In today’s perioperative setting, staff members are potentially exposed to a variety of safety and environmental concerns. As health care organizations implement measures to provide safe environments for perioperative team members, organizational leaders must pivot away from antiquated mindsets and responses and other hierarchical models of leadership. Foundational to creating and fostering safe environments is providing an atmosphere in which staff members, regardless of their role, are empowered to speak up for safety. This article defines a just culture; explores the critical elements of a just culture, including psychological safety, leader and staff member responsibilities, and staff member empowerment; and provides tools and resources that may be beneficial for leaders who are creating a just culture for staff safety in the perioperative setting.

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N urse practitioners (NPs) have been providing comprehensive and complementary care for over 40 years. In the past 10 to 15 years, however, the role of the NP has expanded to include greater responsibilities and a more extensive scope of practice. The expanded role for NPs is primarily the result of two factors: the shortage of physicians and the demand for a more cost-effective health-care system. Increasingly, NPs are being asked to assist with and perform invasive medical procedures. This allows physicians to reach a larger number of patients while NPs perform these more time-consuming procedures. The utilization of NPs for invasive procedures can also be very cost-effective with similar reimbursement for procedures performed. 1 This article is intended to specifically outline a methodology for training and assessing competency in performing invasive procedures, using bone marrow aspirates and biopsies as an example. This methodology was