Despite investments by government and private institutions to increase patient safety, progress has been slow and uneven, according to researchers

The study reported that nearly 30 percent of hospital nurses gave their hospitals unfavorable grades on patient safety.

The majority of U.S. hospitals have room to improve nurses’ work environments and assure adequate nurse staffing to improve patient safety, according to a recent study in Health Affairs.

Olga Jarrín, an assistant professor at Rutgers School of Nursing and Institute for Health, Health Care Policy, and Aging Research, is part of a team of researchers that investigated whether hospitals have implemented key recommendations of the National Academy of Medicine (NAM) to reduce patient harm nationwide. The National Institutes of Health funded study is led by Linda Aiken at the University of Pennsylvania School of Nursing. 

According to the study, which followed 535 hospitals in four large states between 2005 and 2016, only 21 percent of hospitals substantially improved their clinical work environments, while 71 percent made no improvements, and 7 percent worsened.

“Both nurses and patients recognize that patient safety issues are worse in hospitals with clinical work environments that do not provide the structures, resources and time for nurses to provide optimal patient care,” said Jarrín. Nearly 30 percent of hospital nurses in 2016 gave their hospitals unfavorable grades on patient safety, and 55 percent definitely would not recommend their hospital to a family member or friend who needed care.

Patients also expressed concern about quality and safety with 30 percent reporting that they definitely would not recommend their hospital. Nearly 40 percent of patients said that they did not always receive help quickly from hospital staff, and nearly 40 percent reported that medications were not always explained before given.

“A nurse who has a good relationship with management and their coworkers can better advocate for their patients. A nurse who is caring for more patients has less time with each.  The math is simple,” said Jarrín. “This study reinforces the continuing need for hospitals to improve work environments for registered nurses as part of an effort to improve patient safety and patient outcomes.”