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Letter to the Editor by Khasawneh on "Patient Safety: Who Guards the Patient?"

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October 25, 2005
in response to topics Patient Safety: Who Guards the Patient? (September 30, 2003)
and Nurse Safety: Have We Addressed the Risks? (September 30, 2004)

Dear Editor:

I am responding to the recent OJIN topics of Patient Safety and Nurse Safety. Nursing information technology can play a key role in protecting patients by eliminating nursing mistakes. For example it can enable nurses to use hand-held devices for accurate prescribing and medical problem solving and for using records of dermatological photos to help in the correct diagnosis of skin rashes. Information technology can also have a significant role in enhancing nurse safety by reducing their exposure to negative conditions. For example, it can provide music and other pleasing sounds (water, wind, bird songs) in the workplace thereby helping to decrease anxiety and manage emotional state. Information technology can also monitor and control environmental conditions such as humidity, by decreasing humidity so as to decrease the growth of microorganisms or increasing humidity to prevent the build-up of static electricity with a concomitant risk of fire.

However, an important part of managing information technology is managing the people who use it. As nurses we need to examine the environmental phenomena which impact the way we introduce information technology so as to make health care agencies safer for nurses and patients alike. One such phenomenon is the culture of blame which casts fear over doctors, nurses, and other hospital workers. Between medical malpractice lawsuits and anxiety over tarnishing one's reputation, hospital staffers are often afraid to raise even the aroma of a problem in the way their work is conducted, even if they personally did nothing wrong. Now, a movement is gaining ground that could transform health care's culture of blame into a culture of safety. Its main tenet is to encourage voluntary disclosure of medical errors without fear of punishment. Promoting trust within an organization by doing away with blaming individuals who make errors helps nurses to feel safer in reporting errors and near misses. These reports enable nurse leaders to identify weak areas and strengthen organizational systems.

Rami Raja Saleh Khasawneh, RN, BSN, MPH -
Health Care Administration, Ward Nurse
Royal Hospital
Accident/Emergency Department
Sultanate of Oman, Muscat
Email: rami_khasawneh2000@yahoo.com

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