At NANDA-I Confab Nursing Expert Addresses Patient Safety

May 25th, 2012


By , BSN, RN

NANDA-I whipped it up to full throttle today. The conference officially opened with the equivalent of a nursing authority rock star giving the keynote address. Maybe we should make it a country star since she was speaking in Texas and even agreed to a photo op in her appreciation gift of a cowboy hat decorated with an official NANDA-I scarf.

If you have read any nursing research about the nursing shortage in this country you probably have heard of Linda Aiken, PhD, FAAN, FRCN, RN. She is an authority on causes, consequences, and solutions for nurse shortages in the U.S. and internationally. Aiken leads the International Hospital Outcomes Consortium studying the impact of nursing on patient outcomes in 13 countries and she is a leading expert on global nurse migration, its consequences, and solutions in developing and developed countries.

NANDA-I, in part, defines its mission as contributing to patient safety through the integration of evidence-based terminology into clinical practice and clinical decision-making. In other words, if we all use the same language, all understand the same terminology our patients are safer, since we are all on the same page for treatment and care. Aiken’s opening speech was right in line with that sentiment—Nursing: The Key To Making Patient’s Safe.

”I am starting at the beginning of nursing, at least as we know it in the western world, with Florence Nightingale,” Aiken said. “Most folks in the Crimean War were dying of preventable causes. She created this idea there should be trained individuals to keep people safe—and that was the beginning of modern nursing.”

”What I think is that nursing is the major unfinished patient safety agenda,” Aiken continued. She then continued on talking about some of the challenges facing nursing outcome research. Among those challenges she listed was the absence of a universal language.

She included language needs describing nurses’ qualifications, important features of nursing care, and nurse interventions included in hospital computerized administrative clinical records across state and national jurisdictions such as medical procedures and patient outcomes.

What Is A Good Work Environment?

Aiken went on to discuss her work in studying nurse work environments around the globe. She has been looking at nurse burnout rates and the ties to patient safety. In reviewing 12 European countries with high nurse dissatisfaction and burnout numbers patient safety is threatened. The US fared only minimally better. It was interesting to note, as Aiken told us, that almost three-quarters of nurses in every country say that management does not respond to problems pointed out by RNs at the bedside. Sound familiar?

According to Aiken, here is what we do know about the relationship between nurses and patient safety:

  • Lower patient to nurse ratios are associated with lower mortality, less failure-to-rescue, higher patient satisfaction when work environments are good.
  • More BSN nurses are associated with lower mortality and failure-to-rescue under all types of work environments.
  • More nurses with specialty certification are associated with lower mortality and failure-to-rescue but only when BSN educated.
  • Improvements over time in work environments, percent of BSNs, and nurse staffing are all associated with reduced mortality and failure-to-rescue and higher patient satisfaction, i.e. growing evidence that investments in nursing are causally linked to better patient outcomes.

Aiken gave all in attendance something to think about. As the keynote speech was wrapped up she asked if there were any questions. Seeing as this is the nursing language meeting of the year those questions and comments concerned the role of nursing language in her research. NANDA-I members wanted to know where standardizing language could fit into her future studies pertaining to patient safety and last I heard, there were promises of e-mail exchanges and suggestions for future projects.

The NANDA-I 40th Anniversary Meeting Conference left the starting line at full speed and I look forward to more interesting turns to come.

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