Normalization of Deviance and Practical Drift

Bedside Report: Nursing Handoffs Impact Outcomes for Caregivers, Healthcare Providers, and Organizations

“…These improvements validated to staff EBP initiatives can impact nursing transfer of care and patient and family satisfaction. Ongoing data monitoring by clinical leaders remains a priority to address percentage decreases and minimize the likelihood of practice drift, further hardwiring the practice change (Harvey & Sotardi, ). Informal rounding at change of shift reveals nurses engaging in care transfer outside patient rooms and inside with families actively participating.…”

Exploring normalization of deviance and examining factors that predict culture of safety in the operating room.

“…It is important to identify, expose, and acknowledge the phenomenon within high-risk healthcare environments. Gaining a better understanding of the concept opens doors to learning how to thwart its harmful consequences (Harvey & Sotardi, 2017).…”

“…Although normalization of deviance exists in healthcare (Amalberti et al, 2006;Price & Williams, 2018;Harvey & Sotardi, 2017), there is a dearth of literature relating to its exact nature. One of the reasons cited is that while healthcare is submerged in rules and regulations, there is typically extra space for clinical judgement, and so it is difficult to define when a violation has actually occurred.…”

“…Although the origins of the normalization of deviance concept arose within investigations into the safety practices of NASA (Vaughan, 1996), it has been determined that it has a ubiquitous presence in healthcare (Banja, 2010;Harvey & Sotardi, 2017;Gerstle, 2018). In healthcare, deviation from sound safety practices may offer perceived advantages, such as efficiency from a time standpoint (Reid, 2014;Harvey & Sotardi, 2017); some healthcare personnel speciously accept that deviations offer a path to increased productivity. Unfortunately, over time, short cuts are prone to becoming the cultural norm (Gerstle, 2018).…”

“…Unfortunately, over time, short cuts are prone to becoming the cultural norm (Gerstle, 2018). This phenomenon unhinges the safety culture within an organization by gradually tolerating lower safety standards, which increases organizations' vulnerability to errors and adverse patient outcomes (Prielipp, Magro, Morell, & Brull, 2010;Harvey & Sotardi, 2017).…”