Background: 210,000 to 440,000 deaths have been caused by errors in healthcare. Providers who are committed to core values that emphasize safety contribute to a “culture of safety.’ This culture is required for healthcare institutions to achieve high-reliability status demonstrating high potential for error but few adverse outcomes. There is little known about contributors to the culture of safety and the commitment of providers to its core values.

Purpose: To determine relationships among the predictors- EBP culture, individual evidence-based decision making, organizational implementation of evidence-based practice - and a culture of safety.

Design: Correlational Predictive Design.

Sample: Two-hundred seventeen nurses from nine acute care institutions across East Texas participated in the study.

Analysis: Path analysis was used to evaluate the relationships among predictor variables and a culture of safety.

Results: Individual evidence-based practice implementation and beliefs were correlated (r = .38, p < .001). Evidence-based practice implementation and beliefs had direct effects on EBP culture (β = .25, p < .001; β = .24, p < .001, respectively). EBP culture had a direct effect on culture of safety (β = 0.38, p < .001). Evidence-based practice implementation and beliefs accounted for 16% of the variance in EBP culture, and evidence-based practice implementation and beliefs, along with EBP culture, accounted for 15% of the variance in culture of safety.

Conclusion: Nursing administrators allocating resources to build a culture of safety can now include enhancing evidence-based implementation and beliefs of nursing staff as well as an EBP culture that supports evidence-based practice.

Date of publication

Spring 5-1-2019

Document Type




Persistent identifier


Committee members

Ellen Fineout-Overholt, Danita Alfred, Zhaomin He


PhD - Nursing

Included in

Nursing Commons