NURS 8302 Discussion: Just Culture

Sample Answer for NURS 8302 Discussion: Just Culture Included After Question

BY DAY 4 OF WEEK 1

Post an explanation of whether your organization uses a just culture. Then, explain how this might impact quality and safety for your healthcare organization, and why. What is the DNP-prepared nurse’s role in supporting a just culture environment in a healthcare organization? Be specific and provide examples.

BY DAY 6 OF WEEK 1

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding upon your colleague’s post or suggesting an additional alternative perspective on the role of the DNP-prepared nurse in supporting a just culture in a healthcare organization.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

A Sample Answer For the Assignment: NURS 8302 Discussion: Just Culture

Title: NURS 8302 Discussion: Just Culture 

In our healthcare organization, we have embraced the principles of a just culture. This approach recognizes that errors are often the result of system failures rather than individual negligence. By fostering an environment where healthcare professionals feel comfortable reporting errors and near misses without fear of punitive measures, we aim to enhance transparency and promote continuous learning (Barnsteiner & Disch, 2017).

How This Might Impact Quality and Safety for My Healthcare Organization

The impact of a just culture on quality and safety within our organization is substantial. Firstly, it encourages increased reporting of errors, enabling us to identify and address system issues promptly (American Nurses Association, 2010). This proactive approach to error reporting contributes to a culture of continuous improvement, where we can analyze incidents, share insights, and implement changes to prevent similar errors in the future (American Nurses Association, 2010). Secondly, a just culture enhances staff engagement and satisfaction by shifting the focus from blame to learning. This positive work environment promotes collaboration, morale, and ultimately, better patient care (American Nurses Association, 2010).

DNP-Prepared Nurse’s Role in Supporting a Just Culture Environment

The DNP-prepared nurse plays a pivotal role in maintaining and promoting a just culture within our healthcare organization. For instance, a DNP may lead educational initiatives to ensure that healthcare professionals understand the principles of a just culture and feel empowered to report errors. Additionally, the DNP can advocate for fair and transparent policies related to disciplinary actions, ensuring that consequences align with the nature of the error and are conducive to a culture of learning rather than punishment (Walker et al., 2020). Through leadership in quality improvement projects and data analysis, the DNP contributes to the ongoing evolution of our organization’s safety culture, ensuring that it remains robust, supportive, and focused on continuous enhancement of quality and safety in patient care (Walker et al., 2020).

References 

American Nurses Association. (2010). Just culture [Position statement]. https://www.nursingworld.org/~4afe07/globalassets/practiceandpolicy/health-and-safety/just_culture.pdf

Barnsteiner J., & Disch J. (2017). Creating a fair and just culture in schools of nursing. American Journal of Nursing117(11), 42–48. 10.1097/01.NAJ.0000526747.84173.97 PMID:29076855

Walker, Danielle PhD, RN, CNE; Altmiller, Gerry EdD, APRN, ACNS-BC, FAAN; Hromadik, Lora PhD, RN; Barkell, Nina MSN, RN, ACNS-BC; Barker, Nancy EdD, RN; Boyd, Teri EdD, MNSc, RN; Compton, Michelle MSN, RN; Cook, Pamela MSN, RN; Curia, Marianne PhD, MSN, RN; Hays, Deana DNP, FNP-BC; Flexner, Randi DNP, APN, RN; Jordan, Janet MSN, RN; Jowell, Vicki MSN, RN, RN-BSN; Kaulback, Michelle EdD, RN, FNP-BC; Magpantay-Monroe, Edna EdD, APRN; Rudolph, Bethany MSN, RN; Toothaker, Rebecca PhD, RN; Vottero, Beth PhD, RN, CNE; Wallace, Sharon PhD, RN, CCRN-K. Nursing Students’ Perceptions of Just Culture in Nursing Programs: A Multisite Study. Nurse Educator 45(3):p 133-138, 5/6 2020. | DOI: 10.1097/NNE.0000000000000739

A Sample Answer 2 For the Assignment: NURS 8302 Discussion: Just Culture

Title: NURS 8302 Discussion: Just Culture 

I am amazed at the name of Just Culture to describe team members who recognize errors and report them willingly. I remember the days of being the new nurse on the block and was terrified when I made an error. I believe that some errors result from system failures or short comings thus the need for continued developments in the biomedical field. According to the article by van Baarle, et al., Just culture is not punitive but it is an opportunity to learn from errors in healthcare (van Baarle, et al., 2022). I believe that a just culture environment will encourage nurses to willingly report errors rather than covering them up. It also will help nurses to create a mind set that errors will occur, and there is a level of accountability to openly report them.

There was an incident that occurred in my organization. A patient was postpartum after having a baby boy. Her religious affiliation rejects circumcision of males. A nurse approached the patient to sign a consent for the patient’s son to be circumcised. she explained the procedure and the patient signed the consent form. The child was circumcised.

Later that day, the patient’s husband went to visit his wife and baby, and discovered his son was circumcised. He ran down to the nurses’ station screaming frantically. Security had to be called, and he was escorted to a private area until he calmed down. There was a significant breakdown in communication because the nurse thought the patient understood English as the patient just answered yes to the nurse and did not ask any questions. The nurse was rushing through the procedure because in her mind this was very routine, and almost all the male infants were circumcised. She worked in the nursery and didn’t have much contact with the patient.

Unfortunately, she was terminated, and the incident went into litigation resulting in a large settlement that was paid to the family. When I think of this situation I wondered if Just Culture was in place in this organization would the outcome be different for the nurse. The system may have failed the nurse because at that time there were very few interpreters available. In the past, before we had access to interpreters on site or the language line, some nurses used family members to interpret. Currently the organization uses the language line and there are staff member onsite that translate various languages.

According to Battard, healthcare workers can work cumulatively to identify errors, and some errors results from systems that are flawed. (Battard 2017). DNP prepared nurses can provide input for the development of systems to prevent errors as they are first line respondents to work flows. They can be active in building awareness,  developing and implementing policies that nurture just culture. I believe this is an innovative practice as when I practiced in the clinical setting years ago, errors meant that nurses were incompetent. System failures or lack there of were not considered to be contributors to errors.

References:

Eva van Baarle, Laura Hartman, Sven Rooijakkers, Iris Wallenburg, Jan-Willem Weenink, Roland Bal, & Guy Widdershoven. (2022). Fostering a just culture in healthcare organizations: experiences in practice. BMC Health Services Research22(1), 1–7. https://doi.org/10.1186/s12913-022-08418-z

Battard, J. (2017). Nonpunitive response to errors fosters a just culture.Nursing Management,48(1),55 https://journals.lww.com/nursingmanagement/FullText/2017/01000/Nonpunitive_respon

https://journals.lww.com/nursingmanagement/FullText/2017/01000/Nonpunitive_response_to_errors_fosters_a_just.12.aspx

A Sample Answer 3 For the Assignment: NURS 8302 Discussion: Just Culture

Title: NURS 8302 Discussion: Just Culture 

Just Culture in Nursing

Medical errors are common among healthcare providers, even with their high standards of expertise. Man is to error; no one is perfect. Our organization’s success can be mainly attributed to our just culture. Errors in healthcare are considered inevitable inside our firm. It does not guarantee the accuracy of its healthcare providers. To avoid or reduce mistakes in the future, it finds the underlying cause of the problem and applies evidence-based solutions (Barkell & Snyder, 2021). The management and legislators have benefited much from openness and transparency in devising solutions for the practice areas where medical errors are most common (Barkell & Snyder, 2021). Errors are not seen as personal failings but rather as the system as a whole in our organization.

The just culture impacts the standard and security of care provided in our medical facility. First, lowering medical errors has had a significant role in reducing unfavorable healthcare outcomes. The risk has been mitigated partly by the equitable treatment of healthcare professionals. The just culture has helped the management group to determine the underlying reasons behind medical errors. Previously, our establishment used to report any instances when medical mistakes resulted in unfavorable patient outcomes. Risk analysis revealed that the small number of nurses hired were overburdened with the growing patient load (Barkell & Snyder, 2021). Then management moved quickly to increase the number of nurses on staff, contributing significantly to the healthcare facility’s magnetic state.

Nurses with a Doctor of Nursing Practice degree (DNP) should utilize their extensive expertise and background to foster a just culture within healthcare institutions. Initially, DNPs act as the public face of healthcare concerns. DNPs promote a decent society by drawing on insights from their study to create healthcare regulations that support establishing a just organization (Tenhunen et al., 2019). They can take advantage of their roles as public health experts and healthcare policy analysts, directors, analysts of information systems, and senior positions to support an equitable workplace.

References

Barkell, N. P., & Snyder, S. S. (2021, January). Just culture in healthcare: An integrative review. In Nursing Forum (Vol. 56, No. 1, pp. 103–111).

Tenhunen, M. L., Heinonen, S., Buchko, B. L., & Frumenti, J. (2019). The DNP-prepared nurse’s expert role impacts healthcare systems: Bench to bedside, classroom to boardroom.