Nurses’ Perception toward the Relationship between Just Culture and Patient Safety Activities: A Literature Review

Abstract

Purpose: This review aimed to explore “Just Culture”, patient safety, and the relationship between them from nurses’ perceptions working in healthcare settings. Also, to highlight recommendations for nurse managers regarding the explored concepts and provide evidence-based resource guiding future researches and nursing practice. 
 Methodology: EBSCOhost, PubMed, and Clinical Key for Nursing were the databases selected for this review, accessed directly or through available online libraries.
 Findings: A total of 21 studies met the screening criteria and were included. Studies recruited multiple levels of nursing positions, conducted in different countries and healthcare settings. Two themes were developed accordingly: Nurses’ perceptions toward “Just Culture” and Nurses’ perceptions toward patient safety. 
 Unique Contribution to Theory, Practice and Policy: The relationship between “Just Culture” and patient safety from nurses’ perceptions is found to be correlated with high or low nursing performance. Healthy work environments that foster “Just Culture” achieve desirable safety outcomes. The major role of organizational and nursing management is creating positive workplace cultures that maintain patient safety. Additionally, it is crucial to establish policies that demonstrate fair responses to incidents, adopt rational investigations based on balanced accountability, and avoid unjustified blame for nurses. “Just Culture” should not be promoted as a blame-free approach but as a balanced accountability. Hence, these managerial endeavors should encourage the voluntary reporting of incidents by nurses for learning and improvement purposes while nurses remain accepting their responsibility at the level they contributed to that incident.