1. Freda, Margaret Comerford EdD, RN, CHES, FAAN, EDITOR

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I've always had heroes in nursing, and the list is constantly evolving. My heroes in nursing have ranged from staff nurses I've known who have given their all for a patient in a harrowing situation to some of the biggest "names" in our profession. In my next few editorials I'd like to discuss my current heroes in nursing. Perhaps some of them you've heard of, and some maybe not. Linda Aiken is the first. Dr. Aiken has made many invaluable contributions to nursing, among them developing and testing research methods to document the significant contributions of nurses to the quality of care and patient outcomes in hospitals. To do this, Dr. Aiken developed and applied the "failure-to-rescue" concept as a measure of hospital nursing care. "Failure to rescue" measures how well hospitals do in saving the lives of patients who become worse without warning, and is based on the idea that nurse surveillance is critical to early detection and successful management of unexpected complications. This work is some of the most important work done by nurses for nurses in my lifetime and, I'll bet, in yours.


Recently I was privileged to attend a lecture Dr. Aiken gave at Stony Brook University about patient safety. It was standing room only, in one of the large lecture halls, with every health discipline in the audience. The CEO of the university hospital and the deans of the medical and nursing schools were in the front row, anxious to hear Dr. Aiken's message. Quite a reception for a talk about patient safety. And what did she discuss? Not computer systems, not record keeping, not falls, not acuity levels. She discussed the importance of nursing. She discussed the essential nature of nursing to the very essence of patient safety. It was the presentation I've hoped someone would give for many decades!! Dr. Aiken, through her meticulous research at the Center for Health Outcomes and Policy Research at the University of Pennsylvania, has demonstrated that it is nurses who act as the surveillance system in hospitals. It is nurses who are the early warning system for safety at institutions. It is nurses who improve patient outcomes, and nurses who therefore must be nurtured. Her research has shown that it is not computerized pharmacy order systems that will have the greatest impact on patient safety, but rather it is improving the work-place for nurses and making nurses satisfied with their jobs. Her presentation wasn't opinion, it was research. There is no doubt about her results. As each of her studies built upon the next in her talk, it became completely clear: More nurses, and better-educated nurses, equal better outcomes and increased patient safety. In the face of a nursing shortage, she has shown that better-educated nurses, even in smaller numbers, equal better outcomes and increased patient safety. No polemics, no diatribes, no "us against them." Just data. Powerful, exciting data. Dr. Aiken and her group have published many, many articles, and I'm not going to list them here, because it would take up most of my space for this editorial. But you should put her name in the keyword section of PubMed, find these articles, and read them. You'll be excited and thrilled to find that there is proof that nurses are the engine that drives patient safety and that institutions are finally seeing that reality.


Everyone in healthcare is talking about patient safety, but precious little is being done to improve the situation yet. Dr. Aiken is doing her part by conducting this groundbreaking research and presenting it to nurses, administrators, and physicians all over the country. We need to do our part by reading her work, and making sure our CEOs have read it as well. I'd go so far as to say you're not doing your job as a nursing leader or administrator appropriately if you are not fully aware of Dr. Aiken's work and the impact it should have on the everyday work situation of nurses. Use her research to force change in the work environment for nurses at your institution. We've been waiting a long time to have these data. Now we must use them to our advantage. When a hero comes along, we should all listen, and take action.