Normalization of Deviance: Concept Analysis

ANS Adv Nurs Sci. 2021 Apr-Jun;44(2):171-180. doi: 10.1097/ANS.0000000000000356.


Normalization of deviance is a phenomenon demonstrated by the gradual reduction of safety standards to a new normal after a period of absence from negative outcomes, which suggests that the absence of negative outcomes tends to reinforce the behaviors associated with cutting corners, bypassing safety checklists, and ignoring alarms. While the concept was first identified within the National Aeronautics and Space Administration, it has a strong, dangerous presence within health care, holding specific peril within high-risk environments such as the operating room. The aims of this article are to (1) analyze the concept of normalization of deviance and (2) identify the role of normalization of deviance with respect to the behavior of nurses in high-risk health care environments to prevent adverse patient outcomes. The steps outlined by Walker and Avant are applied to guide the concept analysis.