Principle C
Nurses and nursing staff manage risk, are vigilant about risk, and help to keep everyone safe in the places they receive health care.
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Principle C focuses on the safety of all people (patients, visitors and staff), the environment, organisational health and safety, management of risk, and clinical safety.
You may find the following commentary article about Principle C a useful starting point for exploring this Principle. It is published by the Nursing Standard as part of an introductory series on the Principles of Nursing Practice:
Currie L et al (2011) Safety: Principle of Nursing Practice C. Nursing Standard 25(30) 30 March pp.35-37 (PDF 565KB) [see how to access PDF files].
Other useful resources are:
- examples of how the Principles are being used
- example measures that can be used to give feedback against each Principle.
A selection of RCN resources which are particularly relevant to Principle C
The following resources and services produced by the RCN provide guidance and support to people wishing to use the Principles for quality improvement purposes or their own continuing professional development.
To access any Learning Zone content you will be asked to enter your RCN membership number. If you require assistance with entering the Learning Zone, or would like further information on becoming a member of the RCN please contact RCN Direct on 0345 772 6100.
Some of the resources referred to below are in PDF format – see how to access PDF files.
Guidance on safe nurse staffing levels in the UK (2010) (PDF 1.7MB): a publication which sets out the different factors that influence the total demand for nursing staff across the four UK countries. Safety issues are discussed throughout the guidance but there is also a specific section on patient safety which looks at evidence around the impact of staffing on patient outcomes and safety of care. Appendices set out some recommended staffing minimums in the UK and describe different staff planning tools, their key features, advantages and disadvantages.
Infection prevention and control: an online resource which brings together the latest news and guidance on infection prevention as well as resources that will help you prevent and control infection.
Making IT SAFER (PDF 195.5KB) (2010): a publication in the eHealth and nursing practice series which uses the mnemonic SAFER to highlight safety and risk management issues which need to be considered when using computer systems in caring for patients and clients.
NICE care: Venous thromboembolism prophylaxis (VTE): a Learning Zone area which has been developed to support healthcare practitioners to implement the NICE guideline 'Venous thromboembolism: reducing the risk'. It focuses primarily on understanding and preventing VTE, identifying patients at risk and includes an in depth look at VTE risk assessments. This learning area is also available as part of the patient safety online resource.
Numeracy skills: a Learning Zone area which provides exercises, techniques and clinical examples to help nurses develop their numeracy skills.
Nursing Standard:
The following series of five articles which look at the relationship between patient safety and human factors can be accessed in full text through the RCN e-library via E-journals.
- Currie L (2012) Introduction to patient safety series. Nursing Standard 26(32) 11-17 April p.35
Introduces the series. - Norris B, Currie L and Lecko C (2012) The importance of applying human factors to nursing practice. Nursing Standard 26(32) 11-17 Apr pp.36-40.
Discusses the importance of human factors in nursing and how the principles of human factors can be applied. - Norris B (2012) The diversity of human factors: illustrating the relevance for nursing. Nursing Standard 26(33) 18-24 April pp.35-40.
Looks at a selection of human factors tools and activities that may be used in nursing practice to improve the safety of patient care including the Human Walk-Around tool and the Foresight training. - Beaumont K and Russell J (2012) Standardising for reliability: the contribution of tools and checklists. Nursing Standard 26(34) 25 Apr-1 May pp.35-39.
Describes two initiatives from the National Patient Safety Agency (NPSA) - Recognising and responding appropriately to early signs of deterioration in hospitalised patients and How to Guide: Five steps to safer surgery which incorporate tools influenced by a human factors approach and which can help to increase reliability and improve outcomes. - Reid J and Bromiley M (2012) Clinical human factors: the need to speak up to improve patient safety. Nursing Standard 26(35) 2-8 May pp.35-40
Uses a case study about poor management of an emergency situation during an operation to demonstrate the role that human factors can have in health care and its importance in interprofessional training. It emphasises the importance of being able to speak up if the safety of a patient is threatened. - Scrivener R and Brown R (2012) Human factors and online learning. Nursing Standard 26(36) 9-15 May pp.35-37.
Describes how human factors informed the development of an online patient safety course by the Royal College of Nursing and the use of action mapping in designing the course.
Nutrition and hydration: an online resource which builds on the learning and activities from the RCN Nutrition Now Campaign and related initiatives across the UK, using the RCN Principles of Nursing Practice to illustrate the nursing contribution to good nutrition and hydration. It highlights what is known about the strategies required to improve nutritional care and signposts policy, guidance and tools across all four UK countries that support improvements in nutritional care. Examples and case studies demonstrate what can be achieved.
Older people: this resource brings together a range of resources that can inform and support care for older people. This includes information and publications from work that the RCN has been carrying out on older people's care such as the guidance on safe staffing levels for older people’s wards. There is a best practice gallery highlighting examples of good practice in older people’s care and demonstrating the RCN Principles of Nursing Practice, and policy and guidance from across the UK are also signposted.
Patient safety and human factors: an online resource which introduces you to a broad range of activities relating to patient safety and human factors. The resource signposts further resources and support available from the RCN, and provides an overview of the active patient agenda being pursued across the United Kingdom. This includes a section on preventing venous thromboembolism.
Patient safety: a Learning Zone area which will help you to understand the scale and gravity of patient safety incidents in health care settings.
Perioperative fasting: an online resource based on the NICE guideline on perioperative fasting in adults and children. The resource presents the guideline recommendations and key principles and related resources to support implementation of safe and appropriate care in preoperative fasting.
Preventing health care associated infections: this Learning Zone area offers a quick and practical way to build your awareness and knowledge of issues around HCAIs and how to reduce the risks into an action plan.
Safeguarding: this resource aims to help RCN members locate information that is practical, useful, relevant and adaptable in different settings. Resources are arranged under the headings: adult; children and young people; vulnerable people; safeguarding professionals.
Supporting people’s nutritional needs – getting started: this Learning Zone area has been primarily developed for health care assistants (HCAs) but is also a useful learning opportunity for student and registered nurses for updating their own practice. The focus is on general nutritional needs. RCN members will be able to access the additional links in the 'Useful resources' section within these topics via the RCN e-library system using their membership number login.
Whistleblowing hotline: this is an additional service for RCN members who have concerns over clinical and staff safety in the workplace. Registered nurses have a duty under the NMC to report concerns where patient care may be affected. It is important that nurses raise concerns directly with their employer.
For further RCN publications see Publications.
RCN e-library: provides a range of resources that RCN members can access for further information. These include full text journals, databases, e-books and Fast searches which are up-to-date searches on frequently asked selected topics.

