A Culture of Care Abstract

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ACulture of Care


Theculture of safety has been a priority in the healthcare system overthe years. However, its incorporation within the healthcareprofessionals’ education system has been receiving less attention.Students need to know more on system vulnerabilities as well asunderstand how skills, attitudes and knowledge to promote safetyscience would enable safer care of families and patients. They mustbe incorporated within the nurses’ education programs to improvestructure processes. This paper will outline the key components ofculture of safety and what is necessary for students to learn. Theactivities that promote high reliability and safety will beillustrated within this paper. Additionally, it is appropriate toelucidate how culture of safety strategies would be incorporatedwithin the curriculum.

Thoughthe goal of a culture of safety is to minimize harm on patientsthrough personal performance and system effectiveness, variousthreats as well as errors on care delivery still exist. Thehindrances include intricate and risk prone systems, limited written,electronic and verbal communication systems, limited standardizationand ownership of patient safety. Errors are bound to happen in ahealthcare system. However, with a responsible system that hasknowledgeable nurses who have the right attitude, quality of patientcare can be improved. Most failures arise from blunt organizationalpolicies, resources allocation and procedures. The errors can bedivided into management errors, technical failures or even externalfailures. As per the institute of medicine (IOM), emphasis has beenput on encouraging safety by initiating vast system changes. Creatinga culture of safety within the learning institutions, knowing therestrictions of human factors as well as appreciating the motives ofcomplete reporting techniques are quite crucial in the modern dayhealthcare system.

Keycomponents of a culture of safety

Thekey components include patient involvement, transparency,accountability and organizational priorities. Additionally, featuresof a culture of safety entail shared goals and core values,encouragement of safety through trainings and education, non-punitiveapproach to errors and other adverse conditions. For safety cultureto succeed, it needs a robust and committed leadership as well as anempowered employees. The employees ought to be engaged as well [ CITATION Jan11 l 1033 ].

Abalance has to be attained between tolerating errors and not blamingpeople or rather individuals in a safety culture. The balance isreferred to as the “just culture” and focuses on teamwork.Teamwork is regarded as a core component in achieving high quality,safe patient care. One of the detriments to quality care involvesreporting of error. Traditionally, the healthcare practitioners tendto blame one another whenever there is an error. Focus is directed toestablish whoever is at fault so as to discipline them. This tactictends make people hide rather report erroneous deeds. It is quiteconverse to the culture of safety. Contrary to this traditionalmeans, a safety culture ought to emphasize excellence, mutualrespect, integrity, accountability and must be non-punitive. In thecurrent safety culture, focus is directed towards “what might havegone wrong” and not “who is at fault” [ CITATION Jan11 l 1033 ].

Patientcare should be a component within the curriculum. Healthcarepractitioners ought to learn on how to care for patients withconstant education and trainings also necessary. A safety cultureintegrates constant changes within the healthcare sector withappropriate traditional cultures. It should be able to use goodtraditional practices in correlation with current better means.Patients must also be involved when outlining priorities. Apart fromencouraging an accountable, transparent healthcare system, a safetyculture prioritizes patients while instilling the organizationspriorities. Additionally, the healthcare system must have similargoals so as not to bring about conflicts whenever there is an issue[ CITATION Kel12 l 1033 ].

Severaltools that evaluate healthcare safety culture exist. The Agency forHealthcare Research and Quality (AHRQ) introduced a tool known asCulture of Patient Safety Assessment to evaluate the culture ofsafety. To maintain a qualified personnel, Quality and SafetyEducation for Nurses (QSEN), was created. This body helps studentsunderstand the intricate means of care delivery techniques at earlystages. Traditionally, education was directed towards individualpatients and families without the knowledge of complex care deliveryschemes. QSEN has improved the competency levels since patients aretaught on how to provide safe care with the available resources. Akey component of QSEN is the patient-centeredcare,which ensures patients participate when making decisions. They areable to understand and make appropriate plans of care therebyavoiding errors. QSEN also advocates for evidence-basedexercisethat directs clinicians to use current technologies as well asassists them design an appropriate care plan. Collaborationand teamworkis another aspect that brings together the healthcare crew, improvingcommunication and decision making. Shared decision making ensureshigh quality and safe care. Another feature is qualityimprovementwhich evaluates the trends and analyze current data comparing it withother organizations to determine vulnerable sections of the system inneed of correction. Clinicians also utilizeinformaticsto backup decision making, communicate as well as access knowledge [ CITATION Jan11 l 1033 ].

Eventsthat encourage safety

Accordingto the institute of medicine (IOM), patient safety can be improveddwelling on nine components. They include

Integratinguser-centered strategies

Thisstrategy approaches forcing functions, constraint, affordance andvisibility. For instance, visibility is increased by utilizing a setof written directions on all equipment outlining how to move back andforth as well as alter settings. Affordance elaborates how to performan activity. On the other hand, constraint governs and prevents onefrom making a mistake whereas forcing function makes it difficult tomake a mistake [ CITATION Joh11 l 1033 ].

Eludingthe reliance on memory

Thisis done by standardizing and reducing procedures. Utilization ofprotocols as well as checklists minimizes the dependence on memoryalways providing steps. A good example is the determination of theusual dose of a particular medication and installed electronically.Whenever needed, one only has to refer hence avoiding dependence onmemory.

Worksafety attendance

Patientsafety is affected by work-loads, distractions, interruptions, workhours and staffing ratios. In some healthcare facilities, theyutilize “sacred zones” and “safe zones” to improve theworking environment ensuring limited distractions.

Avoidingdependence on vigilance

Alarms,rotation of staff, adequate breaks and checklists minimize relianceon vigilance. For example an alarm may be put in place to notify anurse when to administer a drug.

Otherevents include team collaboration trainings, antedating theunexpected, including patients in care, and planning for recovery,refining accessibility to timely and accurate information.


Institutionsexercising appropriate cultures of safety tend to foster learningenvironments and promotes a conducive working environment. Generally,they promote a highly reliable institution. As elaborated above, asafety culture benefits both patients and health practitioners. Thesafety culture contains several components that interrelate topromote a sustainable working environment.


Barnsteiner, J. (2011). Teaching the Culture of Safety. The online Journal of Issues in Nursing.

Birk, S. (2015). Accelerating the adoption of a safety culture. Accelerating the adoption of a safety culture, 1-6.

Maier, K. (2012). Developing a safety culture in the healthcare wrkplace. Developing a safety culture in the healthcare wrkplace, 1-8.

Reiling, J. G. (2011). Creating a Culture of Patient Safety through Innovative Hospital design. Creating a Culture of Patient Safety through Innovative Hospital design, 425-440.

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