NUR 2058 Discussion Culture of Safety

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NUR 2058 Discussion Culture of Safety

NUR 2058 Discussion Culture of Safety

In this discussion, emphasis is on awareness of client quality and safety and in particular what is a “culture of safety.”

Based on the review of the following websites at the Institute of Healthcare Improvement and Agency for Healthcare Research and Quality answer the following questions.

What values ensure a culture of safety?

How can healthcare facilities establish a culture of safety?

What is the nurse’s role in maintaining a culture of safety

Numerous studies show a link between a positive safety culture (where safety is a shared priority) and improved patient safety within a healthcare organization. The evidence is so convincing that the National Patient Safety Foundation (NPSF) lists leadership support for a safety culture as the most important of eight recommendations for achieving patient safety.

An organization whose leaders embrace a safety culture makes safety its number one priority. Leaders demonstrate their commitment by supporting the organization to learn about errors and near misses, investigate errors to understand their causes, develop strategies to prevent error recurrence, and share the lessons learned with staff so they recognize the value of reporting their concerns.

Risk managers are essential in helping the organization achieve a safety culture. A culture of safety brings a focus on error analysis and mitigation that is fundamental to the functions of risk management.

The term “safety culture” has been defined by various organizations. Generally, a safety culture is viewed as an organization’s shared perceptions, beliefs, values, and attitudes that combine to create a commitment to safety and an effort to minimize harm (Weaver et al.). In the simplest of terms, a safety culture is the combination of attitudes and behaviors toward patient safety that are conveyed when walking into a health facility.

A safety culture is not limited to healthcare. The concept is used in other high-risk industries, such as nuclear power and aviation, that seek to understand safety incidents to prevent future disasters.

Indeed, the concept of a safety culture has been around for more than two decades. In its sentinel event alert on the role of leadership in developing a safety culture, the Joint Commission references James Reason’s concepts about safety culture in his 1997 book on human error, Managing the risks of organizational accidents. Still applicable today, the three key elements of a safety culture are the following (Joint Commission “The Essential Role of Leadership”):

  • Fair and just culture
  • Reporting culture
  • Learning culture

This guidance article describes each of the three elements of a safety culture and provides recommendations on how an organization can approach each element.

Action Recommendations

  • Communicate leadership support for a culture of safety.
  • Model expected behavior within a safety culture.
  • Develop and enforce a code of conduct that defines appropriate behavior to support a culture of safety and unacceptable behavior that can undermine it.

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  • Create an environment in which people can speak up about errors without fear of punishment; use the information to identify the system flaws that contribute to mistakes.
  • Apply a fair and consistent approach to evaluate the actions of staff involved in patient safety incidents.
    NUR 2058 Discussion Culture of Safety

    NUR 2058 Discussion Culture of Safety

  • Support event reporting of near misses, unsafe conditions, and adverse events.
  • Identify and address organizational barriers to event reporting.
  • Cultivate an organization-wide willingness to examine system weaknesses and use the findings to improve care delivery.
  • Promote collaboration across ranks and disciplines to seek solutions to identified safety problems.
  • Periodically assess the safety culture of an organization to track changes and improvements over time.
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