Learning Objective #1: Define failure to rescue as it is used in research and discuss expanding FR to encompass medical shortfalls other than those ending in death

Learning Objective #2: Identify contributing factors to FR, ways to eliminate these factors, and uses for personal accounts of FR as a springboard for continuing staff education

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The monetary issues in heathcare including funding shortages for many programs and cuts in hospital budgets has lead to many challenges and changes health care delivery today. Since nursing makes up a large part of most hospital budgets, these caregivers are often first to be downsized (Gordon, 2000). Understaffing is a constant battle, raising cost more as hospital's offer incentives for staff retention (Price, 2002). Increasing patient acuity adds to the nurses' frustrations when staffing levels are not increased to match. Lack of experienced nurses places a larger responsibility on more experienced staff. Unfortunately, these problems can add up to one devastating fact: Decrease in the quality of patient care and safety. Not surprisingly, the decrease in quality care and increase in adverse events has a price tag: almost $50 billion each year (Kohn, Corrigan, & Donaldson, 2000). Failure to rescue (FR), a term first found in medical literature in the early 1990's, has been only recently applied to nursing situations (Clarke & Aiken, 2004). Failure to rescue has been used as an outcome measure for hospital, nursing, and medical research, most gathering data from discharge documents. The first publication with FR as an outcome variable was the 1992 study by Silber, Williams, Krakauer, and Schwartz which identified characteristics of post-operative mortality. The National Quality Forum (NQF) which provides a framework for evaluating nursing care listed failure to rescue first in a group of 15 nurse sensitive performance measures (2004). FR could be utilized globally, at the unit level, or with an individual nurse to identify areas for improvement, including hospital systems and patient care models, continuing education programs, and optimum staffing matrixes. Discussion of FR scenarios should increase nurses' ability to recognize the “weak signals,” allowing for intervention before a manageable complication progresses to failure to rescue.