Enhancing High Reliability in Oncology Care: The Critical Role of Nurses-A Systematic Review and Thematic Analysis

Background/objectives: The oncology setting is complex and recognized as a high-risk area, with an increased potential for errors due to the complexity of therapeutic modalities and different processes. Nurses are pivotal in fostering a culture of patient safety and high reliability and actively contribute to the enhancement of safety standards in oncology care. This review systematically identified and examined the critical role of nurses in promoting high reliability within oncology organizations to ensure optimal patient outcomes. Methods: A systematic review was performed in the PubMed, CINAHL, and Cochran Library databases in accordance with PRISMA guidelines. Using Tomas and Harden's three stages, 12 studies were deductively and thematically analyzed to discover themes. Results: We identified eight themes concerning nurses' roles in achieving high reliability in healthcare within oncology organizations: establishing standardized and safe administration, enhancing situational awareness, promoting effective communication, advocating for patients, building a culture of safety, leading safety culture improvements, engaging staff, and fostering patient engagement. Conclusions: Nurses play a critical role in identifying, communicating, and correcting safety threats, overcoming various organizational barriers to safety concerns, and maintaining and developing a culture of safety for patients and families. Although this review included a relatively limited body of literature, the findings highlight the need for further research that considers the unique characteristics of health and healthcare systems. Protocol registry; UMIN Clinical Trials Registry (UMIN-CTR) Registry No. UMIN000056140.