9.4: Summary

Safety: Individual and Environmental

Individual safety is an essential component of good health, and it should be prioritized above anything else. There are many aspects for the nurse to consider when maintaining individual safety including understanding a patient’s developmental stage of life, physical and psychosocial health risk factors, and any knowledge deficits. Nurses can incorporate Maslow’s hierarchy of needs to help prioritize care. Environmental safety is also a major concern. Nurses must educate their patients on topics such as falls, fires, poisoning, suffocation, exposure to substances, and weather-related issues like hypothermia. Occupational safety is needed to prevent or reduce the risk of work-related injuries. Occupational, environmental, and personal safety are all interconnected and must be prioritized to prevent accidents, injuries, and illnesses.

Safety measures must also be taken regarding the nurse themselves. Creating a just culture is one way to help reduce errors such as near misses and never events. Just culture allows nurses to learn from their mistakes and the mistakes of others without the fear of judgment. Just culture also allows the organization to see why a mistake happened and how to best keep it from happening again.

Nurses play an important role in educating patients, families, and communities regarding safety concerns but should consider any SDOH when planning education. Nurses assess and address patient safety risks related to each individual situation. There are many populations that experience increased prevalence and burden of diseases. These populations are more at risk because of the lack of access to quality health care. This is defined as SDOH. The SDOH include a person’s lack of access to sufficient water, shelter, food, support, and financial resources. Many groups of people experience health disparities related to age, gender, ethnicity, socioeconomic status, and mental health. Nurses must be mindful of each individual’s unique situation and plan care accordingly to help minimize any risk to safety.

Safety: Violence

There are many different forms of abuse that can occur across the life span. The nurse needs to have a thorough understanding of different types of abuse to effectively plan care for their patients. Recognizing cues associated with physical, psychological, financial, and substance abuse is one way the nurse can make informed clinical decisions. For example, if a nurse was to notice bruising or other markings on a patient consistent with physical abuse, they would report these findings immediately per the facility’s protocol. Family violence is also a concern for the nurse when making clinical decisions. Family violence includes intimate partner, child, and elder abuse. Sometimes the nurse is the first person to discover this form of abuse, whether it be in a primary care office, hospital, or community resource location. Nurses must perform comprehensive assessments to properly recognize signs, plan appropriate interventions, and provide the patient with resources.

Social violence can take place in many different forms and settings. A few examples include bullying, incivility, workplace violence, and human trafficking. Nurses need to address social violence from a multifaceted approach. This means identifying the root cause to promote safety and well-being of the person and community. Nurses can advocate by promoting policies that reduce access to weapons and other dangerous objects as well as addressing issues such as poverty, discrimination, and inequality that can contribute to social violence. After discovery of an act of social violence, nurses can provide support and resources to those who have been impacted. Examples of such resources to help patients heal from the trauma of violence include counseling and mental health care.

While it may seem as though bullying, other forms of social violence, and workplace violence are outside the role of the nurse, nurses do work in schools and in communities and can be a vital link to help those who are suffering. Nurses have a vital role in assessing for and intervening in circumstances of violence that require assessment and intervention from a nursing perspective. Nurses can do this in a way that is supportive of the needs and wishes of the victims of violence.

Security: Privacy and Informatics

While technology has enhanced nursing practice and healthcare delivery, it has also presented some challenges. The introduction of technology has led to the need for increased attention to privacy and the protection of patients’ personal health information. Nurses must ensure patient information is protected, and thus, they play a vital role in the use of healthcare technology. The introduction of technological advancements, such as EHRs, has made it easier for healthcare providers to share accurate patient information with one another. Patient access to EHRs has increased the ability for patients to take accountability for their own health care by accessing lab results and managing their appointments. Technologies related to patient care have evolved, making care safer and more efficient. Nurses have and will continue to have a key role in this, evidenced by the emergence of nursing informatics as both a specialty and expected competency for all nurses. Artificial intelligence and similar new technologies challenge nurses to adapt their practice while continuing to meet expected requirements related to protection of information and privacy.