Patient Safety Culture and Practice Change Frameworks

Patient safety is a crucial concern for care providers because it is directly connected to the quality of care and patient outcomes. Fostering a culture of patient safety can help to avoid errors in care provision, as well as the resulting adverse events. It can also impact the quality of care through continuous practice improvement. Hence, nurse leaders need to understand the factors that influence patient safety culture and various practice change interventions.

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Patient Safety Culture

Culture has a critical influence on patient safety in healthcare settings. Sammer and James (2011) define culture as the set of “values, beliefs, and norms that are important in the organization” (para. 3). A culture of safety focuses on patients and their health outcomes, thus supporting the implementation of attitudes and behaviors that are required to ensure safe, high-quality care provision (Sammer & James, 2011). The lack of a safety culture, on the contrary, has a negative influence on patient outcomes because it affects how nurses and other care providers fulfill their duties. For instance, a weak safety culture could lead staff to disregard the protocols and procedures necessary for promoting patient safety.

The case discussed in the article focuses on studying patient safety in a particular hospital through the experiences of a fictional patient. During her stay in a surgical intensive care unit, the patient suffered several adverse outcomes, including pneumonia, hypoglycemia, and central line-associated bloodstream infection (Sammer & James, 2011). Given that the patient had a history of diabetes and acquired both infections while in the hospital, it is evident that there was a lack of patient safety culture in the facility. In the discussed scenario, the hospital’s leaders took action to improve safety through evidence-based education, staff training, improved teamwork, and safety measurement (Sammer & James, 2011).

The most crucial factor that led to the practice change was the shift to evidence-based practice. Focusing on proven interventions highlighted the potential solutions for problems in the unit, whereas the application of safety frameworks contributed to the outcomes. Hence, evidence-based interventions should be considered by leaders in nursing whenever there is a need for practice improvement.

Practice Change Frameworks

If I worked in a facility that needed a practice change, I would use frameworks designed for applying evidence-based interventions. This would help to ensure the use of proven techniques that promote a real change in care quality and patient outcomes. For example, the Iowa Model of Evidence-Based Practice is a useful tool for care providers that enables them to translate research findings into clinical practice (Brown, 2014). This approach helps improve organizational and care providers’ knowledge while addressing gaps and deficiencies in practice that affect patient outcomes.

Another example of an evidence-based framework for practice change is the Tyler Collaborative Model, which was developed by nursing researchers in 2004. This framework takes a strategic, holistic approach to practice change. According to Camargo et al. (2017), this model encourages organizations to analyze the factors that affect practice improvement, diagnose the problem correctly, and apply evidence-based techniques to implement and sustain change. Because the model focuses on the collaboration between leaders, staff, and interdisciplinary teams, it could be particularly useful in complicated healthcare settings.


Overall, patient safety is a critical concern for care providers, including nursing. Leaders should strive to improve patient safety through changes in culture and practice. Evidence-based frameworks for practice change can assist healthcare leaders in ensuring the effectiveness of any interventions used. The two specific change frameworks that I would utilize to foster practice change are the Iowa Model and the Tyler Collaborative Model.

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Brown, C. G. (2014). The Iowa model of evidence-based practice to promote quality care: An illustrated example in oncology nursing. Clinical Journal of Oncology Nursing, 18(2), 157-158.

Camargo, F. C., Iwamoto, H. H., Galvão, C. M., Monteiro, D. A. T., Goulart, M. B., & Garcia, L. A. A. (2017). Models for the implementation of evidence-based practice in hospital based nursing: A narrative review. Texto & Contexto-Enfermagem, 26(4). Web.

Sammer, C. & James, B. (2011). Patient safety culture: The nursing unit leader’s role. OJIN: The Online Journal of Issues in Nursing,16(3), Manuscript 3. Web.

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