Failure to rescue as a nurse-sensitive indicator

Problem: The aim of this concept analysis was to clarify failure to rescure as a nurse-sensitive indicator. Although the concept of failure to rescue as a nurse-sensitive outcome has appeared in the nursing literature for over a decade, conceptual clarity is needed to address its variable and ambiguous use in health care. Methods: Walker and Avant's eight-stage method of concept analysis was used to explore the concept of failure to rescue in nursing practice. Twenty-one papers were retrieved from Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE databases and selected for review and synthesis. Results: Failure to rescue as a nurse-sensitive indicator was found to be a "failing to rescue" process characterized by a cascade of events, including four key attributes: (1) errors of omission in care, (2) failure to recognize changes in patient condition, (3) failure to communicate changes, and (4) failures in clinical decisionmaking. Conclusions: Nurses have a pivotal role in "failing to rescue" through early recognition, escalation, and intervention of subtle changes signaling complications. Upstream strategies, such as the use of early warning sign indicators, structured communication, and teamwork, shift the discourse from failure to rescue, to processes in nursing practice of good catch events.