Patient safety perceptions: a survey of Iowa physicians, pharmacists, and nurses.

BACKGROUND: Patient safety is of concern to consumers, health professionals, policymakers, insurers, and researchers. OBJECTIVE: Assess the perceptions of health care providers regarding the impact of parts of the health care system on patient safety, barriers to patient safety, and strategies to improve patient safety. METHODS: Statewide survey mailed in May 2001. Participants rated the impact of 10 parts of the health care system on patient safety, selected barriers to patient safety that they thought should be priorities, and selected the best strategies for improving patient safety. RESULTS: Of random samples of 1310 physicians, 1310 pharmacists, and 2620 nurses licensed by the state of Iowa, 5075 providers were eligible and 2388 responded (47%). Provider education, norms and values, patient and family characteristics, and continuity of care were rated as having a major impact on patient safety by at least 70% of each provider group. A general lack of consensus exists among providers about which barriers to patient safety should be priorities and which strategies would best improve the system. However, a majority of providers agreed that educating patients about their role in health care and sharing information between providers and across settings of care are important strategies for improving patient safety. CONCLUSION: In areas in which providers agree on the best strategies, broader, system-wide interventions that include physicians, pharmacists, and nurses in multiple settings may be implemented to improve patient safety. Health care organizations and providers must get patients more involved in their care by asking them to help define roles, design educational materials, and develop useful methods of sharing information across settings.

Key ethical issues encountered in healthcare organizations: the perceptions of staff nurses and nurse leaders.

The authors compare the results of a May 2002 ethics issues survey of staff nurses who are members of the American Nurses Association (ANA) with those of a February 2000 survey of American Organization of Nurse Executives (AONE) nurse leaders. The findings reveal a common set of key ethical issues that result from the ineffective management of the conflict between clinical ethics and organizational ethics. Implications for healthcare professionals and the organizations that employ them are discussed.

Ethical helps and challenges faced by nurse leaders in the healthcare industry.

Professional healthcare providers are held responsible for technologic and financial decisions and also for the moral ramifications of their decisions. The authors report the findings of a survey of nurse leaders conducted to determine the key factors that provide help and present challenges as they seek to respond ethically to the dilemmas encountered in the course of their work. Implications for the healthcare industry and the nursing profession are discussed.