1. Alexander, Mary MA, RN, CRNI(R), CAE, FAAN

Article Content

Each May, we observe National Nurses Week. We take time to recognize the contributions nurses make to patient care as well as their professional achievements that affect the nursing profession specifically and health care in general. This year's observance calls attention to the concept of a culture of safety and the link it has to patient outcomes and quality of care.

Figure. No caption a... - Click to enlarge in new windowFigure. No caption available.

The American Nurses Association (ANA) has designated 2016 the year of the culture of safety. The slogan of the observance is Safety 360 Taking Responsibility Together. Safety is everyone's responsibility, and a hierarchy of accountability should not exist. Clinicians, administrative and professional staff, and nonclinical personnel must engage with patients, families, and the community to help ensure we're all working to develop a culture of safety. Safety requires empowering every voice.


ANA defines a culture of safety as one in which core values and behaviors-resulting from the collective and sustained commitment of an organization's leaders, managers, and workers-emphasize safety over competing goals. Attributes of a positive safety culture include openness and mutual trust when discussing safety concerns and solutions without individual blame; marshaling of appropriate resources, such as safe staffing and skill-mix levels; a learning environment in which health care professionals learn from errors and proactively detect systemic weaknesses; and transparency and accountability.1


Fifteen years ago, the Institute of Medicine (IOM) released To Err Is Human, a landmark publication that focused public attention on patient-safety concerns associated with medical errors and adverse events. In a recent report assessing the state of patient safety during that time, the National Patient Safety Foundation reiterated the importance of establishing and sustaining a total-systems approach and a culture of safety.2 Recent studies suggest that patients in this country experience a far greater number of adverse events each year than was suggested by the IOM 15 years ago. A 2013 study published in the Journal of Patient Safety revealed that preventable adverse events accounted for 210,000 to 440,000 deaths among hospital patients each year.3


Safety has always been at the crux of infusion practice. Not only do infusion nurses focus on the delivery of safe patient care, they also are aware of the need to protect themselves from harm. Infusion therapy is inherent with risks, and INS understands the importance of providing resources that will enable nurses to practice safely. The Infusion Therapy Standards of Practice (the Standards)4 is a perfect example. It provides a framework that guides clinicians in their practice and leads to improved patient outcomes. Each of the Standards directs clinicians to discard outdated practices and to replace them with practices supported by the most current evidence and research.


There is work still to be done to foster a culture of safety, and while it's everyone's responsibility, nurses will play a key role. The annual Gallup survey has revealed again for the fourteenth year in a row that the public ranks nursing as the leading profession for honesty and ethical standards.5 Nurse leaders will need to ensure that resources, such as providing adequate staffing, equipment, and education, are available to achieve safety results. Nursing organizations, such as INS and ANA, must harness the passion and commitment of our members, recognizing that they are the champions who can set the example for creating a culture of safety. Their expertise, skills, and intellectual capital will help us create ways to engage others and, ultimately, affect safe patient care.


Our work as nurses can be challenging, but it's also rewarding. Each of us has something to contribute. Let's celebrate our colleagues' accomplishments and efforts to foster a culture of safety. We will all benefit-nurses, patients, and society alike.




1. Creating a culture of safety. American Nurses Association. Accessed April 4, 2016. [Context Link]


2. National Patient Safety Foundation. Free from Harm: Accelerating Patient Safety Improvement Fifteen Years After to Err Is Human. Boston, MA: National Patient Safety Foundation; 2015. Accessed April 1, 2016. [Context Link]


3. James JT. A new evidence-based estimate of patient harms associated with hospital care. Patient Saf. 2013;9(3):122-128. [Context Link]


4. Gorski L, Hadaway L, Hagle ME, McGoldrick M, Orr M, Doellman D. Infusion therapy standards of practice. J Infus Nurs. 2016;39(suppl 1):S1-S159. [Context Link]


5. Honesty/ethics in profession. Gallup. Updated December 2-6, 2015. Accessed April 4, 2016. [Context Link]