• Ada Sue Hinshaw.
• School of Nursing, University of Michigan, Ann Arbor, MI 48109-0482, USA. ahinshaw@umich.edu
• Nurs Res. 2008 Jan 1;57(1 Suppl):S4-10.

AbstractBalancing the development of cultures of safety with nursing workforce challenges is similar to navigating the perfect storm. The perfect storm is characterized as a tempest of extreme intensity that happens rarely, maybe once every 100 years, as a result of multiple factors that end in a situation worse than people have ever seen. Such a storm is currently evident when attempting to ensure patient safety while being confronted with a shortage of nurses and nursing faculty unlike any other shortage experienced in over a number of decades. Based on research, the threats to patient safety from healthcare system and health professional errors have become of paramount concern. The prevention of such errors is the focus of healthcare organizations as they create cultures of safety. A major aspect of cultures of safety is nurses with their many roles in caring for patients and families, especially the constant surveillance they provide, which often prevents complications and deaths secondary to failure to rescue. However, providing such surveillance requires adequate numbers of well-prepared nurses in attendance. The perfect storm is created because of the existence of a steadily worsening shortage of nurses and nursing faculty. Multiple factors have converged to develop and sustain such a shortage. A blueprint for healthcare organizations is proposed, with examples of numerous innovative strategies that are being developed and studied for handling the major challenges posed by this perfect storm.

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