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Journal of Nursing Administration:
doi: 10.1097/NNA.0b013e3181ae9653

On the Ball: Leadership for Patient Safety and Learning in Critical Care

Tregunno, Deborah PhD, RN; Jeffs, Lianne MSc, RN; Hall, Linda McGillis PhD, RN; Baker, Ross PhD; Doran, Diane PhD, RN; Bassett, Sue Bookey MEd, RN

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Objective: To explore nursing leadership for patient safety in critical care and identify opportunities to improve leadership that promotes patient safety.

Background: There is limited systematic evidence about how nurses lead the microsystem of critical care and to the creation of a culture of patient safety.

Methods: Focus groups of multidisciplinary frontline providers and managers were used to gain insight into leadership that promotes patient safety and learning.

Results: Gains in critical care patient safety require a skilled nursing leader who is mindful of bedside situations and has real-time decision-making authority. Patient safety is seen as management of the moment, rather than a function of organizational systems and processes.

Conclusion: Leadership for improved patient safety resides primarily with nurses who provide direct patient care. These nurse leaders play 3 critical roles: they are the "go-to," they are "on the ball," and they "keep the ball rolling."

© 2009 Lippincott Williams & Wilkins, Inc.



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