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Rounds with Leadership

Cynthia McCurren, AACN Board Chair and Deborah Trautman, AACN President and CEOWelcome to Rounds with Leadership, a forum for AACN’s Board Chair and President/CEO to offer commentary on issues and trends impacting academic nursing.

April 27, 2022 - Sustaining a Culture of Safety

Rarely are errors the fault of an individual, rather, they are the culmination of characteristics of systems of care. Rather than attach blame to individuals for errors committed, organizations must design non-punitive approaches to error and look well beyond individual providers to understand and redesign system-level processes for error prevention.

                                                Tri-Council for Nursing, Response to the Institute of Medicine’s Report To Err is Human, September 2000

The joy connected with hosting an in-person AACN Deans Annual Meeting last month was tempered by the news of the criminal conviction of former nurse RaDonda Vaught for making a fatal medication error. Despite numerous system failures contributing to this tragic accident, the individual nurse was held responsible for this terrible outcome, even though she was forthcoming about the unintentional errors made.

For more than 20 years, building a safer, quality-focused healthcare system has been a strategic focus for the health professions, following the release of a landmark report by the Institute of Medicine (now the National Academy of Medicine) in 1999 titled To Err is Human: Building a Safer Health System. This report makes clear that “it is simply not acceptable for patients to be harmed by the healthcare system that is supposed to offer healing and comfort” (p. 3). The authors call for focusing on understanding and eliminating systemic failures that contribute to medical errors while creating environments where healthcare providers can be transparent about mistakes made, which is critical to understanding how future errors can be avoided.

The response to the RaDonda Vaught verdict has reignited conversations about how to reinforce safety measures and adapt systems to focus on error reduction. Statements from the American Nurses Association, American Organization for Nursing Leadership, American Association of Critical-Care Nurses, and others in the discipline condemn the criminalization of medical errors and raise real concerns about how this might impact the honest reporting of mistakes by healthcare providers fearful of prosecution.

The potentially dangerous precedent set by this case is reverberating throughout the healthcare arena. Several leading authorities, including the Institute for Healthcare Improvement, see criminalizing medical errors as a risk to patient safety. On April 19, the National Academy of Medicine issued a statement citing the following:

A core finding of To Err is Human is that medical errors are most often caused by failures in systems, processes, and conditions that lead people to make mistakes or do not prevent them. The report does not absolve individuals from accountability but emphasizes that errors are typically the result of shortfalls in system safeguards against individual missteps. When an error occurs, the most effective way to prevent future errors is through systems-level changes that make it as simple as possible for individual health care workers to “do the right thing” and establish multiple protective mechanisms to prevent harm to patients even when an individual error might occur.

AACN is concerned that the progress made to adapt systems and create a culture of transparency when errors are made could be reversed if we do not focus on addressing systemic issues that compromise patient safety. In our new Essentials document, which outlines expectations for preparing professional nurses, we call for creating safe and just environments that “minimize risk to both recipients and providers of care. This requires a shared commitment to create and maintain a physically, psychologically, secure, and just environment. Safety demands an obligation to remain non-punitive in detecting, reporting, and analyzing errors, possible exposures, and near misses when they occur” (p. 39).

As academic nurse leaders, we remain committed to preparing professional nurses who are accountable for the care they provide and put patient safety first. We must continue to study all the factors that contribute to medical errors, while working collaboratively to uncover root causes and system failures.

Past Rounds with Leadership

April 27, 2022 - Sustaining a Culture of Safety
March 30, 2022 - Advancing a Strategic Plan
February 23, 2022 - New Dimensions in Leadership
January 26, 2022 - Engagement, Advocacy, and Impact
December 22, 2022 - Wishing You Good Health and Well-Being
October 27, 2021 - Following the Data
September 29, 2021 - Incubating Innovation
August 25, 2021 - First Steps Toward Implementing the Essentials
July 28, 2021 - Accelerating Momentum for Change
June 30, 2021 - Charting the Future of Academic Nursing – Part II
May 26, 2021 -  Charting the Future of Academic Nursing – Part I
April 28, 2021 -  Sustaining the Nurse Faculty Population
March 31, 2021 - Divining the Data
February 24, 2021 - Collaboration, Community Engagement, and a Cure
January 27, 2021 - New Year, New Congress, New Administration
December 23, 2020 - Building a Solid Foundation
October 28, 2020 - Co-Creating the Future of Academic Nursing
September 30, 2020 - Combating Racism and Cultivating Inclusion
August 26, 2020 - Moving Towards Reopening Schools of Nursing
July 22, 2020 -  Bridging the Distance
June 24, 2020 -  Is Paying for Clinical Preceptors in Our Future?
May 27, 2020 -  Investing in the Future of Academic Nursing
April 29, 2020 -  Sustaining Nursing Education Pathways
March 25, 2020 -  Rising to Meet the Challenge
February 19, 2020 -  The Year of the Nurse Educator
January 29, 2020 -  A 2020 View of the Nursing Workforce
October 23, 2019 -  Building on the Past, Envisioning the Future
September 25, 2019 - A Legacy of Risks and Rewards
August 28, 2019 -  Academic Nursing and the Fourth Industrial Revolution
July 31, 2019 - A Time for Generative Thinking
June 26, 2019 - Celebrating the Power of Compassionate Care
May 29, 2019 - On the Front Line of the Opioid Crisis
April 24, 2019 - Galvanizing Support for Nursing Now USA
March 27, 2019 - Advocating for the Future of Nursing
February 27, 2019 - Monitoring Trends in Higher Education
January 30, 2019 - Taking Action to Champion the PhD in Nursing
November 28, 2018 - Artificial Intelligence
October 24, 2018 - AACN LEADS: Your Leadership Journey Accelerated!
September 26, 2018 - The Nursing Community Coalition Celebrates 10 Years
August 29, 2018 - Collaborating to Advance the PhD in Nursing
July 25, 2018 - Exercising Thought Leadership
June 27, 2018 - Moving Nursing Science from the Margin to Mainstream
May 23, 2018 - Rallying Support for Nursing Education
April 25, 2018 - Watching the Numbers
March 28, 2018 - Surveying the Landscape of Higher Education
February 28, 2018 - With Appreciation
January 31, 2018 - Strengthening the Pipeline to the PhD
November 29, 2017 - From Dialogue to Collaboration
October 25, 2017 - Bridging the Nurse Faculty Shortage
September 27, 2017 - Joining the Conversation about Competency-Based Education
August 23, 2017 - A Time for Moral Courage
July 26, 2017 - Leading the Way
June 28 - 2017 - Understanding Health Equity
May 24, 2017 - A Global Commitment to Advancing Academic Nursing
April 26, 2017 - Why We Need to Talk About Nursing Science
March 22, 2017 - Vital Directions for Nursing
February 22, 2017 - Standing on the Shoulders of Giants
January 25, 2017 - New Year, New Home Base for AACN
November 16, 2016 - The Lame-Duck Session and the New Administration
October 26, 2016 - Harnessing the Power of Technology
September 28, 2016 - Contemplating the Future of Higher Education
August 24, 2016 - Taking the Lead on Information Curation