Until safety alerts are acted on, patients will still be put in unnecessary danger

Who knows, but it is a powerful incentive to get things right - and there can be no argument that aviation has an enviable safety record.

It is not a boast that health care can make. That one in ten interventions leads to avoidable harm is one of western medicine's guiltiest secrets.

But, what - in the absence of firing squads for errant healthcare professionals and managers - can improve that record?

Almost any experienced nurse in any area of care will be able to point to an example of practice that - through poor adherence to an evidence-based approach or the lack of trained staff - puts patients in danger.

A good example is provided by our piece on resuscitating patients in mental health settings. While it is not an obvious area of concern for the uninitiated, nearly 10% of the 599 incidents investigated resulted in patient harm.

The introduction of safety alerts identifying potential threats was an important step forward in improving health care's record.

Industries with risk-filled environments such as offshore oil exploration have shown that they can be highly successful
in reducing error.

That these health safety alerts do not always find their way to frontline staff and, that when they do, are not always acted on is something nurses should be concerned about.

As it so often is, the problem appears to be a belief that communications from the centre will inevitably trickle down to those delivering care and automatically be implemented. The truth is, of course, that there are 100 ways in which messages
can become diverted or distorted.

The National Patient Safety Agency has picked up on this failure to drive the message home. The key change it is keen to make is to explain to nurses why safety alerts matter. Good for them, but nurses too must play their part.

Responsibility for patient safety is both a team and an individual responsibility. Fourteen safety alerts of various types have been issued by the NPSA in the last 12 months. Are you aware of them all and that they can help keep your patients safe?

Alastair McLellan editor, Nursing Times

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