Quality and Safety in Nursing: Recommendations From a Systematic Review

Area of Science:

• Nursing
• Healthcare Quality and Safety
• Evidence-Based Practice

Background:

• Nurses are crucial for 24-hour patient care quality and safety (Q&S).
• A lack of comprehensive, evidence-based recommendations for nursing interventions to improve Q&S exists.
• Military hospitals require specific Q&S guidance within nursing professional practice models.

Purpose of the Study:

• To develop evidence-based recommendations for the Q&S component of nursing professional practice models.
• To guide nursing interventions aimed at enhancing patient care Q&S.
• To provide a foundation for Q&S practices adaptable to various healthcare settings.

Main Methods:

• A systematic literature review was conducted by a triservice military nursing team.
• Covidence software was utilized for literature screening and data extraction.
• Five databases were searched, and 249 articles met the inclusion criteria.

Main Results:

• Ninety-four practice recommendations were generated from the reviewed literature.
• Eight key focus areas emerged: communication, adverse events, leadership, patient experience, quality improvement, safety culture/committees, staffing/workload/work environment, and technology/electronic health record.
• These findings offer practical suggestions for Q&S implementation.

Conclusions:

• The systematic review successfully generated evidence-based recommendations for nursing Q&S practices.
• The identified focus areas provide a framework for enhancing patient care quality and safety.
• The recommendations are adaptable and can inform Q&S initiatives across diverse healthcare systems.