Annotated Bibliography
Paradiso, L., & Sweeney, N. (2019). Just culture: It’s more than policy. Nursing Management, 50(6), 38-45. https://doi.org/10.1097%2F01.NUMA.0000558482.07815.ae
Summary
The article “Just Culture: It’s more than policy” was authored by Paradiso and Sweeney (2019) after conducting a study at an urban teaching hospital in New York to examine the association between error reporting, and just culture. The authors established that although effective and safe care is the main objective of any hospital, medical error has remained the third leading cause of death in the U.S. Due to competing demands, they argue nurses are forced to develop workarounds and improvise, which causes errors in the process. Therefore, clinical nurses have a significant responsibility for reducing errors since they are closer to the patients. They should identify errors and share the events and their impacts on safe care.
The authors contend that although many organizations have adopted a non-punitive response approach to errors, barriers such as disciplinary risk and negative responses from leaders still hinder nurses from speaking up. To eliminate these barriers, the authors suggest that hospitals must strive to develop a trusting and just culture. Just culture supports error reporting as it makes the organization assume accountability for their systems’ design and the incident analysis, exempting the individual. The study findings established that a just culture can help implement meaningful and visible improvements and constant communication of outcomes to clinical nurses to encourage and validate error identification and reporting. The authors concluded that since a just culture is a culture of balancing responsibility, implementing policies that foster just culture principles in an organization could be a good start.
Evaluation
The authors conducted extensive research and wrote an informative and comprehensive evidence-based article. This demonstrates that they have the requisite knowledge and skills and knowledge to write such an article with precision. For instance, Dr. Linda Paradiso is a recognized scholar who graduated from CUNY and has spent forty years of her life in the public health sector caring for stigmatized, marginalized, and under-served people. She has also been in charge of daily clinical operations in various hospital systems in New York City. The co-author, Nancy Sweeney, Ph.D., APRN-BC, is also a renowned scholar who is currently the director of the Nurse Executive DNP Program at Old Dominion University. Therefore, these authors understand the importance of establishing a just culture within an organization to minimize medical errors.
The authors also employed a quantitative, correlational, cross-sectional study methodology to collect data from 1500 clinical nurses and 80 nurse leaders conveniently recruited. The sample increased the probability of data collection as it exceeded the required number, resulting in a response rate of 11.6%. Additionally, the authors used an anonymous self-administered survey, which enhanced the respondents’ autonomy. The article is also relevant to “just culture,” as it conducts comprehensive research in an urban hospital to assess the relationship between error reporting, trust, and just culture. The authors conclude that aligning how nurses perceive just culture with trust can improve employee satisfaction, enhance patient safety outcomes, and reduce medical errors.
Reflection
The article’s findings and arguments relate to my understanding of just culture and my experiences as a healthcare professional in many ways. For example, my understanding of just culture is that it promotes collective responsibility in an organization by fostering trust for improving processes, hence reducing the mistrust that arises from blame and disciplinary risks from executives. This relates to the article’s definition of just culture as a haven supporting error reporting. In my experiences as a healthcare professional, I have witnessed organizations determining the response to an error depending on its severity. Errors that result in death carry heavy punishments, while those causing minimal or no harm are ignored. In most cases, this reduces trust and discourages error identification and reporting. According to the authors, a just culture should treat all types of medical errors equally to build trust and offer opportunities for redesigning the system and staff education.
Reference
Paradiso, L., & Sweeney, N. (2019). Just culture: It’s more than policy. Nursing Management, 50(6), 38-45. https://doi.org/10.1097%2F01.NUMA.0000558482.07815.ae
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