‘It's a matter of patient safety’: understanding challenges in everyday clinical practice for achieving good care on the surgical ward – a qualitative study

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Excerpt

Surgical care plays an important role in the acute hospital's delivery of safe, high‐quality patient care. The surgical ward is a multiprofessional work place in which high‐quality care, and positive patient outcomes depend upon close interprofessional collaboration between various departments and many health professionals. Medical progress has led to larger and older populations and hence to increased hospital admissions of elderly patients with multiple diseases for care and treatment, including surgery 1. Surgical departments also face organisational changes including fewer inpatient beds, shorter hospital stays and higher turnover of Registered Nurses. Although demands for effectiveness are high in surgical wards, quality of care and patient safety must also be secured. However, a recent systematic review 2 reports that healthcare systems face a major challenge in ensuring safe care and preventing harm. Although many healthcare professionals have a positive attitude towards patient safety, their knowledge of safety issues continues to be reported as deficient. The nursing profession is considered a key factor for patient safety and quality care. Previous research shows strong links between nurse staffing + education and patient mortality 3 and between adequate nurse staffing + resources and improved assessment of patient safety 4. Collegial nurse–physician relations and present, visible, competent leadership have also been reported to relate strongly to patient safety outcomes 4.

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