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Nurse Perception of Workplace Safety Affects Patient Care

Zolot, Joan PA

AJN, American Journal of Nursing: February 2017 - Volume 117 - Issue 2 - p 14
doi: 10.1097/01.NAJ.0000512286.71113.23
In the News

When RNs feel safe, experience and outcomes improve for nurses and patients.

Joan Zolot, PA



Nurses’ sense of physical and emotional safety in the workplace translates into greater nurse satisfaction and better patient care, according to a report released by health care consulting firm Press Ganey (see Its analysis examined two factors: nurse perception of workplace safety and nurse perception of surveillance capacity. Workplace safety refers to the presence of measures that minimize the risk of physical or psychological harm—for example, safe patient handling and mobility practices, and reasonable patient care assignments, meal-break practices, and shift duration. Surveillance capacity refers to having adequate resources on the unit so that nurses can effectively monitor and evaluate information in order to make decisions regarding patient care.

Press Ganey assessed associations between nurse reports of safety and surveillance capacity and the experience and outcomes of nurses and patients, utilizing data it collected from more than 600 hospitals and from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare Web site. Higher scores for both workplace safety and surveillance capacity were associated with higher nurse ratings of quality of care, lower rates of missed-care events (tasks that were left undone on the last shift), and lower rates of pressure ulcers and patient falls. Organizations ranked in the top quartile of RN-perceived workplace safety had a 52% lower rate of RN-perceived missed care, a 27% higher rate of job enjoyment, and a 22% higher CMS overall hospital quality rating, compared with organizations in the bottom quartile. Regarding surveillance capacity, organizations in the top quartile had a 26% lower rate of hospital-acquired pressure ulcers, a 13% lower rate of RN-perceived missed care, and a 5% higher CMS overall hospital quality rating compared with hospitals in the bottom quartile.

The findings highlight the many benefits to hospitals of developing and maintaining policies that assure nurses they are safe and have adequate resources at work. Policies include those affecting nurses directly, such as nurse-to-patient ratios and adequate unit staffing, as well as hospital-wide policies for occupational safety. One example is the standards and precautions for handling hazardous drugs, which must be maintained and updated periodically. For a list of hazardous drugs used in health care settings and information on handling them, go to —Joan Zolot, PA

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