Answer to Question 1
Answer: A, B, E
Just culture is based on the understanding that errors are often the result of system failures rather than human failures. It recognizes that an atmosphere of punishment impedes error prevention by promoting intimidation and secrecy rather than shared accountability. Just culture focuses on the system rather than the individual while still maintaining an environment of individual accountability for both front-line staff and leaders and managers. Successfully establishing an environment of just culture requires that leadership encourage proactive system management as well as individual accountability. Just culture does not accept or tolerate conscious disregard of client and staff safety. Each member has the responsibility to take action to prevent errors and also to respond to errors, recognizing that errors are more often the result of system failures than individual error, and that when individual error does occur, it is more likely to be accidental than willful or neglectful. As more organizations begin to embrace just culture, front-line staff is likely to feel more support from management in critical areas, including staffing. However, nurses and other front-line staff may find themselves in situation where management is unresponsive to suggestions for improvement or reporting of critical shortages or potential for errors related to client safety. In these cases, staff may find themselves in the awkward position of needing to report these problems outside the agency.
Answer to Question 2
Answer: A
The nursing supervisor cannot assume that the nurse sustained the injuries in an accident, nor can the nursing supervisor assume abuse. However, older adults are subjected to abuse, and the charge nurse would want to ask about the injuries. The authorities should not be notified until some proof of abuse is noted. Security is not the appropriate department to notify unless the injuries were sustained at work. Nurses are bound to report abuse, so the nursing supervisor would at least question the older nurse regarding the injuries.