Patient safety forms the founda-tion of healthcare delivery justas biological, physiological,and safety needs form the foundation of Maslow’s hierarchy (Maslow, 1954). Little else can be accomplished if the patient does not feel safe or is, in fact, not safe. But the healthcare system is extremely com- plex, and ensuring patient safety requires the ongoing, focused efforts of every member of the healthcare team.

Patient safety forms the founda-tion of healthcare delivery justas biological, physiological,and safety needs form the foundation of Maslow’s hierarchy (Maslow, 1954). Little else can be accomplished if the patient does not feel safe or is, in fact, not safe. But the healthcare system is extremely com- plex, and ensuring patient safety requires the ongoing, focused efforts of every member of the healthcare team.

Patient safety moved to the fore- front in health care with the release in 1999 of the Institute of Medicine (IOM) landmark report, To Err is Human: Building a Safer Health System, which estimated that annually in the United States, up to one million people were injured and 98,000 died as a result of medical errors (IOM, 2000). The re – port caught the attention of the media, and there were headlines across the nation about the safety (or lack of safe- ty) for patients in healthcare organiza- tions. In 2013, James updated the esti- mate of patient harms associated with

Beth Ulrich Tamara Kear

Continuing Nursing Education

Beth Ulrich, EdD, RN, FACHE, FAAN, is Editor, the Nephrology Nursing Journal, and a Professor, the University of Texas Health Science Center at Houston School of Nursing. She is a Past President of ANNA and a member of ANNA’s Sand Dollar Chapter. She may be contacted direct- ly via email at BethUlrich@aol.com

Tamara Kear, PhD, RN, CNS, CNN, is an Assistant Professor of Nursing, Villanova University, Villanova, PA, and a Nephrology Nurse, Liberty Dialysis. She is on the Editorial Board for the Nephrology Nursing Journal, serves as the ANNA Research Committee chairper- son, and is a member of ANNA’s Keystone Chapter.

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This CNE article meets the Nephrology Nursing Certification Commission’s (NNCC’s) continu- ing nursing education requirements for certification and recertification.

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Ulrich, B., & Kear, T. (2014). Patient safety and patient safety culture: Foundations of ex – cellent health care delivery. Nephrology Nursing Journal, 41(5), 447-456, 505.

In 1999, patient safety moved to the forefront of health care based upon astonishing sta- tistics and a landmark report released by the Institute of Medicine (IOM). This report, To Err is Human: Building a Safer Health System, caught the attention of the media, and there were headlines across the nation about the safety (or lack of safety) for patients in healthcare organizations. In the ensuing years, there have been many efforts to reduce medical errors. Clinicians reviewed their practices, researchers looked for better ways of doing things, and safety and quality organizations focused attention on the topic of patient safety. Initiatives and guidelines were established to define, measure, and improve patient safety practices and culture. Nurses remain central to providing an envi- ronment and culture of safety, and as a result, nurses are emerging as safety leaders in the healthcare setting. This article discusses the history of the patient safety movement in the United States and describes the concepts of patient safety and patient safety culture as the foundations for excellent health care delivery.

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