Date of Conferral

2014

Degree

Doctor of Nursing Practice (DNP)

School

Health Services

Advisor

Sue Bell

Abstract

An organizational culture of safety affects employees' attitudes, beliefs, perceptions, and values related to safe practice as well as their behaviors and level of engagement. The purpose of this project was to determine the influence of introducing the just culture model through staff engagement in an interactive workshop. A convenience sample of acute care staff were recruited for this 1-sample pretest and posttest project design. The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture instrument was used to measure safety culture perceptions on 7 dimensions pre and post intervention. For the theoretical framework, Ajzen's theory of planned behavior and Kantar's empowerment theory were used. Welch's t test results showed significant improvement in perception scores overall (t = 2.7, p < 0.01), with posttest mean scores ('= 3.7) higher than pretest mean scores ('= 3.5). The dimension-specific mean posttest scores were significantly higher on 3 of the 7 dimensions including teamwork (t = 2.99, p < 0.05), feedback and communication (t = 2.14, p < 0.05), and frequency of event reporting (t = 2.31, p < 0.05). Major implications for social change include reduction of preventable errors and iatrogenic events; creating a healthcare environment that is safe, fair, transparent, and reliable; creating organizational learning through evidence-based patient safety training; and promoting the use of perception surveys to measure and improve the culture in one's organization. The project may provide a road map for just culture implementation. Future qualitative and quantitative research should explore effects of a just culture on safety reporting patterns and specific events such reducing medication errors or risk-taking behaviors.

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