Mixed method integrative review exploring nurses' recognition and response to unsafe practice.

Area of Science:

• Nursing
• Patient Safety
• Healthcare Quality

Background:

• Established practice guidelines define safe nursing care.
• Nurses encounter difficulties in identifying and addressing unsafe practice.
• Recognizing and responding to unsafe practice is critical for patient safety.

Purpose of the Study:

• To explore how nurses identify and respond to unsafe practice.
• To understand the factors influencing nurses' recognition and responses to unsafe practice.

Main Methods:

• An integrative review guided by Whittemore and Knafl's framework.
• A comprehensive literature search of CINAHL, Medline, Embase, and PsychoINFO (2004-2014).
• Analysis of 19 articles from 15 studies using a mixed-method integrative approach.

Main Results:

• Identification of unsafe practice is influenced by organizational and individual factors.
• Nurses' responses to unsafe practice are inconsistent.
• Reporting unsafe practice carries professional and personal consequences for nurses.

Conclusions:

• Nurses can identify unsafe practice among peers, impacting patient outcomes.
• There is a need for nurse awareness training and supportive strategies for responding to unsafe practice.
• Improved reporting systems that protect whistleblowers are essential.
• Further research is needed on organizational and individual factors influencing practice changes in safety.