The development of patient safety and the influence of the nurse: A discursive narrative.

Abstract

Background: Death, harm, or adverse outcomes as a result of accessing healthcare were recognised as a global endemic in the late 1990s and the trigger for the contemporary patient safety discipline.

Aim: To critically review the development of the patient safety movement; and, to determine the influence of the practitioner, in particular, nurses on patient safety.

Design: A discursive narrative using a conceptual framework.

Methods: We developed a conceptual framework consisting of the patient, practitioner, clinical setting, profession, clinical setting, culture of risk, wider society, and the healthcare system, to analyse the development of the patient safety movement. The data sources were considered across three eras commencing with Ancient Greece to the twenty-first century.

Findings: There has been no reduction in patient harm rates across two decades either in Australia or globally, despite resourcing and financial investment. The application of a conceptual model to analyse the influences on the development of the patient safety movement is the contemporary innovation of this discursive narrative. The importance of the practitioner and their influence across all eras was illustrated. The practitioner is the final critical line of defence to maintain the minimum requirement of patient safety.

Conclusion: Patients are no safer accessing healthcare then they were two decades ago. Nurses spend more time with patients than any other health discipline and therefore have a critical role in monitoring and maintaining safe care. Yet, the influence of the nursing profession on the development of the patient safety movement is largely absent in the literature. There is a need for a standardised approach to teaching and evaluating patient safety curricula.

Reporting method: No EQUATOR guidelines were discovered for the discursive paper format.