Narrowing the Gap Between Safety Policy and Practice: The Role of Nurses’ Implicit Theories and Heuristics

This chapter addresses the question of why, despite enormous investments in developing clear policy guidelines and best practices for addressing safety issues, health care staff still decides to cut corners, and fail to comply with safety regulations. It begins with integrating two lines of research: psychological research on heuristics in the individual’s decision-making process, and organizational safety literature. The chapter discusses theoretical framework, before extrapolating this to empirical findings which illustrate nurses’ decision-making processes that discourage safety behaviour. It proposes managerial approaches aimed at changing nurses’ decision processes and at directing more attention to safety issues. In health care organizations, efforts to maintain patient safety typically focus on the role of repetition and routine. In such bureaucratic settings nurses frequently perceive that safety is the responsibility of the managers, while their primary focus is on the continuing the care for patient.