care. It is not enough for nurses to know what safe systems in health care are. It is necessary to understand how to improve the work environment and the quality as well as the safety of patient care. In the paper, one of the sections from the Agency for Healthcare Research and Quality will be discussed to understand the peculiarities of working conditions for nurses and learn how to connect them with such concepts as accountability, teamwork, safety, communication, cultural responsiveness, and control.
Creation of a Safe and High-Quality Health Care Environment
Taking into consideration the fact that US health care is a constantly developed sphere, the importance of nurses and other experienced medical workers cannot be neglected. According to Stone, Hughes, and Dailey (2008), high nurse turnover has been already recognized as a serious problem in the healthcare field. Such changes influence the quality of care offered to patients. Besides, many healthcare events can be harmful to patients because of the inabilities to understand how to create an appropriately safe and high-quality health care environment.
Stone et al. (2008) mention that several safety climate scales and measurements have been already developed and introduced in the fields of occupational health and safety of patients. The investigations touch upon the medical errors that define treatment methods, the ways of analysis of clinical and laboratory data, and even the levels of job satisfaction. Hospitals and other clinical organizations need to have a team that takes responsibility for the development of working environments. Research proves that medical workers, patients, and other stakeholders are satisfied when they find themselves in climates with supporting leadership, organizational arrangements, and collaboration (Stone et al., 2008). Therefore, the same factors and contributions have to be taken into consideration in case the ratings of nurse turnover and patient safety have to be improved.
Concepts of Teamwork and Interdisciplinary Communication
The investigations of Weller, Boyd, and Cumin (2014) show that modern healthcare has to be delivered by the representatives of properly organized healthcare teams that could be the multidisciplinary examples of effective communication and trust. It is necessary to consider human factors and ethical principles with the help of which nurses offer safe patient care and support. When nurses learn how to communicate, what kind of information should be stored or exchange in a short period, and why their practices could be both, safe and unsafe for patients, they could use their knowledge to improve the conditions offered to them. In some organizations, nurses do not try to change something but follow the rules and regulations offered to them. However, Stone et al. (2008) underline the fact that nurses and healthcare providers have to make efforts to understand and change organizational conditions and components in case they could be related to patient safety. Interdisciplinary communication and teamwork help to start the required activities.
Accountability for Nurses
White, Jackson, Besner, and Norris (2015) investigated the practices of registered nurses and proved that the abilities of healthcare providers were not effectively utilized because of poorly understood nurse accountabilities. Accountability is a crucial component of nursing practice and patient safety because it means that nurses realize that all their actions are taken and decisions made have a certain impact on patients. Nurses have to evaluate their responsibilities and duties to help patients and develop an appropriate working environment. A positive organizational climate is one of the crucial evidence-based implications for nurses (Stone et al., 2008). Even if nurses may not have a direct leader to rely on, there is always one common leader, a patient, the needs of whom cannot be neglected.
In addition to nursing accountability, the analysis of quality initiatives and medical errors could be offered to clarify the conditions in nursing practice. People could make mistakes and realize that their errors could cause accidents that influence someone’s lives. Boysenll (2013) explains that healthcare errors and accidents could result in morbidity and even mortality. Therefore, organizational changes and the promotion of a safe working environment is the task nurses cannot neglect or perform poorly. Nurses have to follow the rules in the organizations they work in. Still, there are situations when nursing initiatives are preferable. Therefore, nurses should demonstrate their readiness to evaluate the situation, consider their past knowledge and experience, ask for some pieces of advice, and make a decision that does not worsen the patient’s condition. Though there are many cases when nurses make mistakes and have to take responsibility for their decisions, it is wrong to believe that not making such a decision is the best solution to avoid deaths or other negative outcomes.
The promotion of patient safety means the necessity to combine such concepts as collaborative practice and cultural competency successfully (Oelke, Thurston, & Arthur, 2012). The discussions of Stone et al. (2008) prove that organizational climate is also malleable and open to the changes that are based on cultural differences. Culture is usually related to several norms, values, and beliefs. Patient safety could be promoted only in case there is a certain balance between all those norms and values. The peculiar feature of any cultural aspect is its possibility to be developed in time and impossibility to be changed with time. Nurses cannot change or neglect their cultural responsiveness but think about the ways of how to protect patients and demonstrate their respect for any cultural choice. A patient is the center of nursing practice, and any requests or concerns mentioned by patients have to be properly identified and evaluated by nurses to make sure they create a safe and high-quality working environment.
Patient Safety in Care Environment
The promotion of patient safety in the care environment is task number one for nurses. However, there are situations when nurses get distracted or suffer from fatigue. In such cases, work-related fatigue could negatively affect the safety of patients and the well-being of nurses (Smith-Miller & Shaw-Kokot, 2014). The organization of rest, appropriate working conditions, and the possibility to use individual approaches in health care are the best solutions that could be offered to promote safety and the absence of fatigue. Nurses are under a threat of several personal and professional problems and challenges as any other healthcare workers and the representatives of other spheres. It is hard to avoid the qualities that are usually inherent to people. The only thing that could be done is the investigation of the situations and the development of new plans for nurses. Though nurses have to take care of patients and promote collaboration between all medical workers, they should never forget about personal needs and the importance of solving personal problems and challenges.
There are many ways of how caring that could be integrated into all levels of nursing practice. The theory developed by Watson is one of the possible approaches for nurses to realize how human caring has to be integrated into the nursing environment. The core principles of the theory include the balance between equanimity and kindness, personal spiritual needs, and the deep belief of other people. This theory proves that a person has to take care of other people but never forget about personal care. As soon as a person could demonstrate respect for personal health, there are all chances this person could create an appropriate working environment and promote patient safety.
In general, the topic of working conditions and the promotion of the work environment for nurses play a very important role in nursing practice. There are many rules and standards nurses have to take into consideration. At the same time, nurses have to realize that their contributions could gain a variety of forms. Therefore, nurses have all changes to create a safe and high-quality health care environment and make sure they promote patient safety and care. Healthcare is the field that is open for numerous contributions, changes, and improvements, and nurses are the doers of actions whose roles cannot be neglected.
Boysenll, P.G. (2013). Just culture: A foundation for balanced accountability and patient safety. The Ochsner Journal, 13(3), 400-406.
Oelke, N.D., Thurston, W.E., & Arthur, N. (2013). Intersections between interprofessional practice, cultural competency and primary healthcare. Journal of Interprofessional Care, 27(5), 367-372.
Smith-Miller, C.A., & Shaw-Kokot, J. (2014). An integrative review: Fatigue among nurses in acute care settings. The Journal of Nursing Administration, 44(9), 487-494.
Stone, P.W., Hughes, R., & Dailey, M. (2008). Chapter 21: Creating a safe and high-quality health care environment. In R.G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses. Rockville MD: Agency for Healthcare Research and Quality. Web.
Weller, J., Boyd, M., & Cumin, D. (2014). Teams, tribes and patient safety: Overcoming barriers to effective teamwork in healthcare. Postgraduate Medical Journal, 90(1061), 149-154.
White, D.E., Jackson, K., Besner, J., & Norris, J.M. (2015). The examination of nursing work through a role of accountability framework. Journal of Nursing Management, 23(5), 604-612.