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Patient safety is just not possible without the right number of nurses

World Patient Safety Day helps us focus on what the evidence says about the role of nurses

World Patient Safety Day helps us focus on what the evidence says about the role of nurses


 A nurse attends to a patient at a hospital in Kenya Picture: Alamy

Most days of the year are international awareness days for something or other.

Some causes are more worthy than others. On the day I write this column, for example, we can commemorate Cheesecake Day. However, many days are dedicated to raising awareness of important health-related issues.

Why the world needs to mobilise on patient safety

The United Nations obviously sees the value of these international days as it marks more than 170 of them, with the intention of ‘mobilising political will and resources to address global problems and celebrating and reinforcing achievements of humanity’.

A new date on the calendar is World Patient Safety Day on 17 September. The International Council of Nurses (ICN) has worked closely with the patient safety leads at the World Health Organization (WHO) and we are pleased to mark this.

Patient safety is a principle for all nurses, and nursing is critical to the patient safety agenda every day of the year. It is not just about ensuring nursing practice is safe: nurses also have a vital role in monitoring, detecting and preventing issues that could give rise to patient harm.

The evidence base on nurse numbers

Earlier this year, ICN and the Saudi Patient Safety Center launched our White paper on Nurse Staffing Levels for Patient Safety and Workforce Safety.

This brings together evidence from a wide range of sources, covering different countries and contexts, showing that having the right numbers of nurses in the right place and at the right time, delivers quality and safety for the populations they serve, and will help to retain nurses.

‘When nurses are working under constant pressure, their ability to detect problems as they arise and protect patients is compromised’


WHO director-general
Tedros Adhanom Ghebreyesus

WHO director general Tedros Adhanom Ghebreyesus emphasised how vital nurses are to patient safety in his speech at this year’s ICN Congress in Singapore.

He said nurses have an important role to play in reducing patient harm: ‘If systems fail, it’s the nurse who can prevent harm.’

But Dr Tedros acknowledged that when nurses are working under constant pressure, their ability to detect problems as they arise and protect patients is compromised.

The right number of nurses prevents harm and saves lives

This was the same message we heard at congress from the renowned nurse researcher Linda Aiken, whose latest research confirms her previous findings that having the correct number of registered nurses on duty prevents harm and saves patients’ lives.

Professor Aiken’s research also shows that the things that cause nurses to burn out are the same things that cause patients to be dissatisfied with their care and put them at risk. ‘All these things are connected,’ she said. ‘And they can be solved by improving staffing and the working environment.’

Patient safety and nurse satisfaction are two sides of the same coin: satisfied nurses are more likely to stay in their jobs and want to continue to work. Dissatisfied nurses risk burnout and are more likely to leave the profession.

With the massive shortages of nurses predicted over the next decade, governments must set up systems for safe staffing that will retain existing staff and recruit the new generation of nurses that we need for the future.

Bringing expert care to crisis zones


 A hospital in Afrin, Syria following an air strike Picture: Getty

Another day on the awareness calendar that I want to draw your attention to is World Humanitarian Day on 19 August, which this year honours the work of women working in the world’s crisis zones.

Nurses are the largest qualified health profession, and wherever healthcare crises arise, whether through famine, natural disaster or infection, nurses will be in the vanguard, helping wherever they can, even to the extent of putting themselves at risk.

19 August is a day to remember those nurses who put their lives on the line for their patients.

We should be pressing for needs-based nurse staffing

Wherever nurses are caring for patients, we should be campaigning for investment in safe, effective and needs-based nurse staffing: it is not only critical for patient safety, it can also reduce the unnecessary cost of treating avoidable healthcare-associated conditions, and help keep nurses safe too.

As Dr Tedros said, any country that has too few nurses is working with one hand tied behind its back.


Howard Catton is chief executive of the International Council of Nurses and former head of policy and international affairs at the RCN

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