IOM: Work environment of nurses needs to change to prevent medical errors

Once again, research is backing up what nurses have been saying for years: Too much time on the job is dangerous for patients.

For a while now, nurses have been speaking out about the barriers to good patient care: mandatory overtime and short staffing. A recent report from the Institute of Medicine (IOM) says that the work environment of nurses needs to be transformed to better protect patients from medical errors. In 1999, the IOM report, "To Err Is Human," estimated that each year as many as 98,000 people who are hospitalized die because of errors.

The new report focuses on nurses. They are key to safety because nurses spend the most time with patients and they are largest segment of the healthcare workforce, say researchers. The institute calls for changes in how nurse staffing limits are established, and for mandatory limits on nurses' work hours, as part of a comprehensive plan to improve patient safety. According to the researchers, four areas threaten patient safety and need to be improved: management, workforce deployment, work design and organizational culture.

The panel stresses that none of the IOM recommendations is less important than the others. "No one or two actions by themselves can keep patients safe," says Donald M. Steinwachs, chair of the committee that wrote the report.  "Rather, creating work environments that reduce error and increase patient safety will require fundamental changes in how nurses work, how they are deployed, and how the very culture of the organization understands and acts on safety."