Nursing Errors in Intensive Care Unit by Human Error Identification in Systems Tool: A Case Study

Recommendations to prevent nursing errors: Content analysis of semi-structured interviews with intensive care unit nurses in a developing country

AIM

To elicit intensive care unit (ICU) nurses' recommendations to prevent nursing errors.

BACKGROUND

Errors are usually induced by faulty systems, and managers play a key role in building a safe health care system.

METHOD

A qualitative research design was used. Semi-structured interviews with 112 Egyptian ICU nurses were conducted, and responses were analysed using qualitative content analysis.

RESULTS

Responses from 108 nurses were analysed. Six themes of recommendations were identified: improvement and better organisation of resources, policy modification, education and training, likeness minimization, use of technology and work environment changes.

CONCLUSION

Nurses' recommendations reflect the poor-resource context in developing countries. Several recommendations, however, are relatively cheap to implement strategies.

IMPLICATIONS FOR NURSING MANAGEMENT

All reported recommendations are organisational issues. Improvement and better organisation of human and non-human resources is a priority issue to prevent or minimize nursing errors. Policy modification, education and training, and likeness minimization are relatively cheap, easy-to-implement strategies to tackle the occurrence of nursing errors in developing countries. Staff nurses should be actively involved in policy reform. Patient safety education should be supported by adopting modern technology and work environment reform.

The effect of nurse empowerment educational program on patient safety culture: a randomized controlled trial

BACKGROUND

The complexity of patients' condition and treatment processes in intensive care units (ICUs) predisposes patients to more hazardous events. Effective patient safety culture is related to lowering the rate of patients' complications and fewer adverse events. The present study aimed to determine the effect of empowering nurses and supervisors through an educational program on patient safety culture in adult ICUs.

METHODS

A randomized controlled trial was conducted during April-September 2015 in 6 adult ICUs at Namazi Hospital, Shiraz, Iran. A total of 60 nurses and 20 supervisors were selected through proportional stratified sampling and census, respectively, and randomly assigned to the experimental and control groups. The intervention consisted of a two-day workshop, hanging posters, and distributing pamphlets that covered topics such as patient safety, patient safety culture, speak up about safety issues, and the skills of Team Strategies and Tools to Enhance Performance and Patient Safety. Data were collected through a hospital survey on patient safety culture. Eventually, 61 participants completed the study. Data were analyzed using descriptive statistics, independent-samples t-test, paired-samples t-test, and Chi-square test. P < 0.05 was considered statistically significant.

RESULTS

In the experimental group, the total post-test mean scores of the patient safety culture (3.46 ± 0.26) was significantly higher than that of the control group (2.84 ± 0.37, P < 0.001). It was also higher than that of the pre-test (2.91 ± 0.4, P < 0.001). Additionally, significant improvements were observed in 5 out of 12 dimensions in the experimental group. However, dimensions such as non-punitive response to errors and the events reported did not improve significantly.

CONCLUSION

Empowering nurses and supervisors could improve the overall patient safety culture. Nonetheless, additional actions are required to improve areas such as reporting the events and non-punitive response to errors.

TRIAL REGISTRATION

IRCT2015053122494N1 . Date registered: March 2, 2016.