Just Culture and Nursing Regulation: Learning to Improve Patient Safety

Effective public protection depends on learning from mistakes. Disciplining nurses in response to human error does not improve public safety, though nurses who make reckless choices must be held accountable. To achieve a balance between learning from mistakes and using disciplinary action effectively, the North Carolina Board of Nursing (BON) developed a Just Culture assessment instrument called the Complaint Evaluation Tool (CET) and tested it in pilot projects. The CET was designed to guide employers in using Just Culture principles when reviewing practice errors and to clarify the criteria for reporting nurses to the BON. This article describes the results of the pilot projects and demonstrates the use of the CET using clinical scenarios.