Establishing Patient Safety in Intensive Care— A Grounded Theory

Abstract

Background: The modern intensive care unit (ICU) is a complex and high-risk environment, and even small adverse events and changes may deteriorate the patient's conditions and eventually cause harm. Many factors can potentially be associated within an increased amount of errors, leading to adverse events. Nurses, nurse managers, and other leaders all play important roles in establishing patient safety. Aim: This study aimed to obtain a deeper understanding of leaders' and nurses' main concerns in establishing patient safety in Swedish intensive care units. Method: A grounded theory methodology was used. Data from 15 interviews with leaders and nurses involved in critical care in Sweden were collected, analysed and constant compared. Findings: The main concern in establishing patient safety was promoting quality of care, work engagement, and staffs well-being in strained ICUs. The core category building trust explained how the leaders' and nurses' strove for quality of care and wished a healthy, safe work environment. This is further explained in the categories "Being an accessible and able leader", "Creating knowledge and understanding", and "Establishing collaborative practice". Conclusion: Establishing patient safety in the ICU requires that staffs enjoy going to work, have good work relations, are committed and want to stay at the unit. A healthy, salutogenetic unit with a work environment marked by trust provides a better opportunity to establish patient safety, and various leaders have potential to achieve this.

“Attempting to protect self and patient”: A grounded theory study of error recovery by intensive care nurses

“…We also found inter‐professional interactions as a contextual factor affecting the ER process. This is in line with the findings of a former study which reported that trust and respect among healthcare providers enhance their satisfaction, improve their sense of responsibility towards patients, promote their involvement in care delivery, and thereby, improve patient safety and care quality (Häggström et al, 2017 ). Inter‐professional collaboration and interactions not only improve staff's satisfaction and reduce their stress but also promote their adherence to patient safety standards (Vaismoradi et al, 2020 ).…”