Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands.



Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform — monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis — provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system.



During the past two decades, substantial changes have been made in the organization and delivery of health care — and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk.



This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.



Table of Contents


Front Matter
Executive Summary
1 Nursing: Inseparably Linked to Patient Safety
2 A Framework for Building Patient Safety Defenses into Nurses' Work Environments
3 Nurses Caring for Patients: Who They Are, Where They Work, and What They Do
4 Transformational Leadership and Evidence-Based Management
5 Maximizing Workforce Capability
6 Work and Workspace Design to Prevent and Mitigate Errors
7 Creating and Sustaining a Culture of Safety
8 Implementation Considerations and Needed Research
Appendix A: Committee Membership and Study Approach
Appendix B: Interdisciplinary Collaboration, Team Functioning, and Patient Safety
Appendix C: Work Hour Regulation in Safety-Sensitive Industries
Index