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Can civility in nursing work environments improve medication safety?

In recent years, healthcare organizational leaders have become aware of the importance of promoting a culture of patient safety. Organizations deemed safe have systems to identify high-risk, errorprone situations, supportive atmospheres that discourage blame and encourage civility, and collaboration among all healthcare providers to seek appropriate solutions to hazardous situations. Many organizations have invested in technologies such as computerized physician ordering and automated medication dispensing systems in an effort to prevent medication errors. Although thought to be effective, their safe use relies on the willingness of all healthcare professionals to stringently ensure that patients receive their medications correctly. Because these types of technologies are often cost prohibitive to purchase, implement, and monitor, the traditional method of nurse-initiated incident reports often remains a major source of identifying and reporting medication errors in many hospitals. However, empirical evidence indicates that nurses are fearful to report medication errors because of the responses exhibited by their managers, colleagues, and physicians.