Addressing the nursing work environment to promote patient safety.

TOPIC The nursing work environment has a critical impact on patient safety. Yet confusion on the specific roles and competencies of nurses, staff ratio issues, and lack of nurse empowerment create weaknesses that result in safety risks. PURPOSE These interrelated issues must be addressed systemically to impact the nursing care system. DISCUSSION Educational reform focusing upon standardized, higher level nursing education using a military model, appropriate staff ratio laws derived from the outcomes literature, and recurrent training incorporating policy-making powers can result in nurse empowerment and improved patient safety. CONCLUSION Improving the nursing environment requires a broad approach to benefit patient safety. By treating the work environment as a complex system, approaches can result in greater nurse professionalism, empowerment, and patient safety.