Introduction
Modern nurses must regularly improve their skills and knowledge to understand their tasks correctly and follow the required guidelines and standards. Many concepts and theories in nursing affect interpersonal relationships and the quality of care offered to patients and their families. Some theories address social and cultural aspects of nursing, while other models aim to determine nurse roles and responsibilities.
Despite the approach chosen by a nursing theorist, the use of particular concepts remains inevitable in practice. According to Almeida et al. (2022), theories should be applied to promote safe nursing care in various contexts and situations. Safety is one of the main goals to be recognized by all nurses in quality management and patient care (Shenoy, 2021).
This paper aims to analyze the concept of safety and its relation to nursing practice, including education, management, nursing theory, and Leininger’s Culture Care Theory. Safety may be interpreted in multiple ways, and nurses must learn how to create and maintain a safe environment for their patients. The combination of safety and culture in nursing care cannot be ignored to ensure positive health outcomes and nurse-patient relationships.
Safety Concept in Nursing Practice
Safety is one of the central concepts in nursing because it defines everything that is done for patients and by nurses within a particular healthcare setting. On the one hand, patient safety is a cornerstone of high-quality care intrinsic to all healthcare professionals (Shenoy, 2021). People who visit hospitals and cooperate with doctors and nurses expect to improve their health and feel safe in diagnosis, treatment, and medication prescriptions. On the other hand, nurses should remember that a healthy work environment is characterized by satisfaction, empowerment, and safety (Wei, Sewell, Woody, & Rose, 2018).
Thus, the concept of safety touches not only patients and direct nursing responsibilities but also an overall environment where nurses spend much time. Safety has to be taken into consideration in education and human resource management because its absence provokes adverse events and becomes one of the ten leading causes of human disability and death (World Health Organization, 2019). It is not enough for nurses to provide their patients with guarantees of safe and effective care. It is more important to develop a better understanding of the chosen concept and apply it to different situations appropriately.
The definition of safety in nursing has been developed for many years, and many organizations have contributed to a better evaluation of its major characteristics. For example, the Institute of Medicine (IOM, 2004) defines patient safety as a system-wide approach to preventing harm and avoiding injuries to patients (as cited in Shenoy, 2021). For several years, the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Network attempted to expand the IOM explanation to include “freedom from accidental or preventable injuries produced by medical care” (as cited in Shenoy, 2021).
Therefore, nurses are responsible for preserving patient safety by offering efficient (waste avoidance), effective (scientific knowledge), patient-centered, timely, and equitable care (Shenoy, 2021). According to the World Health Organization (2019), patient safety is a global health priority that might be related to cost reduction, patient harm prediction, and healthcare system efficiency. All these definitions prove patient safety as a fundamental component in health and nursing care that promotes success and progress.
In addition to a commonly known concept of patient safety, this concept analysis should include environmental and psychological safety at the workplace. Nurses cooperate with patients, their families, doctors, and other healthcare providers who may affect and improve human health. Communication with different people is characterized by certain challenges like the importance of cultural competence, data sharing, and role distribution.
Healthy work environments should be based on the principle of hospital accidental safety. Wei et al. (2018) gave a clear definition of this concept as “unintended events that occurred unplanned and could have been avoided with appropriate efforts” (290). Examples in nursing practice are medication errors, a safe climate, and a supportive culture. The safety concept is hard to neglect when nurses identify their working standards. When people are confident in their working conditions, they are able to deliver high-quality care in a timely and sufficient manner.
Safety Concept in Theory
Many nursing theories make the concept of safety evident. However, it is more interesting and educative to find out how the same concept can be applied and developed through the prism of a theory that is less expected. The factors that affect nursing practice and safety vary, including job satisfaction, teamwork issues, working hours, employees, and occupational hazards (Almeida et al., 2022). Thus, nurses are encouraged to use theories and decide what information is critical, what facts can be poorly interpreted, and what conclusions should be made.
Groves and Bunch (2018) suggest that middle-range theories examining patient safety and safety culture communication are effective for applying the chosen concept of safety. Nurses are key to safe care and patient satisfaction, and if they develop optimistic behaviors through a safe culture, patients get a chance to achieve positive outcomes. Middle-range theories are usually related to limited dimensions that provide guidance for nursing activities. There are many examples of such theories today, and Culture Care Theory is one of them.
At the beginning of the 1990s, Madeleine Leininger introduced her theory of transcultural nursing, also known as Culture Care Theory. The essence of this approach is to provide culturally competent care by explaining and predicting nursing knowledge about cultural congruence in nursing care (McFarland & Wehbe-Alamah, 2019). The theorist aims to help researchers and healthcare providers underline the interdependence between care and culture and recognize the differences in cultural backgrounds (McFarland & Wehbe-Alamah, 2019).
Nurses should understand how to make decisions, improve their skills, and manage their relationships in a team. According to this theory, culturally congruent care emerges when a nurse and a patient define a new lifestyle that enhances well-being based on generic and professional knowledge (Culture care theory, n.d.). Attention should be paid to each other’s values, norms, and beliefs that might affect decisions, as well as an overall understanding of health problems and perception of meanings.
When a nurse uses Leininger’s Culture Care Theory, she is expected to focus on several personal characteristics that define the conditions under which holistic care is offered. Gender considerations, occupation, age, sexual orientation, appearance, and language must be assessed each time (Culture care theory, n.d.). Within the frames of the chosen middle-range theory, safety plays a vital role in nursing care because it is a part of healthy and satisfying culturally-based care.
People should not choose between safety and cultural competence but be sure that integrative care is the only desired outcome with a safe and congruent way of caregiving (McFarland & Wehbe-Alamah, 2019). There are many threats that cultural competence results in decreased patient safety because of different languages, the impact of religious and cultural beliefs, and personal concerns. At the same time, safety is under threat when nurses fail to address the patient’s culture or language with respect, provoking new diagnostic errors and negative responses. Therefore, the theory of transcultural nursing can be significantly improved if the concept of safety is used for its integration into nursing care.
Examples of Using Safety Concepts
With the help of the offered theoretical background and the identification of the concept of safety in nursing, a number of examples of how to improve care can be given. When a nurse and a patient speak different languages, it is important to find a way to exchange credible and clear information about human health, diagnostic techniques, and treatment options. Cultural differences should not prevent care promotion, and patient safety is a key goal to be identified by a nurse (Shenoy, 2021). Remembering safety means avoiding injuries and harm, and even different cultural backgrounds do not change this care principle.
Another example of how the concept of safety is relevant to the nursing practice and education, in particular, is awareness improvement. Nurses should consider lifelong learning to understand what may put their patients at risk of health complications and do everything possible to predict such situations (Almeida et al., 2022). At the same time, nurses are responsible for educating patients and their families about safety basics. Thus, communication and cooperation enhance safety, and cultural competence is obligatory as it is the only way to succeed in sharing information. Instead of focusing on personal differences, patients and nurses must address safety as the only desired outcome in care services.
Finally, Leininger’s theory has made a significant contribution to how nurses should apply the concept of safety. In the chosen theory, nursing is a humanistic profession that promotes various caring activities to help and support patients and maintain their health in culturally appropriate ways (Culture care theory, n.d.). If a nurse neglects the safety basics, all other steps and caring activities do not make sense. Patients cannot be properly treated and healed without safe and reliable care. Nurses, in turn, contribute to job satisfaction when they predict harm and problems with their patients.
Conclusion
In general, this concept analysis turns out to be a unique opportunity for nurse students to understand what makes solid nursing care and how theoretical and practical issues are combined. Patient and workplace safety may be examined from various perspectives, including quality management, cooperation, and patient cooperation. Although many nurses recognize safety as an overreaching goal in patient care, not all are ready to apply this concept to theories.
The example of Leininger’s transcultural theory shows how attention to one issue (culture) may affect the perception of another issue (safety). Sometimes, a nurse is able to demonstrate cultural competence and respect for all client’s needs and expectations through the prism of professional and safe care services. However, there are situations when more work is required to identify the differences between patients and the already applied nursing standards and make correct decisions quickly. Thus, this analysis demonstrates the value of combining safety and cultural concepts in modern nursing care.
References
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McFarland, M. R., & Wehbe-Alamah, H. B. (2019). Leininger’s theory of culture care diversity and universality: An overview with a historical retrospective and a view toward the future. Journal of Transcultural Nursing, 30(6), 540-557. Web.
Shenoy, A. (2021). Patient safety from the perspective of quality management frameworks: A review. Patient Safety in Surgery, 15(1). Web.
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