ANNA study shows nephrology nurses view patient safety favorably, highlights areas for improvement

Most nephrology nurses surveyed for a new study published in the September/October 2014 issue of the Nephology Nursing Journal rated patient safety in nephrology nurse practice settings as favorable.

Authors Beth Ulrich, EdD, RN, FACHE, FAAN, and Tamara Kear, PhD, RN, CNS, CNN surveyed almost 1,000 ANNA members using a survey composed of items from two Agency for Healthcare Research and Quality (AHRQ) patient safety survey tools. The authors also compared their results to AHRQ data.

Twenty six percent of respondents ranked patient safety "excellent" and 51% ranked it "very good." The issues that received scores lower than AHRQ comparative data included handoffs, infection control, medication errors, communication, prioritization, staffing and workload, according to study results.

Some respondents described a rushed nature in their practice setting that led to incomplete work, errors and other challenges. The respondents cited long hours and staffing shortages as contributing factors, with only 61% of respondents saying their unit had sufficient staff to meet the workload.

The article, “Patient Safety Culture in Nephrology Nurse Practice Settings: Initial Findings,” outlines research that is the first of its kind to focus specifically on patient safety culture in all nephrology nurse practice settings. The article provides an overview of results, from error reporting and staffing challenges to manager expectations and best practices.

Additionally, and not surprisingly, according to the authors, teamwork was revealed as a primary strength.

“Since the early days of nephrology care, we have worked as a team with physicians, social workers, dieticians, and patient care technicians,” Ulrich, who is also the editor of NNJ, writes in an accompanying editorial. “Not that it is practiced everywhere, but it is one of the hallmarks of our specialty.”

In her editorial, Ulrich also notes that safety practices in a health care facility aren’t just for patients, but are synergistic with the safety of nurses and other providers. “Safe patient handling and infection control, for example, increase safety for staff as well as patients,” she writes, adding that the same basic safety components apply to all individuals within the facility.

The authors said they were impressed by the response of ANNA members to the survey and pointed out that many provided lengthy narratives and descriptions to the questions.

“Nurses remain central to providing an environment and culture of safety,” the authors write, “and as a result, nurse are emerging as safety leaders in the health care setting.”

Ulrich also points out that "It is every nurse's responsibility to be a leader and an advocate in ensuring patient safety—whether the nurse is the solo RN in a clinic, one of several RNs in a hemodialysis unit, or one of hundreds of RNs in a hospital.” -by Rebecca Zumoff