First Forum for Chief Nursing Officers Emphasizes Leadership Role of Nurses in Patient Safety

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SAN DIEGO, Dec. 16, 2004 – Nationally recognized experts gathered in Indianapolis, Ind. on Nov. 3-4 to emphasize the leadership role nurses must play in making a patient safety a priority within the healthcare system. The nation’s first Chief Nursing Officers (CNO) Patient Safety Leadership Forum, organized by Clarian Health Partners of Indianapolis and sponsored by Cardinal Health, brought together top nursing executives from institutions worldwide, as well as distinguished speakers from the healthcare industry, to apply their collective expertise in addressing and defining nurses’ role in making patient safety a priority.

 

The forum agenda highlighted a series of Institute of Medicine reports on patient safety and best practices for how nurses can improve safety within their individual hospitals and through the implementation of practices developed by national organizations, such as JCAHO, Leapfrog, the FDA and CMS. Roundtable discussions at the Forum identified strategic initiatives that nurses should take in four key areas to accomplish this:

> Technology

> Patient safety models

> Nursing leadership

> Patient safety research

 

Chairperson Karlene Kerfoot, Ph.D., R.N., FAAN, senior vice president and chief nursing officer of Clarian Health Partners, said that the Forum set an important precedent in bringing nursing leadership to the forefront of the patient safety movement. “This first CNO Forum succeeded in developing a clearer, more unified direction for nursing’s critical role in improving patient safety, as well as specific actions we should take to fulfill that mission,” Kerfoot commented. “All of us must view patient safety not as a competitive agenda, but a collaborative one, where we share data and ideas for improving the levels of safety and care that we deliver at each of our hospitals.”

 

Jeffrey B. Cooper, Ph.D., director of biomedical engineering for Partners Healthcare System in Boston, and associate professor of anesthesiology at Harvard Medical School, cited anesthesia safety as an instructive example of what can be accomplished. “Anesthesiology, plagued by a malpractice crisis from 1975-1985, achieved impressive gains in patient safety and can serve as a model for nursing,” he said. “The history of anesthesia safety shows that it can be done.”

 

Dr. Cooper explained that surgical anesthesia, which once had an error rate of 25 to 50 per million patients, reduced its error rate nearly seven-fold. “The first step was collection of data that permitted a systems analysis of errors, rather than a hunt for ‘responsible’ individuals,” he explained. “Through teamwork, practice guidelines, automation, procedure simplification and standardization, anesthesiologists showed that a properly designed system can prevent mistakes or prevent mistakes from doing harm. Today, anesthesiology has among the lowest error rates of any specialty.”

 

With few exceptions, nurses who are closest to patients and whose work is most affected by new practices and technologies are not at the table when key patient safety decisions are made. “If it touches the patient, it should have the nurse’s touch,” emphasized Gloria Whitson-Shea at Grand River Hospital in Kitchner, Ontario. “The fact is that no patient safety program can succeed unless it has nurses at its core.”

 

“The Clarian system has worked to close this gap,” Kerfoot said. “The institution has been designated as a Magnet hospital by the American Nurses Credentialing Center and has earned a reputation as a patient safety leader, with its award-winning Safe Passage© nursing program. With this program, a Safe Passage© clinician is designated by each hospital unit to become the local safety expert and to work jointly with unit staff, risk management, physicians and other departments to continuously find ways to identify and prevent mistakes before they happen.”

 

The Safe Passage© program is headed by Kathy Rapala, RN, JD, director, risk management and patient safety at Clarian, who recently won the first “Todd Pickett National Patient Safety Award” from the American Society for Health Care Risk Management (ASHRM). This new national patient safety award is named as a tribute to a patient, Todd Pickett of San Diego, Calif, who died due to a tragic medical error.

 

Kerfoot also noted that Clarian has been aggressive in implementing technologies at the point of care to help keep patients safe. Clarian was the first health system to fully implement “smart” IV medication safety system technology developed by Cardinal Health Alaris® Products, which helps protect patients and nurses from IV medication dosing errors. The safety software in the system also collects actual use CQI (clinical quality improvement) data for analysis and development of best practices.

 

To accomplish the goals established at the Forum, participants developed several specific recommendations for action, including:

> Give nurses responsibility in the development, purchase and implementation of patient safety technology so that they can become the architects of change.

> Partner with key health care associations to endorse and promote a model such as Safe Passage so hospitals nationwide can learn from proven practices to specially train nurses to take the lead in identifying trouble spots to prevent mistakes and move patients safely through a health care system.

> Develop a process that transforms the work environment into a safe culture, and remove unnecessary work from the nurseÂ’s realm of responsibilities so that s/he can focus on patient safety issues.

> Encourage state hospital associations to use a percentage of dues to fund patient safety programs, leveraging association members with matching funds.

 

The nursing leaders and others attending agreed that the momentum coming out of this first CNO Patient Safety Forum should be sustained through additional gatherings linked to national safety meetings such as the National Patient Safety Foundation and the national meeting of Magnet hospitals, as well as other invitational conferences in 2005 and beyond.

 

Summing up the feeling of many at the Forum, participant Carol Olson, vice president of nursing at Good Samaritan Hospital in Vincennes, IN, commented, “More than anything, we have to draw the line in the sand at zero errors. Being here has given me the courage to say to my staff, ‘OK, here’s what we’re going to do, and here’s how we’ll get there.’”

 

About Clarian Health Partners

Clarian Health Partners, comprised of Methodist Hospital, Indiana University Hospital and Riley Hospital for Children, is an Indiana-based, private, non-profit organization, offering a broad base of tertiary services, specialized pediatric care and a Level 1 Trauma Center. Clarian is IndianaÂ’s first Magnet Hospital System, its largest, most comprehensive health center and is one of the busiest hospital systems in the nation. Clarian HealthÂ’s mission is to improve the health of patients and the community through innovation and excellence in care, education, research and service. To fulfill its mission, Clarian uses the combined resources of its sponsoring institutions and its continuing affiliation with Indiana University School of Medicine, one of the nationÂ’s leading medical education and research centers. Clarian Health Partners, Inc. operates the Methodist Hospital, Indiana University Hospital and Riley Hospital campuses as a single hospital under Indiana law.

 

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