Nurses' Resilience and Patients' Quality of Care: Towards a New Paradigm

Author : Anat Drach Zahavy

Abstract :Despite the impact of the IOM’s landmark report To Err Is Human, improvements in patient care quality over the past thirty years have been relatively modest. Most current quality enhancement efforts are top down, led by hospital administrations, and typically emphasize staff training, adherence to protocols, incident reporting, and organizational learning. However, there is growing recognition of the need for bottom-up, forward-looking, and change-driven approaches—particularly those that leverage nurses’ resilience—to enhance patient safety. Two studies will be reported examining the relationship between nurse resilience and patient safety. The f irst study used a mixed-methods design to explore cognitive and behavioral strategies employed by nurses with high versus low resilience in fall prevention. Findings revealed that high-resilience nurses were more likely to demonstrate skepticism, anticipation, and proactive behaviors—strategies that enabled them to critically evaluate risks and take initiative to prevent falls beyond standardized protocols. The second study tested a moderated-mediation model based on data from 101 nurses and 271 patients, showing that nurses’ proactive behavior significantly improved patient education for fall prevention, especially in settings with low procedural adherence. The results underscored that both personal resilience and workplace social capital are necessary to foster proactivity, and that proactivity has the greatest impact when institutional rigidity is low. Together, these findings propose a new paradigm: nurse resilience should not be viewed solely as a buffer protecting staff well-being, but as a direct contributor to patient safety and care quality. This paradigm shift emphasizes resilience as a proactive resource that enables nurses to detect, anticipate, and prevent harm in dynamic clinical environments. These findings imply that to enhance patient safety, nursing managers should focus on developing nurses’ resilience and strengthening organizational resilience within clinical teams. Fostering a work environment that balances procedural adherence with autonomy can empower nurses to act proactively. Future research should explore interventions to cultivate these capabilities and examine their broader impact on patient outcomes across diverse clinical settings.

Keywords :Nurse resilience boosts safety; proactive care thrives with support and autonomy.

Conference Name :International Conference on Nursing and Healthcare (ICNH-25)

Conference Place London, UK

Conference Date 7th Oct 2025