NURS 8302 Discussion Just Culture
Sample Answer for NURS 8302 Discussion Just Culture Included After Question
As an alternative to a punitive system, application of the Just Culture model, which has been widely used in the aviation industry, seeks to create an environment that encourages individuals to report mistakes so that the precursors to errors can be better understood in order to fix the system issues.
—American Nurses Association, 2010
Mistakes happen. There is no way to avoid all mistakes, so how might your practice change if the reporting of mistakes was welcomed, versus penalized? How might this lead to a better understanding of quality improvement and safety needs? How might patient safety be improved?
For this Discussion, consider the role of just culture in your organization. Reflect on your experience with just culture and consider how this model might support patient care.
NURS 8302 Discussion Just Culture Reference:
American Nurses Association. (2010). Just culture [Position statement]. https://www.nursingworld.org/~4afe07/globalassets/practiceandpolicy/health-and-safety/just_culture.pdf
Photo Credit: ilkercelik / Adobe Stock
To Prepare:
- Review the Learning Resources for this week, and reflect on your experiences with just culture.
- Consider how just culture connects to quality and safety. What is the role of the DNP-prepared nurse in promoting just culture in organizations and nursing practice?
By Day 4 of Week 1
Post an explanation of whether your organization uses a just culture. Then, explain how this might impact quality and safety for your healthcare organization, and why. What is the DNP-prepared nurse’s role in supporting a just culture environment in a healthcare organization? Be specific and provide examples.
By Day 6 of Week 1
Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by expanding upon your colleague’s post or suggesting an additional alternative perspective on the role of the DNP-prepared nurse in supporting a just culture in a healthcare organization.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
NURS 8302 Discussion Just Culture Grading Criteria
To access your rubric:
Week 1 Discussion 2 Rubric
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A Sample Answer For the Assignment: NURS 8302 Discussion Just Culture
Title: NURS 8302 Discussion Just Culture
Accidents involving injuries or fatalities are frequently caused by human error. According to Quillivan (2020), those involved in accidents or errors are frequently held accountable and may face punishment to resolve the issue. Although the error is the system’s fault, it is frequently assumed that the individual is to blame. The issue would persist if the system remained unchanged and people were altered instead. According to Battard (2017), medical errors result from flawed systems, circumstances, and procedures rather than the fault of healthcare professionals. The culture of safety can be achieved in a good working environment. However, due to the persistence of harsh work situations, frontline employees in most healthcare businesses are at risk of medical errors.
Establishing a Just Culture in my organization
Healthcare organizations must be open and honest about reporting medical errors for patient safety. Transparency entails having no secrets to allow medical errors to be discussed publicly and information to flow freely (Quillivan, 2020). Furthermore, openness promotes accountability and fosters confidence when freely sharing medical errors. Therefore, a just culture is required for Transparency to occur—an atmosphere of candor and openness results from a just culture. In my organization, healthcare workers are encourage to report medical errors. For example, when a nurse commit a medical error in my organization, the case is investigated, and the nurse is send for further training. There was a case where a nurse in my unit did not follow up with the pharmacy to obtain insulin for a diabetic patient. The patient was later sent to ICU for DKA. The nurse was sent for training and got a warning from the hospital administration. Nurses are also reported to the board of nursing, suspended or terminated for medical errors that result to fatal injury or death. While the healthcare institution owes its patients and staff a duty, everyone is ultimately accountable for their choices. Healthcare professionals should not be held accountable for systemic errors they cannot control. However, a just culture is a shared obligation that should address all medical issues in a facility (Battard, 2017). Therefore, when nurses respect safety and exercise caution when there is a threat to safety, a just culture is established.
The Role Nurse Leaders
Ensuring public safety through developing a just culture requires a shared duty between businesses and employees. Shared responsibility creates a setting where mistakes and faults can be carefully examined to promote learning (Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). 2019). Establishing a culture of accountability and responsibility for patient safety is a duty and responsibility of nurse leaders. As mistakes are revealed, nurses must be held accountable and responsible to move toward a just culture. Accountability and responsibility entail determining why mistakes occur and which conditions, systems, and procedures are to blame (Quillivan, 2020). In order to prevent medical errors, nurse leaders must supervise their personnel and ensure that dangerous habits are recognized early on. As a result, nurse leaders must provide their staff members the freedom to use their abilities and expertise while still acting morally. For several eyes to spot mistakes and for everyone to feel comfortable pointing out and reporting safety hazards, hospitals must also use their workforce (Battard, 2017). In order to avoid mistakes made during work procedures, nurse leaders must collaborate with frontline nurses to find solutions through candid communication. Therefore, nurse leaders may foster an atmosphere of accountability by involving staff members in the solutions sought as problems are found.
In conclusion
A just culture arises where mistakes are openly discussed to ensure patient safety. Transparency helps staff members and nursing leaders spot and fix systemic problems that could cause medical errors and avert harm. As a result, a just culture is a shared responsibility that should handle every medical issue in a healthcare facility. However, healthcare professionals should be held accountable for preventable errors.
References
Battard, J. (2017). Nonpunitive response to errors fosters a just culture.Nursing Management,48(1),55https://journals.lww.com/nursingmanagement/FullText/2017/01000/Nonpunitive_responhttps://journals.lww.com/nursingmanagement/FullText/2017/01000/Nonpunitive_response_to_errors_fosters_a_just.12.aspx
Marx, D. (2019). Patient safety and the just culture.Obstetrics and Gynecology Clinics,
46(2),239-245. https://www.obgyn.theclinics.com/article/S0889-8545(19)30004-X/fulltext
Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019).The healthcare quality
book: Vision, strategy, and tools (4th ed.). Health Administration Press
Quillivan, R. R. (2020).Just Culture in Healthcare Error Management: Nurse-in-Training View of Just Culture and Outcomes of Event Involvement(Doctoral dissertation,University of Memphis).https://www.proquest.com/openview/4d4ab5161676c4e084c1a19b773c34e0/1?pq-origsite=gscholar&cbl=51922&diss=y
A Sample Answer 2 For the Assignment: NURS 8302 Discussion Just Culture
Title: NURS 8302 Discussion Just Culture
Our healthcare organization upholds a just culture that acknowledges the occurrence of errors and views them as opportunities for growth rather than grounds for disciplinary action. Adopting this approach fosters an environment where individuals are sufficiently at ease to acknowledge their errors. As opposed to assigning blame to particular individuals, the focus shifts to identifying systemic issues and formulating remedies (Mihdawi et al., 2020).
Encouraging open communication and transparency within an equitable culture yields favorable outcomes in terms of patient care quality and safety (O’Kane et al., 2021). A more comprehensive understanding of safety and quality improvement requirements can be attained when healthcare personnel are permitted to disclose errors without apprehension of retaliation. This facilitates the development of valuable insights. Ensuring the overall safety of patients becomes a collective responsibility when identifying and rectifying system errors.
The promotion of an equitable culture is a critical responsibility of the DNP-prepared nurse, who must also advocate for policies that prioritize learning from mistakes over assigning blame. By emphasizing the importance of error reporting and the continuous enhancement of patient care, they can take the lead in initiatives to educate staff regarding this matter (World Health Organization, 2021). A physician of nursing practice-educated nurse contributes to the establishment of a more secure healthcare system through the promotion of a culture of accountability and mutual regard among personnel. This facilitates improved patient outcomes through continuous innovation, collaboration, and development.
Reference:
Mihdawi, M., Al-Amer, R., Darwish, R., Randall, S., & Afaneh, T. (2020). The influence of nursing work environment on patient safety. Workplace health & safety, 68(8), 384-390.
O’Kane, M., Agrawal, S., Binder, L., Dzau, V., Gandhi, T. K., Harrington, R., … & Schummers, D. (2021). An equity agenda for the field of health care quality improvement. NAM perspectives, 2021.
World Health Organization. (2021). Global patient safety action plan 2021-2030: towards eliminating avoidable harm in health care. World Health Organization.
A Sample Answer 3 For the Assignment: NURS 8302 Discussion Just Culture
Title: NURS 8302 Discussion Just Culture
A just culture in a psychiatric hospital involves fostering an environment where individuals are held accountable for their actions while emphasizing fair and consistent responses to errors. This approach recognizes that errors are inevitable in complex healthcare systems and aims to distinguish between human error, at-risk behavior, and reckless behavior (American Nurses Association, 2010).
How This Might Impact Quality and Safety for My Healthcare Organization
The impact of a just culture on quality and safety in our psychiatric hospital is significant. By promoting open communication and reporting of errors without fear of punishment, a just culture encourages healthcare professionals to share valuable information about potential risks and safety concerns. This transparency enables the identification of systemic issues and the implementation of preventive measures to enhance patient safety (Paradiso & Sweeney, 2019).
DNP-Prepared Nurse’s Role in Supporting a Just Culture Environment
The role of the DNP-prepared nurse in supporting a just culture environment is crucial. DNPs can contribute to the development and implementation of policies and procedures that prioritize fairness and accountability. They can also lead educational initiatives to ensure that all staff members, from clinicians to administrators, understand the principles of a just culture and feel empowered to report errors and near misses (Kim & Yu, 2021). DNPs can participate in the analysis of adverse events, working collaboratively with interdisciplinary teams to identify root causes and implement evidence-based strategies to improve the quality and safety of care (Kim & Yu, 2021).
A DNP-prepared nurse in a psychiatric hospital might lead training sessions on just culture principles, emphasizing the importance of shared accountability. They could also be involved in the review of critical incidents, facilitating discussions to determine the contributing factors, and implementing changes to prevent similar occurrences in the future. Overall, the DNP’s leadership and expertise play a vital role in cultivating a just culture that positively impacts quality and safety in the psychiatric healthcare setting.
References
American Nurses Association. (2010). Just culture [Position statement].
Kim, B. & Yu, S. (2021). Effects of Just Culture and Empowerment on Patient Safety Activities of Hospital
Nurses. Healthcare (Basel, Switzerland), 9(10), 1324. https://doi.org/10.3390/healthcare9101324
Paradiso, L., & Sweeney, N. (2019). Just culture: It’s more than policy. Nursing management, 50(6), 38–45.
https://doi.org/10.1097/01.NUMA.0000558482.07815.ae
Post by Day 4 of Week 1 and Respond by Day 6 of Week 1
To Participate in this Discussion:
Week 1 Discussion 2
What’s Coming Up in Week 2?
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Next week, you will examine the definitions of quality. You will explore nurse-sensitive quality indicators and evaluate the influence of these indicators on nursing practice.
Looking Ahead: IHI Modules
This Assignment requires completion of 13 IHI Open School modules and the completion of the Certificate of Completion at the Basic level. There are 13 modules that you must complete over the course of these 11 weeks.
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| Improvement Capability | Patient Safety |
| QI 101: Introduction to Health Care Improvement | PS 101: Introduction to Patient Safety |
| QI 102: How to Improve With the Model for Improvement | PS 102: From Error to Harm |
| QI 103: Testing and Measuring Changes With PDSA Cycles | PS 103: Human Factors and Safety |
| QI 104: Interpreting Data: Run Charts, Control Charts, and Other Measurement Tools | PS 104: Teamwork and Communication in a Culture of Safety |
| QI 105: Leading Quality Improvement | PS 105: Responding to Adverse Events |
| Triple Aim for Populations | Person and Family-Centered Care |
| TA 101: Introduction to the Triple Aim for Populations | PFC 101: Introduction to Person- and Family-Centered Care |
| Leadership | |
| L 101: Introduction to Healthcare Leadership |
To access the IHI Certificate Program, go to IHI.org, and register to create an account. Be sure to enter Walden University as your organization. Under Role, you will select student. Under Organization, you will select school, and under education type, you will select nurse.
Go to the Education tab, and select Open School Courses. Click on Online Courses and then on Certificates and CEUs. You want to ensure that you are viewing the Basic Certificate in Quality and Safety. Click on Earn Your Certificate Today, and you should be in your student dashboard to begin completing the IHI modules. You will want to click on Go to your Learning Center. On the left-side navigation menu, you will want to Search Catalog to search for, and enroll in, each of the 13 modules required for this certificate.
You will earn contact hours for each module, and once all 13 are completed, you will download the certificate of achievement. Please save this certificate. You will be required to upload this to gradebook in evidence of your completion.
You must complete all IHI modules and submit your certificate by Day 2 of Week 11.
Looking Ahead: Clinical Assignment: DNP Project Faculty Advisor and Site Identification
Preparation for project planning will begin during the clinical component of NURS 8302. By Day 7 of week 6, you will identify an organization that you will approach to discuss a gap in practice or practice change that you might assist with as your DNP project.
Possible appointments to explore a site for the project include those made with the chief nursing officer, director of quality improvement, or director of education. In a clinic or community agency, the contact person may be the director or someone in human resources. You may complete the project at your place of employment, as long as you are not working on your own unit or with people that you supervise.
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This project will include a development of a staff education program, development of a clinical practice guideline, or an evaluation of an existing quality improvement process. The project process cannot include patients or nursing students. The project cannot be completed at an academic setting.
Preparation for project planning will begin during the clinical component of NURS 8302. The DNP Project must follow guidelines set forth in one of the following DNP Project manuals:
- Clinical Practice Guidelines Manual
- Staff Education Manual
- Quality Improvement Evaluation Manual
NOTE: All forms and manuals are found on the DNP Capstone Resources site:
https://academicguides.waldenu.edu/research-center/program-documents/dnp
Your project team will consist of a preceptor or project mentor from the organization, and a three-member Faculty committee from Walden who will be assigned upon completion of this course. You will begin your project in the next term through the mentoring course, NURS 8702.
Lopes Write Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Important information for writing discussion questions and participation
Welcome to class
Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to
I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.
Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.
If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.
Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.
Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.
I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!
Hi Class,
Please read through the following information on writing a Discussion question response and participation posts.
Contact me if you have any questions.
Important information on Writing a Discussion Question
- Your response needs to be a minimum of 150 words (not including your list of references)
- There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
- Include in-text citations in your response
- Do not include quotes—instead summarize and paraphrase the information
- Follow APA-7th edition
- Points will be deducted if the above is not followed
Participation –replies to your classmates or instructor
- A minimum of 6 responses per week, on at least 3 days of the week.
- Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
- Each response needs to be at least 75 words in length (does not include your list of references)
- Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
- Follow APA 7th edition
- Points will be deducted if the above is not followed
- Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
- Here are some helpful links
- Student paper example
- Citing Sources
- The Writing Center is a great resource