Health & Medical Children & Kid Health

Point-Counter Point: A Culture of Safety in the NICU?

Point-Counter Point: A Culture of Safety in the NICU?

Pro (Carole Kenner)


Many systems have been put into place to ensure patient safety. These include Situation, Background, Assessment, Recommendation (SBAR), electronic health records (EHRs), medication reconciliation systems, interprofessional walking rounds—including parents, and recognition of worker fatigue resulting in reduced resident hours, to name a few. Each of these does contribute to a culture of safety.

The SBAR's purpose was to increase the accuracy of the hand offs between shifts through the standardization of this communication and improve continuity of care. In 2005 the Patient Safety and Quality Improvement Act passed which led to the development of Patient Safety Organization (PSO) programs. These programs in turn led to the development of databases to house data collected regarding safety issues. Raju, Suresh, and Higgins (2010) examined patient safety in the NICU from the context of research or evidence and education. They noted that patient safety is a recognized concern in health systems today and that more emphasis is placed on the use of technology to improve immediate access to information and for simulated training. In neonatal care most of the errors occur during resuscitation, feedings, procedures, misidentification of patients, and diagnostic errors. The implementation of consistent identification of neonatal patients, the use of the SBARs, EHRs, simulated experiences as part of ongoing staff competencies, as well as training, and interprofessional walk-rounds has improved neonatal safety.

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