Learning from errors in nursing practice

Abstract

Little attention is paid to the issue of errors in nursing practice. Staff are reluctant to discuss or publicize them. However, as clinical audit and quality management become more important and established in the health service, there is now a greater need to investigate and monitor the incidence of errors. The purpose of this study was to examine the causes and consequences of errors as well as the potential for errors to initiate changes in practice. One hundred and twenty-nine nurses answered a 22-item questionnaire relating to an error they had made. Nurses reported that the most common causes of errors were lack of knowledge or information, work overload, stressful atmosphere and lack of support from senior staff. Nurses were found to have recourse to a number of coping strategies in the aftermath of the error. Accepting responsibility and planful problem-solving were found to lead to positive changes in practice, whereas distancing and self-controlling strategies were associated with defensive changes, particularly with a tendency not to divulge the error. The findings also showed that errors had the potential to effect learning. The study suggests the need for staff to be encouraged to accept responsibility for their error within the framework of support. Strategies should be developed so that errors can be managed in a more constructive manner.

Supporting involved health care professionals (second victims) following an adverse health event: A literature review

“…Family members, friends and colleagues seem to provide more support than managers and physicians (Wolf et al, 2000). Most of the nurses felt they need to be supported and do this by discussing their errors with colleagues and nurses in the ward (Meurier et al, 1997).…”

“…Support can be given by asking about the emotional impact of the adverse event and how the colleague is coping (Meurier et al, 1997;Wu, 2000). Scott et al (2008) described key phrases that managers can use to stimulate a critical conversation with second victims and suggested some key actions for interacting with the second victim.…”

Patient safety and job-related stress: A focus group study

“…A stressful atmosphere is identified to be the strongest factor when errors are made, fol-lowed by insensitivity of the senior staff (Meurier et al, 1997). The participants emphasised the importance of support from experienced nurses and their willingness to give inexperienced nurses enough time to do their job thoroughly and safely.…”

“…In addition, the work tempo is very high and the likelihood of errors concerning procedures and medication is always present. According to Meurier et al (1997) the most important reasons for mistakes in the ER are lack of knowledge and experience followed by work pressure under a stressful environment. A stressful milieu in addition to enormous work pressures can also result in decreased patient safety (Carayon and Gurses, 2005).…”

Doctors’ experiences of adverse events in secondary care: the professional and personal impact

“…UK studies published to date are small-scale, conducted at either one or two NHS Trusts, and/or have not included a sample of doctors. [35][36][37][38] This survey of physicians Box 1. Definition of an adverse event and a near miss.…”