Promoting Workplace Safety in Nursing

Safety is important in any workplace, particularly in health care settings. According to the World Health Organization (WHO), the economic, personal, and social cost of unsafe health care results in the loss of trillions of dollars worldwide.

Workplace safety issues significantly affect nurses, who are the bedrock of our health care system. When safety in nursing isn’t a priority, the effect on nurses’ morale, retention, and productivity can be profound.

A 2020 report in the journal BMJ Quality & Safety summarized a survey of nurses and patients in 254 hospitals immediately before the COVID-19 pandemic. It found that nearly half of nurses gave their hospitals poor grades on patient safety and were experiencing high burnout; almost a quarter of them planned to quit within one year.

Fortunately, nurses have the power to strengthen workplace safety. Particularly when in leadership roles, nurses can take action to promote safety, improve nurse retention, bolster productivity, and improve hospital rankings and reputations. Individuals who’ve been considering enrolling in an online Master of Science in Nursing (MSN) program or an online MSN program to become a nurse practitioner can benefit from becoming familiar with promoting safety in nursing.

Common Workplace Safety Issues in Nursing

It’s important for nurses to know about common workplace safety issues that affect them and their  patients. Safety issues can cause inaccuracies, impact the quality of care, and create hostile working environments

Safety Issues That Nurses Face

According to the U.S. Bureau of Labor Statistics (BLS), common safety issues that nurses face include:  

• Risks associated with physically handling patients (for example, overexertion in lifting patients)
• Workplace falls
• Being struck by objects or equipment

These types of safety risks can result in nurses suffering sprains, strains, contusions, or even fractures.

Workplace violence also is a risk for nurses. A 2021 article in the Journal of Occupational Health noted that about 25% of registered nurses had been assaulted by a patient or a patient’s family member, and violence in the workplace causes about 17% of nurses to quit their jobs every year.

Additionally, fatigue can be a challenge to maintaining safety in nursing. According to the Centers for Disease Control and Prevention (CDC), the prevalence of nurses working long shifts under stress can leave them vulnerable to muscle injuries, needlesticks, a higher susceptibility to infectious diseases, and burnout.

Safety Issues That Patients Face

WHO cites medication errors as the most common cause of patient injury in health care. Other patient safety issues include:

• Diagnostic errors
• Health care-associated infections
• Radiation errors
• Unsafe injection practices
• Unsafe surgical procedures
• Unsafe transfusions

WHO asserts that adverse events that patients experience due to unsafe care are likely among the top 10 causes of death or disability worldwide.

Nurse Responsibilities in Helping to Ensure Workplace Safety

Nurses have an obligation to help ensure safety. The American Nurses Association’s Code of Ethics for Nurses contains several provisions regarding safety. For example:

• Provision 3 requires nurses to protect, promote, and advocate for the safety of the patients. That includes nurses’ duty to promote an overall culture of safety and report impaired practice to the appropriate authority.
• Provision 5 describes nurses’ obligations to mitigate the effects of fatigue and compassion fatigue by caring for their own health and safety.
• Provision 6 discusses nurses’ duty to strengthen the ethical environments where they work to promote safe health care.

To reinforce the importance of safety in nursing, the CDC also notes nurses’ obligations to adhere to the safety policies, practices, standards, and procedures developed by their health care organizations. These policies can cover basic topics, such as hand hygiene, or larger topics, such as required training and education.

The Occupational Safety and Health Administration (OSHA) stresses that when health care organizations demonstrate a strong commitment to safety, health care workers are more likely to adhere to standard precautions when conducting their work.

How Nurses Can Promote Workplace Safety

A significant action that nurses in leadership roles can take to ensure workplace safety is to promote an overall culture of safety. According to nonprofit health care safety organization ECRI, health care leaders can promote a culture of safety by:

• Investigating errors and understanding their causes.
• Creating strategies to prevent the recurrence of errors.
• Sharing lessons learned from previous errors with staff.
• Enforcing that activities that undermine safety are unacceptable.
• Evaluating a health care organization’s culture of safety and making changes identified through that process.

How Nurses Can Promote Safety for Nurses

Nurses have many different avenues to promote workplace safety for nurses. For example, WHO recommends:

• Emphasizing a strong connection between nurse and patient safety policies. This can include linking occupational health and safety with infection prevention and control programs.
• Working to encourage nurse training programs to teach health and safety skills. Training is critical for health care providers at all levels, according to WHO.
• Creating metrics for nurse safety. This can include integrating metrics for nurse safety with metrics for patient safety within a health care organization’s information system.
• Protecting nurses from workplace violence, injury, and biological hazards. This can include appointing ombudspersons to address instances of workplace violence, providing ergonomic equipment to reduce injury, and ensuring that nurses have adequate personal protective equipment.

Nurses can also promote the appointment of a safety officer or an occupational health nurse. A 2019 report in Workplace Health & Safety noted that occupational health nurses can focus on promoting workplace health and safety and creating programs to prevent and mitigate workplace hazards.

How Nurses Can Promote Safety for Patients

In promoting patient safety, nurses have a range of options. For example, they can:

• Advocate for adequate nurse staffing and engagement. A 2020 report in the Journal of Nursing Care Quality noted a clear connection among patient safety, adequate nurse staffing levels, and nurses’ participation on unit councils and hospital committees.
• Ensure that health care organizations develop systems for reporting safety issues. According to a 2021 report in American Nurse, health care organizations can use these systems to encourage nurses to learn from past errors and strengthen safe nursing practice.
• Encourage patient and family engagement. The Agency for Healthcare Research and Quality (AHRQ) noted in 2020 that patient and family engagement can help to reduce problems in communication, medication, and diagnosis that can reduce patient safety.
• Incentivize patient safety and teamwork. The American Organization of Nurse Executives (AONE) recommends, for example, developing a safety monitoring or auditing plan and recognizing good patient safety and teamwork by creating an annual award related to patient safety.

Create a Culture of Safety in Nursing

Workplace safety is critical in health care, both for patients and the health care professionals who treat them. Nurses who want to strengthen workplace safety and move into other roles in nursing leadership can explore Norwich University’s online MSN and online MSN: Nurse Practitioner programs, which include courses in quality and safety. The path to nurse leadership begins with education. Embark on that path today.

Recommended Readings

How to Prevent Nurse Burnout
Leadership in Health Care: Gain Skills to Advance Your Career
Nurse Leadership Qualities for Your Future Career

Sources:

WHO Calls for Urgent Action to Reduce Patient Harm in Healthcare, World Health Organization
Chronic Hospital Nurse Understaffing Meets COVID-19: An Observational Study, BMJ Quality &  Safety
Occupation Snapshot, Registered Nurses, 2015-2019, U.S. Bureau of Labor Statistics
Workplace Violence in Nursing: A Concept Analysis, National Center for Biotechnology Information
Managing Fatigue During Times of Crisis: Guidance for Nurses, Managers, and Other Healthcare Workers, Centers for Disease Control and Prevention
Patient Safety, World Health Organization
Code of Ethics for Nurses with Interpretive Statements, American Nurses Association
Safety Culture and Health Care, Centers for Disease Control and Prevention
Organizational Safety Culture - Linking Patient and Worker Safety, Occupational Safety and Health Administration
Culture of Safety: An Overview, ECRI
Keep Health Workers Safe to Keep Patients Safe: WHO, World Health Organization
Balance, Health, and Workplace Safety, SAGE Journals
Association of Nurse Engagement and Nurse Staffing on Patient Safety, National Center for Biotechnology Information
Adverse Event Reporting and Root Cause Analysis, American Nurse
Making Healthcare Safer III: A Critical Analysis of Existing and Emerging Patient Safety Practices, Agency for Healthcare Research and Quality
Role of the Nurse Executive in Patient Safety, American Organization of Nurse Executives