Various factors can be cited that contribute to the current nursing shortage. In this article, the authors present reasons for the shortage that have less to do with the numbers of nurses and patients and more to do with the structures and processes imbedded in health care delivery today. Factors that are discussed include the business model of health care and entrenched interests within the health care system. The authors recommend that health care professionals, nurses, and physicians unite to promote change within the healer-patient relationship that forms the moral foundation for care providers.
Over the last two decades there has been a growing recognition in the need for a systematic study of adverse events, errors and difficulties in health care. The systematic investigation of this topic and the resultant database have grown and diversified exponentially. We believe that the time has come to evaluate the achievements of this first wave of research, and discuss directions for the next stage. The participants in the panel have been major contributors to this area of work. They differ in their background and specific research interests, which reflect aspects of the overall medical system. The panel addresses several key questions: Merit of different information sources, retrospective versus prospective studies, implementation methods, and education needs. The discussion examines communalities and differences of philosophy, principles and approaches, with an eye on guiding future work.
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