Patient safety - Are we speaking the same language?

Background: Since the radical years following the To Err is Human report, patient safety research has become settled on standardisation and audit cultures. Recent work suggests a change in direction. Current efforts exploring the intricate relationship between stability and change within organisations establish a more balanced patient safety perspective. Frontline staff insights are key to this new knowledge. Aim: This study aims to explore the patient safety perceptions of registered nurses working directly with patients in acute care settings. Method: Facilitated reflexive workshops were conducted with nine wards from October to November 2022. Data analysis explored creative works and reflective notes of group discussions with frontline registered nurses using a critical lens. Findings: We offer four analytical interpretations of how frontline registered nurses understand and experience patient safety. These are as follows: buzzwords, keep ME safe, listen to US, and this is MY role. These manifest the business of patient safety where nurses are, under siege, the silenced team member and experience tension between accountability and responsibility. Discussion: Critical questioning and reappraisal of patient safety practices require the vast knowledge of frontline staff to be fully utilised. Conclusion: This research reveals much of what is avoided in patient safety literature - the tension between what registered nurses understand, experience, and can deliver in patient safety practice. It challenges organisational leaders to enable and support frontline nurses in driving local change. Crown Copyright (c) 2024 Published by Elsevier Ltd on behalf of Australian College of Nursing Ltd.