SAFETY/QUALITY AND THEORY 1

Safety/Quality and Corresponding Theory in Nursing Care

Jack Arnold
Ferris State University

SAFETY/QUALITY AND THEORY 2

Abstract
Safety and quality is defined on a personal level and academic level. The academic level
definitions are supported by cited resources and theory. These definitions differ by contrast
between personal views and scientific views and also between a personal level and viewing
healthcare as a whole with overall outcomes versus individual work ethics.

SAFETY/QUALITY AND THEORY 3

Safety/Quality and Corresponding Theory in Nursing Care
Safety and quality in nursing care are critical elements of the care process. Ensuring
patient safety and quality instills trust in the patient/nurse relationship. A nurse that
demonstrates these traits to their patient and the patients family displays competent skills and
care. These skills are based on proven theory in the nursing process that keeps being refined on
a continual basis.
Safety
Safety by definition is the condition of being safe; freedom from danger, risk, or injury,
a device designed to prevent accidents (The Free Dictionary By Farlex, 2013). By this
definition, nurses could be perceived as the designed device to prevent these accidents. Safety in
the nursing process encompasses a whole range of items. It means: using proper technique for
sterile procedures; assist patients as needed to keep them from falling; ensure proper medications
and dosage as prescribed; questioning orders and procedures that appear unnecessary; and the list
goes on. This is the definition I perceive safety in nursing to be. Lynne Currie (March 30, 2011)
views nurses as being the front line defense for patient safety since nurses are the primary care
givers and identified areas such as pressure ulcers, infection reduction and fall prevention. These
concepts all seem to be saying the same thing, just in different words.
Quality
Quality is defined as an inherent or distinguishing characteristic; a property, a personal
trait, especially a character trait (The Free Dictionary By Farlex, 2013). That is an interesting
definition. I never thought of quality as a characteristic or personal trait, I thought of it more as a
way of performing a task. Doing quality work is a way of maintaining safety in the workplace
SAFETY/QUALITY AND THEORY 4

when it comes to nursing. Quality means doing it right the first time, every time. Quality as
defined by the Institute of Medicine is the degree to which health care services for individuals
and populations increase the probability of desired health outcomes and is consistent with current
professional knowledge of best practice (Thornlow, D., McGuinn, K., March 2010, p. 72). This
definition seems to measure quality more based on outcome, grading the health care system as a
whole instead of individual tasks. This is another perspective in viewing healthcare outcomes
when referring to the healthcare system instead on an individual basis.
Theory
One theory that has incorporated safety and quality into nursing is the concept of patient-
centered care. Gwen Sherwood PhD, (04/2012) expresses patient-centered care as collaboration
between the health care professionals (ex. Dr., RN) and the patient or patient and family to
determine the source of the problem, establish a plan, and track the outcomes and success of that
plan. This theory believes with the direct involvement of the patient and/or family with the care
plan and implementation, safety and quality can be better monitored and achieved. It gives the
patient a sense of control over their care and treatment as well as providing them with a form of
education of the process and what to expect. This partnership also gives the health care
providers a chance to understand what goals the patient hopes to achieve and what outcomes are
anticipated by the patient. With better knowledge of patient desired outcomes, the healthcare
team can provide better safety and quality care curtailed to patient cultural, spiritual, and
physical needs.
Safety and quality have always been a part of health care practices, but as healthcare has
evolved and expectations of positive outcomes have increased, the definitions of those qualities
SAFETY/QUALITY AND THEORY 5

have had to be redefined. Patient-centered care was one nursing theory that was developed to
incorporate the patient and/or their family into the care plan process in an attempt to improve
safety and quality. With the patient/family input, a plan can be detailed to their specific needs
and wants. When this is achieved, the patient can feel more involved in their care thus
increasing the quality of satisfaction with their stay and improving the level of safety of that care.

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Currie, L., Gallagher, R., Lecko, C., & Sunley, K. (2011, March 30). Safety: principle of nursing
practice c [Electronic version]. Nursing Standard, 25(30), 35.
quality. (2009). In The American Heritage Dictionary of the English Language, Fourth Edition
(Fourth ed.). Retrieved October 3, 2013, from http://www.thefreedictionary.com/quality
safety. (2009). In The American Heritage Dictionary of the English Language, Fourth Edition
(Fourth ed.). Retrieved October 3, 2013, from http://www.thefreedictionary.com/safety
Sherwood, J., & Barnsteiner, G. (2012). Quality and Safety in Nursing : A Competency
Approach to Improving Outcomes (pp. 67-72). Hoboken, NJ: Wiley-Blackwell.
Thornlow, D. K., & McGuinn, K. (2010, March). A Necessary Sea Change for Nurse Faculty
Development: Spotlight on Quality and Safety [Electronic version]. Journal of
Professional Nursing, 26(2), 71-81. Retrieved October 3, 2013