1. Lyndon, Audrey PhD, RNC

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I read Dr MacKinnon's article "Rural Nurses' Safeguarding Work: Reembodying Patient Safety" with great interest (ANS, April/June 2011, Volume 34, Issue 2, 119-129). I commend her for highlighting the important work of this skilled group of maternity nurses and their role in patient safety. It surprised me that Dr MacKinnon missed an opportunity to connect more broadly with the existing thread of safety literature examining the nurse's active role in creating and maintaining safe care. MacKinnon is correct that the safety literature too often misses nursing's contributions: two areas where this is particularly prominent are a focus on physicians as "front-line providers" and a focus on risk elimination that can obscure clinicians' central role in safe adaptation to evolving clinical circumstances. However, there are several publications taking a different approach: one that explicitly examines how nurses contribute to safety and what some of the barriers to optimal performance are in this context. In addition to the landmark Institute of Medicine report on this issue,1 selected other publications in this vein include Aiken et al,2 Clarke and Aiken,3 Henneman and Gawlinski,4 Henneman et al,5,6 Lyndon,7 Lyndon and Kennedy,8 Rothschild et al,9 and Rogers et al.10 It will be imperative, as well as interesting, to compare and contrast finding from across multiple settings to further articulate, develop, and make visible nursing's unique, active contributions to keeping patients safe now and in the future.




-Audrey Lyndon, PhD, RNC


Assistant Professor


Department of Family Health Care Nursing


University of California, San Francisco




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2. Aiken LH, Clarke SP, Cheung RB. Educational levels of hospital nurses and surgical patient mortality. JAMA. 2003;290:1617-1623. [Context Link]


3. Clarke SP, Aiken LH. Failure to rescue: needless deaths are a prime example of the need for more nurses at the bedside. Am J Nurs. 2003;103(1):42-47. [Context Link]


4. Henneman EA, Gawlinski A. A "near-miss" model for describing the nurse's role in the recovery of medical errors. J Prof Nurs. 2004;20:196-201. [Context Link]


5. Henneman EA, Blank FSJ, Gawlinski A, Henneman PL. Strategies used to recover medical errors in an academic emergency department setting. Appl Nurs Res. 2006;19:70-77. [Context Link]


6. Henneman EA, Gawlinski A, Blank FS, Henneman PL, Jordan D, McKenzie JB. Strategies used by critical care nurses to identify, interrupt, and correct medical errors. Am J Crit Care. 2010;19:500-509. [Context Link]


7. Lyndon A. Skilful anticipation: maternity nurses' perspectives on maintaining safety. Qual Saf Health Care. 2010;19:e8 [Context Link]


8. Lyndon A, Kennedy HP. Perinatal safety: from concept to nursing practice. J Perinat Neonatal Nurs. 2010;24:22-31. [Context Link]


9. Rothschild JM, Hurley AC, Landrigan CP, Cronin JW, Martell-Waldrop K, Foskett C. Recovery from medical error: the critical care nursing safety net. Jt Comm J Qual Patient Saf. 2006;32:63-72. [Context Link]


10. Rogers AE, Dean GE, Hwang W-T, Scott LD. Role of registered nurses in error prevention, discovery, and correction. Qual Saf Health Care. 2008;17:117-121. [Context Link]