Risk Management in Nursing: 7 Practical Tips to Try Today

Risk is a fact of life for nurses. When you start a shift, you know there’s the possibility of an adverse incident. But risk may be even more prevalent than you think. This is why risk management in nursing is essential. Below we break down 7 practical tips for mitigating risk that you can add to your practice.

Stats About Common Risks Nurses Face

Did you know experts estimate that medication errors occur in 2–14 percent of hospitalized patients and lead to 44,000—98,000 deaths per year in the United States alone? Or that, according to the Centers for Disease Control and Prevention (CDC), on any given day, 1 out of every 31 hospital patients in the United States has a healthcare-associated infection?

Patient falls are another common risk: each year, about 700,000 to 1 million falls occur in U.S. hospitals, and about 800,000 occur in long-term care facilities.

Nurses face other risks too. For example, between 2003 and 2024, more than 46,000 HIPAA violations were investigated — and 67% of those resulted in disciplinary action.

How You Can Help Mitigate Risk at Work

The high prevalence of risk in healthcare means that nurses must practice safety, awareness, and diligence in their day-to-day work. Of course, risk management in nursing is about more than individual responsibility on the part of the nurses: it involves a complex series of clinical and administrative systems, processes, and reporting structures.

But that doesn’t mean nurses are helpless when it comes to identifying, preventing, and responding to risk at work. After all, patient safety is the responsibility of every team member, and high levels of risk impact everyone — not least by increasing the chance that you could be named in a malpractice lawsuit.

According to risk management expert and nurse attorney Dr. Shawna Butler, being proactive is one of the most important things nursing professionals can do to manage risk. “Risk management isn’t just the place you go when something bad happens,” says Butler. “We all have a role to play in promoting safety and preventing risk in the workplace.”

Risk Management in Nursing: 7 Strategies You Should Know

Here are seven practical ways you can help mitigate risk in the workplace to protect your patients — and yourself.

1. Identify your risks

An important step in risk management is identifying and understanding your level of risk — especially risks that are specific to your specialty and practice environment. While some risks are more or less universal, such as breaches of patient confidentiality, medication errors, and patient falls, the likelihood of these occurring is related to the type of practice setting.

For example, medication errors occur more commonly in outpatient settings, where there are more likely to be transitions in care, while patient falls occur more in inpatient environments, where patients are often less mobile.

Some other factors to consider when thinking about your risk level include:

• The types of medical equipment you use
• The procedures your facility performs
• Staffing levels at your workplace
• Patient acuity
• Staff credentials and experience
• The types of medications and treatments you administer to your patients

By considering the risks associated with your specialty and setting, as well as risks specific to your facility, you can start to pinpoint areas where additional vigilance, communication, or advocacy for change may be needed on your part.

2. Make a plan

Risk management plans can be a great way to assess the risks involved in your organization and create strategies to mitigate them. Having a risk management system in place can help you figure out the risks you’re facing, make a plan for how to handle those risks, and even potentially prevent them. But this plan needs to be regularly audited to keep up with changes and learnings as risks evolve.

A risk management plan might include estimates of the severity and likelihood of each risk, as well as the person in charge, the prevention and response strategies you want to implement, and the priority of the implementation.

3. Learn the resources available to you

Another element of being proactive is learning the risk management resources available to you in your workplace and beyond. “Nurses are often so busy that they might not know about the risk management team members on their staff or about the other resources available to them,” explains Butler. “It can sometimes take a little bit of legwork to figure out the risk management hierarchy.”

But it’s worth learning the ropes, and not just in case something goes wrong. Risk management professionals can be great resources for preventing incidents in the first place. “Ideally, risk management should be collaborative, and the risk managers in your workplace can support you. They can give you advice and guide you,” says Butler.

Outside of work, there are a number of risk management resources available to nurses. These include webinars and other continuing education classes, such as those offered by Berxi partner AchieveCE, as well as professional groups like the American Society for Health Care Risk Management (ASHRM) and Patient Safety Organizations (PSOs).

4. Follow safety, documentation & reporting protocols

In most workplaces, there are procedures in place to mitigate risk and respond to adverse events. It may seem obvious, but one of the best things you can do to reduce your exposure to risk is to know these processes and follow them carefully. These risk management guidelines can be as basic as proper handwashing and PPE protocols, as well as more involved procedures such as medication administration.

Another important aspect of risk management, both in terms of providing high-quality patient care and limiting your risk exposure, is charting and documentation. Nurse charts are a crucial way of communicating with other nurses and ensuring patient safety between shifts and staffing changes. Good note-taking can also help protect you if you ever face a malpractice claim.

Following correct incident reporting procedures is also hugely important. According to Butler, it’s good practice to report incidents even if they were only near-misses or raised concerns without causing an adverse event. These reports can help facilities fix recurring issues while also providing a record of your concerns and attempts to address a problem.

“Keep notes, keep your emails, keep a record,” advises Butler. Not only can documentation help protect your patients, it can also help protect you in the event of a lawsuit: proper charting and note-taking might end up being a lifesaver, both literally and financially.

Plus, proper documentation can give you more leverage and legitimacy if you try to advocate for changes at work. “It can be intimidating to report issues, especially if you have to go over someone’s head to do so,” Butler says. “But if you can tactfully and respectfully cite your documentation and say, ‘I told you about this risk on X date, and then again on this date, but we are still having problems with this issue,’ while demonstrating that you’re acting in the best interests of the patients, you’ll be more likely to have success in addressing the issue.”

5. Use your clinical judgment

While it’s important to follow the correct procedures at work, it’s also crucial to use your own clinical judgment. “For instance, most places have electronic medication administration these days, but it’s not foolproof,” explains Butler. “I like to tell the nurses I work with that these systems supplement your judgment, but they don’t replace it.”

“So we want to make sure that yes, we’re following the system properly, but we’re also using our own clinical judgment and expertise to verify that those things are legitimate,” continues Butler. “If something doesn’t seem right, you still have to question it and speak up. We should be assessing the patient, and if an order doesn’t seem right for them, we need to make our voices heard.”

Critical thinking in nursing can help reduce medical errors, protect you from risk, and save lives. Everyone makes mistakes, including doctors, and a vigilant nursing staff who is able to catch and correct these mistakes can make all the difference. To ensure that you have the clinical knowledge you need to best serve your patients, Butler also recommends staying up to date in your field, whether through continuing education or by paying attention to advances in treatment.

6. Know when to walk away

There are a lot of steps you can take to try to mitigate risk in the workplace, but, as Butler notes, “it’s hard for one nurse to fix a sick system.”

Nurse burnout, low staff-to-patient ratios, and stress within the team are pressing matters that can put patients, staff, and organizations at risk. And sometimes, the problems can’t be fixed by a team of nurses alone.

“Most workplaces put some form of unreasonable expectations on nurses, and there are bad days everywhere, even in a place that you enjoy working,” shares Butler. “But if there become more bad days than good days, and the facility seems unable or unwilling to address unsafe conditions and risk, it may be time to start looking elsewhere.”

She continues, “It’s sad to say, but you need to know when to move on, and you should start looking before you’re desperate and it’s affecting your mental health.”

If you’re exploring your options, check out our guide to non-bedside nursing jobs.

7. Make sure you’re protected

No matter how diligent you are, there is the chance you could face a malpractice claim or licensing board complaint — even through no fault of your own. That’s why medical malpractice insurance is so important: it can help give you the protection you need in the event of a claim.

Even if you’re covered by your employer’s plan, it’s worth having your own personal coverage as well. There are many areas, such as HIPAA claims and licensing board actions, where you won’t be covered by your employer’s policy.

Make sure you have the protection you need with a comprehensive medical malpractice policy. Learn more and get a quick quote from Berxi today.

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Last updated on Aug 27, 2024.
Originally published on Aug 12, 2024.

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