633 Discussion VIII

A strong culture of safety is built through daily behaviors that invite transparency, teamwork, and learning. As a new RN I will model speaking up about near misses, use structured handoffs, and encourage nonpunitive reporting so the team can learn rather than hide errors. National data show that hospitals that assess and act on safety culture achieve better outcomes, and that shared values, norms, and leadership commitment are the backbone of safety climate measures in practice (AHRQ, 2024a, 2024b). At the same time, nurse burnout is consistently linked with lower safety and quality scores and lower patient satisfaction, which makes my advocacy for safe staffing and healthy work environments a direct patient safety intervention rather than a personal preference (Li et al., 2024; Murray, 2023).

Quality improvement gives me practical tools to translate those values into safer care at the bedside. I will use Plan Do Study Act cycles to test small changes such as a no interruption zone during medication passes, then study the results and refine the process with the team. Current guidance emphasizes simple, repeated tests of change that are anchored in local data, and evidence shows that targeted interventions to strengthen safety culture can benefit both staff and patients (Barr et al., 2024; Finn et al., 2024). When events occur I will participate in root cause analysis and apply just culture principles that balance learning with accountability, which has been shown to increase transparency and risk reporting in clinical settings (Kiser et al., 2023).

Nurses face dilemmas that can threaten safety, including workload strain, moral distress, and communication barriers. I will mitigate these by advocating for resources, escalating when conditions are unsafe, and using structured communication to reduce hierarchy related silence. I will also engage in unit safety huddles, track trends in falls and medication events, and mentor peers in evidence based prevention bundles. By combining advocacy for healthy work systems with consistent use of improvement methods, I can help create the conditions where patients and staff are safer and where high reliability becomes the everyday expectation rather than an aspiration (AHRQ, 2024a, 2024b; Li et al., 2024; Murray, 2023).

References

Agency for Healthcare Research and Quality. 2024a. What is patient safety culture.

Agency for Healthcare Research and Quality. 2024b. Surveys on patient safety culture Hospital Survey 2 point 0 User Database Report.

Barr, E., Wilson, M., and Shepherd, J. 2024. Quality improvement methods. NCBI Bookshelf.

Finn, M., Raalte, R., and colleagues. 2024. Effect of interventions to improve safety culture on hospital staff and patient outcomes. International Journal for Quality in Health Care.

Kiser, M., Krejci, J., and colleagues. 2023. Using the principles of just culture to improve transparency and risk reporting in the hospital setting. Patient Safety Journal.

Li, L. Z., Yang, X., and colleagues. 2024. Nurse burnout and patient safety, satisfaction, and quality of care A systematic review and meta analysis. JAMA Network Open.

Murray, J. 2023. Ensuring patient and workforce safety culture in healthcare. AHRQ PSNet Perspective.