Abstract

This paper examined the patient safety implications of nurse-led quality improvement within short-stay acute care environments, with particular attention to the organisational, clinical, and transitional risks that shape care delivery in these units. The study was undertaken to explore how nursing leadership can strengthen safety, continuity, and service reliability in settings characterised by rapid assessment, brief observation periods, frequent handoffs, and time-sensitive discharge decisions.
A narrative review approach was adopted, drawing on selected scholarly literature relevant to transitional care, patient safety, nursing leadership, discharge processes, escalation systems, interdisciplinary teamwork, and digital safety infrastructure. The review was structured around the major thematic domains of the paper, including the risk profile of decision units, theoretical foundations for nurse-led improvement, key safety threats, intervention strategies, leadership and culture, digital systems, outcomes, implementation barriers, and future directions.
The findings show that these units are inherently vulnerable because they compress diagnostic uncertainty, clinical monitoring, multidisciplinary coordination, and discharge planning into a highly pressured episode of care. The review identified delayed recognition of deterioration, fragmented communication, medication-related error, premature discharge, and poor continuity across care transitions as major safety concerns. It further found that nurse-led quality improvement interventions, including structured discharge pathways, escalation systems, follow-up communication, preventive care bundles, interprofessional rounding, and data-informed monitoring, can improve both patient safety and operational effectiveness. Leadership, teamwork, safety culture, and interoperable digital systems emerged as critical enablers of successful implementation.
The paper concludes that nursing leadership is central to achieving safer and more reliable care in short-stay acute settings. It recommends strengthening nurse-led discharge planning, early warning and escalation processes, post-discharge follow-up systems, interdisciplinary communication structures, and digital measurement tools. Future research should prioritise context-specific evaluation of nurse-led improvement models and their long-term impact on patient outcomes.