Provision 3
The nurse establishes a trusting relationship and advocates for the rights, health, and safety of recipient(s) of nursing care.
3.3 Responsibility in Promoting a Culture of Safety
Nurses participate in the development of, implementation of, review of, and adherence to policies that promote patient health and safety, reduce errors, and establish and sustain a culture of safety. When errors or near misses occur, nurses immediately assess the patient and report events to the appropriate authority, according to professional and/or institutional guidelines. Communication should start at the level closest to the event and should proceed to a responsive level as the situation warrants. Respect for persons requires responsible disclosure of errors to patients.
Nurses are accountable for individual practice and adhere to standards of care and institutional policies. Nurses collaborate with the interprofessional team to design and engage in processes to investigate causes of errors or near misses. Reporting errors according to institutional policy is critical to maintaining a safe patient care environment. The interprofessional team identifies system factors that may have contributed to the error and advocates for necessary systems change by the healthcare organization. Nurses who commit an error should be supported and advised, while at-risk behavior should be corrected or remediated. Disciplinary action for errors should only be taken if warranted and after consideration of system or process failures. Nurses and their organizations should engage in just culture practices, recognizing that blaming the individual may cause undue harm and discourage prompt reporting and system improvement. The onus for establishing and supporting a just culture does not lie solely with nurses. When an error occurs, whether it is one’s own or that of a colleague, nurses may neither participate in, nor condone through silence, any attempts to conceal the error.