Background: Quality-of-care improvement and prevention of practice errors is dependent on nurses' adherence to the principles of patient safety. Aims: This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses' adherence to patient-safety principles. Methods: Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010-2019. Using the theoretical domains of the Vincent's framework for analysing risk and safety in clinical practice, we synthesized our findings according to 'patient', 'healthcare provider', 'task', 'work environment', and 'organisation and management'. Findings: Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients' participation, healthcare providers' knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses' adherence to patient-safety principles. Conclusions: The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse' adherence to patient-safety principles and their effects on patient-safety outcomes.

Preventing adverse events and enhancing patient safety in health care are key objectives of nursing education. This integrative literature review critically appraises the content of patient safety in prelicensure nursing education, the teaching and learning methods used, and subsequent nursing student learning. The studies (N = 20) reviewed reveal that patient safety in nursing curricula was not necessarily obvious. However, patient safety was taught within both academic settings and clinical environments. The identified content of patient safety was learning from errors, responsible individual and interprofessional team working, anticipatory action in complex environments, and patient safety-centered nursing. The teaching and learning methods used included combining multiple methods. Patient safety curricula included continuing improvement in patient safety competency, sensitivity to nursing students' role, and having a supportive learning environment. Patient safety in the nursing curriculum requires broad, comprehensive attention and development as a specific theme with an interprofessional approach.

Health care organisations and professionals with responsibilities for patient safety should seek to standardise the preparation of nursing students incorporating requisite international standards and benchmarks.

BackgroundResearch on patient safety in emergency medical services (EMS) has mainly focused on the organisation’s and/or the EMS personnel’s perspective. Little is known about how patients perceive safety in EMS. This study aims to describe the patients’ experiences of their sense of safety in EMS.MethodsA qualitative design with individual interviews of EMS patients (n=21) and an inductive qualitative content analysis were used.ResultsPatients’ experiences of EMS personnel’s ability or inability to show or use their medical, technical and driving skills affected the patients’ sense of safety. When they perceived a lack of professionalism and knowledge among EMS personnel, they felt unsafe. Patients highlighted equality in the encounter, the quality of the information given by EMS personnel and the opportunity to participate in their care as important factors creating a sense of safety during the EMS encounter. Altogether, patients’ perceptions of safety in EMS were connected to their confidence in the EMS personnel.ConclusionsOverall, patients felt safe during their EMS encounter, but the EMS personnel’s professional competence alone is not enough for them to feel safe. Lack of communication or professionalism may compromise their sense of safety. Further work is needed to explore how patients’ perceptions of safety can be used in improving safety in EMS.