Perinatal safety: from concept to nursing practice.
Communication and teamwork problems are leading causes of documented preventable adverse outcomes in perinatal care. An essential component of perinatal safety is the organizational culture in which clinicians work. Clinicians' individual and collective authority to question the plan of care and take action to change the direction of a clinical situation in the patient's best interest can be viewed as their "agency for safety." However, collective agency for safety and commitment to support nurses in their role of advocacy is missing in many perinatal care settings. This article draws from Organizational Accident Theory, High Reliability Theory, and Symbolic Interactionism to describe the nurse's role in maintaining safety during labor and birth in acute care settings and suggests actions for supporting the perinatal nurse at individual, group, and systems levels to achieve maximum safety in perinatal care.
Lyndon
Audrey
A
Department of Family Healthcare Nursing, UCSF School of Nursing, San Francisco, California 94143, USA. audrey.lyndon@nursing.ucsf.edu
Kennedy
Holly Powell
HP
D003142:Communication; D003299:Cooperative Behavior; D004059:Diffusion of Innovation; D006804:Ergonomics; D006801:Humans; D007400:Interprofessional Relations; D019300:Medical Errors / Q000451:nursing / Q000517:prevention & control / Q000523:psychology; D015969:National Academies of Science, Engineering, and Medicine, U.S., Health and Medicine Division; D017283:Neonatal Nursing / Q000458:organization & administration*; D024802:Nurse's Role / Q000523:psychology; D009742:Nursing Theory; D009773:Obstetric Nursing / Q000458:organization & administration*; D010344:Patient Advocacy; D018743:Perinatal Care / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration*; D012944:Social Support; D013598:Systems Theory; D014481:United States