Nurse behavior makes patients feel safe

Hospitalized patients over the age of 65 years feel safe in hospital when their nurses can anticipate and provide attentive care, are predictable and responsive, interact on a personal level, and advocate or intervene on their behalf, indicate study results.

The factors required to feel safe did not differ between inpatients in urban and rural hospitals, remark the researchers.

"The knowledge gained about conditions under which feeling safe operates for older adults in acute care will improve healthcare quality by informing nursing practice and thereby enhancing the efficiency and effectiveness of healthcare," say Sue Lasiter and Joanne Duffy from Indiana University, Indianapolis, USA.

A total of 20 patients were interviewed for the study from July through December 2011, half of whom were inpatients at an urban and half at rural institutions. Responses to interview questions including "What does feeling safe in the hospital mean to you?" were analyzed using a grounded theory method to identify the basic social process of feeling safe.

Lasiter and Duffy classified the patients' responses into four categories: oversight, predictable, personalized, and advocate, and defined the basic social process for feeling safe in hospital as "the need for actual or potential interaction with a nurse."

Oversight included the ability of nurses to anticipate care, check frequently on patients, and be attentive. One patient said that she "just felt like they [nurses] watch over the things that could happen," which made her feel safe.

Patients felt safe when nurses were available, could be counted on to be skilled, professional, competent, and responsive, as well as knowing that patient well-being was of "ultimate importance."

Nurse-patient interaction on a personal level helped patients feel safe, with one respondent describing the appreciation of a nurse who "knows my situation."

Finally, acting as the patients' advocates and intervening on their behalf made respondents feel safe, particularly when nurses explained procedures in detail, and communicating with physicians when patients did not wish to continue certain medications

"Creation of a safe and caring environment may influence a reduction in recovery time and improve posthospital outcomes," write the authors in the Journal of Nursing Administration.

And, although the findings cannot be generalized beyond the population studied, "they do have important implications for nurse leaders," they conclude.

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