Nurse’s Week “Culture of Safety” Benefits All Healthcare – Including the Bottom Line

The theme of this year’s National Nurses Week, “Culture of Safety: It starts with YOU,” doesn’t only help protect the safety of patients and nurses but also quality, outcomes and the bottom line of the healthcare enterprise.

“There is evidence emerging showing the link between a culture of safety and patient outcomes,” said Rosemary Gibson, senior advisor to The Hastings Center, a bioethics research institute. “Healthcare organizations that have better safety cultures have fewer medication errors, longer time between infections, fewer pressure ulcers and higher Hospital Consumer Assessment of Health Plans Survey scores. Culture is not just something soft. Culture improves and dictates the bottom line.”

The American Nurses Association (ANA) defines a culture of safety as having core values and behaviors that demonstrate a collective and sustained commitment to emphasize safety over competing goals. Such cultures value openness and mutual trust, provide appropriate resources for safe staffing, learn from errors, assess for weaknesses, display transparency and are accountable.

Making nurse safety a priority is vital for many reasons, said Marcia Faller, RN, PhD, Chief Clinical Officer of AMN Healthcare. The health of all team members is important for its own sake, she said, but it also affects staff morale, nurse retention, patient safety, patient experience and organizational efficiency.

“It’s obvious that improved nurse safety reduces costs from worker’s comp, lawsuits, and nonproductive time,” she said. “In addition, a culture of safety at a healthcare organization results in greater safety for everybody – clinicians and patients. Research has found that hospitals with good nurse work environments have better patient outcomes, lower patient mortality, higher nurse job satisfaction and better reimbursements. A culture of safety is important to a good care environment.”

Healthcare worker safety is a major issue in the industry. The Bureau of Labor Statistics reported that in 2014 the healthcare industry had the most days away from work incidents compared to all other industries. Private sector registered nurses had a higher rate of incidence of illnesses and injuries than the average for all occupations, and nursing assistants had more than triple the rate for all occupations.

Rates of musculoskeletal injuries from overexertion in healthcare occupations are among the highest of all occupations in the United States, according to the Bureau of Labor Statistics. In 2011, the average rate of overexertion injuries for all industries was 38 per 10,000 full time workers. By comparison, the overexertion injury rate for hospital workers was twice the average, while the rate for nursing home workers was over three times the average.

The single greatest risk factor for overexertion injuries in healthcare workers is the manual lifting, moving and repositioning of patients. The Centers for Disease Control recently noted that rising obesity rates, the aging of the patient population and the aging of the healthcare workforce population could collectively increase the risk of musculoskeletal injuries to nurses and other healthcare workers.

Gibson suggests hospital leaders review the results of their safety culture surveys, promulgated by the Agency for Healthcare Research and Quality, and compare them with their outcomes. Organizations can then take steps to improve the culture of safety on any low-scoring units -- to save money, reduce lost time incidents and improve patient outcomes.

“Better safety culture, better financial bottom line,” she said.