Читать книгу Kelly Vana's Nursing Leadership and Management - Группа авторов - Страница 262

Nurse leaders are responsible for creating a fair and just culture to minimize blame and punishment and encourage individuals to report errors so that the system problems can be corrected. In the past, health care took a punitive approach toward errors, viewing those who made errors as “bad apples” (Institute of Medicine, 1999). This approach served as a disincentive to reporting errors and mistakes and resulted in missed opportunities to uncover and correct problems that impacted safety. The approach also over‐simplified safety by overlooking the impact of the system on safety care. More recently, the concept of a just culture has been embraced within health care.

A just culture creates an atmosphere of trust, encouraging and rewarding people for providing essential safety‐related information (Reason, 1997). It views errors as opportunities to improve the understanding of both health care system risk and individual behavioral risk. It changes staff expectations and behaviors so that everyone looks for risks in the environment, reports errors, helps to design safe health care systems, and makes safe choices. A just culture also identifies what constitutes acceptable and unacceptable behavior. The American Nurses Association (2010) has endorsed the just culture model.