National Nursing Week is May 6-12 where we pause to celebrate the patient centric profession of healing and compassion. The theme for this year is “4 Million Reasons to Celebrate”, a reference to the vast number of Registered Nurses in the United States. A group of this number, when organized and focused, can be an effective team capable of making national impact on the outcomes of our patients. However, change of this magnitude was fostered by a single individual at the front step of the age of modern nursing practice over 160 years ago.
Florence Nightingale (1820 –1910), whose birthday coincides with the end of the celebratory week, is recognized as the individual who re-engineered the profession of nursing as a more scientific based practice. Her claim to fame was based, in large part, with her impact on care of the wounded, ill and injured during the Crimean War (1853-1856). Her implementation of hygienic practices and advocacy for greater government support for patient care reportedly reduced death rates from 42% to 2% during the war (according to Dr. Stephen Paget in the Dictionary of National Biography). Additionally, she demonstrated that comprehensive training of its members and incorporating the latest advances in health care with a focus on infection control practice, environmental considerations and healthcare analytics makes a difference in patient care outcomes. It’s not hard to realize that these issues are as relevant today as they were over 150 years ago.
As revolutionary and controversial as Florence’s changes must have seemed in her time, the focus of her efforts always remained on the patient. She recognized the high mortality and suffering that patients in the 1800’s faced. She also knew that nursing, more than any profession, was able to improve on the care of patients and was relentless in her efforts to see our profession take a spot at the forefront of positive change.
Today, our patients face many of the same dangers that plagued their counterparts during Florence’s time despite the advances in modern medicine over the past 160 years in the U.S.
- 7,000 to 9,000 people die each year as a result of a medication error.[i]
- 700,000 to 1 million hospitalized patients fall each year.[ii]
- 5 million patients are affected by pressure injuries each year, resulting in 60,000 deaths.[iii]
- 1 out of every 25 hospitalized patients are affected by a hospital acquired infection resulting in 90,000 deaths annually.[iv]
- 270,000 people die annually from sepsis – one every 2 minutes; more than from prostate cancer, breast cancer and AIDS combined. [v]
Now, as during Florence’s time, nursing is positioned to make a difference in patient outcomes. Consider the contributions that nursing has already made:
- Assertive medication safety programs (5 rights, double-checks, reconciliation, patient education and environmental controls) have been shown to reduce medication errors when protocols are followed.
- Purposeful patient rounding has been demonstrated to reduce hospital patient falls as they are often attributed to patient toileting.
- Effective pressure offloading and control of moisture, when consistently performed, contribute to the prevention of pressure injury formation.
With the national focus on sepsis being a leading cause of death with inpatients, nursing is poised to make a tremendous impact on patient outcomes. Mortality from sepsis increases by as much as 8% for every hour that treatment is delayed. What is alarming is that as many as 80% of sepsis deaths can be prevented with rapid diagnosis and treatment. As nurses, we can turn these statistics around through effective monitoring of patients and recognition of the early signs of sepsis. Notification to the provider staff of our observations and persistence in seeing expeditious treatment started can ensure our patients receive the interventions proven to save lives. We do this through education of ourselves, other members of the health care team and institute measures that facilitate early recognition and treatment.
We must embrace our role as patient care advocates and ensure we remain at the front and center of patient safety. The Joint Commission publication, “Front Line of Defense: The Role of Nurses in Preventing Sentinel Events”[vi], is an excellent resource that is founded in Florence Nightingale’s approach to patient centered care and patient safety. It provides some of the root causes and practical approaches to mitigate common sentinel events associated with a variety health care settings. It provides information on how nursing is a critical part of a highly reliable health care organization.
In summary, take the time during National Nursing Week to celebrate being part of a profession that has proven itself as change agents for positive patient outcomes. Reflect on the contributions that one individual, Florence Nightingale, was able to make in re-engineering the profession that has impacted so many lives. Let us pledge to each other that our 4-million-person team will remain diligent in our efforts to improve on the lives of our patients!
[i] Tariq RA, Scherbak Y. Medication Errors. [Updated 2019 Jan 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
[ii] The Agency for Healthcare Research and Quality. Retrieved from https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit.
[iii] Padula, William & J Pronovost, Peter & Makic, Mary Beth & Wald, Heidi & Moran, Dane & K Mishra, Manish & O Meltzer, David. (2018). Value of hospital resources for effective pressure injury prevention: A cost-effectiveness analysis. BMJ Quality & Safety. 28. bmjqs-2017.
[iv] Magill SS, Edwards JR, Bamberg W, et al. Multistate Point-Prevalence Survey of Health Care–Associated Infections. New England Journal of Medicine 2014; 370:1198-208.
[v] The Sepsis Alliance. Retrieved from http://www.sepsis.org/resources/infograpics.
[vi] Front Line of Defense: The Role of Nurses in Preventing Sentinel Events. Third Edition. Joint Commission and the American Nurses Association. Oakbrook, IL: Joint Commission Resources, Inc; 2018.