Patient Safety Is a Growing Problem, But Nursing and Medical Students Are Resisting the Coursework

• Patient safety failures cost lives, increase costs, and have even led to criminal charges.
• Approximately 200,000 people die each year because of hospital errors.
• Nursing and medical students are not typically engaged in studying patient safety.
• Nurse researchers and educators are surfacing ways to address this.

Healthcare safety remains a problem in hospitals, even in the face of recent advancements. During 2022, The Joint Commission received 1,441 reports of serious adverse impacts on patient health — an increase of 19% over 2021.

There's further evidence of an alarming pattern. For its part, The Leapfrog Group discovered a 60% increase between 2021 and 2022 in the ratio of central line-associated bloodstream infections, a 37% increase in cases involving antibiotics-resistant MRSA bacteria, and a 19% increase in catheter-associated urinary tract infections.

As a result, there is a clear need for clinician awareness, not only of the underlying issues but of the proper protocols for avoiding and mitigating such incidents. Even so, according to recent reports, students are less likely to enroll in patient safety courses. In a study of third-year medical students, surveys found that 59% of students were not aware of system-based approaches to improving safety or how they function.

Barriers to Patient Safety

Back in 2006, a group of physicians, nurses, and patients identified barriers to patient safety, and the physicians and nurses discussed ways that for medical and nursing students, patient safety education could be improved.

In that report, physicians and nurses both highlighted several factors as being potential obstacles to optimal patient safety:

• Increasing complexity of healthcare
• A culture of tolerating medical errors
• The role of healthcare hierarchies
• Punitive response to errors
• Medical safety
• Intersection of medical, legal, and ethical consideration
• Imperfect or complicated error reporting systems
• Overall models for reducing errors.

Nearly two decades later, evidence suggests these problems have not been adequately addressed in either medical or nursing curricula. For example, in the medical student survey, half of trainees reported witnessing or experiencing a patient safety issue — but only 10% said they reported the issue.

At the same time, as little as one day of safety-related instruction left students feeling more empowered to act on patient safety issues as a result of the program.

Effective Patient Safety Education

While one-off training interventions can be effective, patient safety topics are far more sweeping in their scope. This is certainly true for nursing, even as safety training is not always apparent in the average nursing school curriculum. A 2014 literature review found that while patient safety topics are included in the nursing curriculum, “patient safety in nursing curricula was not necessarily obvious.”

In response, nurse educators and other healthcare education experts are exploring deeper integration of patient safety into all aspects of the curriculum. One such approach calls for instruction in the following areas:

• Patient safety principles
• Teamwork
• Communication
• Patient engagement
• Risk management
• Quality improvement
• International Patient Safety Goals

Simulations and case discussions can be strong allies for safety education efforts.

Inclusion of key topics in the nursing curriculum and in professional development offerings can help to address patient safety issues, experts said. This, and bringing patient safety forward as an intentional consideration during other aspects of education, can help to improve patient safety, support and improve nurse morale and work satisfaction, and avoid the trauma caused to both patients and nurses when there are failures in patient safety.