On the ball: leadership for patient safety and learning in critical care

J Nurs Adm. 2009 Jul-Aug;39(7-8):334-9. doi: 10.1097/NNA.0b013e3181ae9653.


Objective: To explore nursing leadership for patient safety in critical care and identify opportunities to improve leadership that promotes patient safety.

Background: There is limited systematic evidence about how nurses lead the microsystem of critical care and to the creation of a culture of patient safety.

Methods: Focus groups of multidisciplinary frontline providers and managers were used to gain insight into leadership that promotes patient safety and learning.

Results: Gains in critical care patient safety require a skilled nursing leader who is mindful of bedside situations and has real-time decision-making authority. Patient safety is seen as management of the moment, rather than a function of organizational systems and processes.

Conclusion: Leadership for improved patient safety resides primarily with nurses who provide direct patient care. These nurse leaders play 3 critical roles: they are the "go-to," they are "on the ball," and they "keep the ball rolling."

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Competence
  • Critical Care / organization & administration*
  • Female
  • Focus Groups
  • Humans
  • Leadership*
  • Learning*
  • Male
  • Models, Organizational
  • Nurse Administrators / organization & administration*
  • Qualitative Research
  • Safety / standards*
  • Skilled Nursing Facilities / organization & administration*
  • United States