Practising Safe Care in Critical Care: A Reflexive Thematic Analysis

Abstract

AimTo explore the meaning of ‘safety’ as it applies to critical care nurses during daily care practice in the intensive care setting.DesignA qualitative study design was employed.MethodsThe study enlisted 18 critical care nurses and nurse leaders from three hospitals in Sweden. Interview data were collected in 2017 and in 2024. The data were examined using reflexive thematic content analysis.ResultsThe meaning of safety within critical care settings was illustrated by the themes ‘Sustaining a safety mindset’, ‘Fostering commitment to patient safety’, ‘Showing individual accountability and continuous learning’ and ‘Managing complexity while prioritising safety standards’. Safe care practice in daily practice also involved adaptability and resilience in response to changing circumstances or unexpected events, ensuring thoroughness and allowing for a return to regular routines when conditions permitted, thereby preventing incomplete care. Core competencies in safety encompassed both technical and non‐technical skills, such as the ability to assess and use technology, remain vigilant and thorough, plan ahead, prioritise and identify, and follow through on nursing interventions, all while working in a team and allocating sufficient time for patients.ConclusionSustaining a safe mindset over time is both challenging and essential. Further research should focus on how to foster a sustained safety mindset. A more proactive approach to learning may be achieved by reflecting on and discussing things that have worked well even in challenging circumstances.Implications for the Profession and/or Patient CareThis study enriches our understanding of practising safe care in intensive care. It furnishes the nursing profession with a deeper theoretical grasp of proactive safety efforts, encompassing various factors that can mitigate risks in a technologically advanced environment.