“Nursing is an art, and to make it an art requires dedication as exclusive and preparation as hard as the work of any painter or sculptor..." (Nightingale, 1868)In today's healthcare system, "quality" and "safety" are one and the same when it comes to patient care. As Florence Nightingale described our profession long ago, it takes work and vigilance to ensure that we do our best to care for our patients. (Mitchell, 2008) The World Health Organization defines 6 quality domains that help shape our definition of what constitutes quality care. These areas are: (1) Effective: using evidence-based practices to improve health outcomes based on the needs of individuals and communities. (2) Efficient: healthcare that maximizes resources and minimizes waste. (3) Accessible: care provided in a timely manner in a setting where skills and resources are matched to medical and geographically reasonable needs. (4) Acceptable/patient-centered: health care that takes into account individual needs, preferences, and culture. (5) Equitable: quality of health care that does not vary because of race, gender, ethnicity, geographic location, or socioeconomic status. (6) Safe: health care that minimizes harm and risk to patients. (Bengoa, 2006) Another factor taken into account in the quality of care is patient satisfaction. There has been debate over whether a patient's perception of their care truly reflects the quality of care. I feel like this can be seen from both angles. The nurse-to-patient ratio certainly factors into this, as does patient acuity, which can vary widely. Just by walking onto the floor, we have a long list of “to do’s” for our patients; doctors to call, test results to look for, protocol...... middle of paper ......of sentinel events. Nursing Management, 37(5), 20. Lippincott, Williams and Wilkins, (2012). Sentinel event alert highlights nurse fatigue. Clinical Cycles, 42(3), 27-29. doi:10.1097/01.NURSE.0000411416.14033.f5Mitchell, PH (2008). Defining patient safety and quality of care, an evidence-based handbook for nurses. Rockville, Maryland: Hughes. DOI: //www.ncbi.nlm.nih.gov/books/NBK2681/Bengoa, R. (2006). Quality of care: a process for making strategic choices in health systems. Geneva: World Health Organization. Wall, Y. and Kautz, D. (2011). Prevent sentinel events caused by family members. Dimensions of Critical Care Nursing, 30(1), 25-27. doi: 10.1097/DCC.0b013e3181fd02a0The Joint Commission. (2013). Sentinel events. Complete Accreditation Manual for Hospitals, retrieved from http://www.jointcommission.org/assets/1/6/CAMH_2012_Update2_24_SE.pdf