When to Escalate
Safety and Ethics Are One Bedside Practice
Patient safety is the prevention of avoidable harm and the rapid reduction of harm when a hazard or incident occurs.
Patient safety is the prevention of avoidable harm and the rapid reduction of harm when a hazard or incident occurs. Ethical practice determines how the nurse protects the person while doing that work: respect the patient’s choices, preserve privacy, provide care within competence, and speak truthfully when care has not gone as intended. These duties are connected. A nurse who notices an incorrect patient identifier but proceeds because the medication pass is busy creates a safety risk and violates the duty to provide competent, safe care. A nurse who corrects the error but hides it prevents the patient and team from making informed decisions and prevents the organization from learning. The Canadian Quality and Patient Safety Framework for Health Services describes five linked goals: 1. safe, effective care; 2. person-centred care; 3. reducing avoidable harm; 4. reducing inequities; and 5. building a safety culture. For an RPN, applying these goals means working within current competence, the assigned role, applicable regulatory requirements, and employer policy. It also means recognizing when a patient’s needs exceed the nurse’s authority or preparation. The appropriate...
