Worries and concerns experienced by nurse specialists during inter-hospital transports of critically ill patients: A critical incident study

Gustafsson, Marcus; Wennerholm, Sara; Fridlund, Bengt

doi:10.1016/j.iccn.2010.01.002

Cited by 22 publications

(30 citation statements)

References 20 publications

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“…Whereas communication between physicians and patients is recognized as an important source of misunderstanding and consequently of potential treatment errors [14-16] our data suggest that insufficient communication between health care professionals and between medical departments is not only a strain for the health care professionals [17,18] but also needs to be recognized as important source of critical incidents in medicine [19-22]. In addition, insufficient communication seems to be a concern for both, physicians and nursing staff.…”

Section: Discussionmentioning

confidence: 99%

Critical incidents in a tertiary care clinic for internal medicine

Scharein

Trendelenburg

2013

BMC Res Notes

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BackgroundReducing medical errors has become an international concern. Population-based studies consistently demonstrate inacceptable high rates of medical injury and preventable deaths. Thus, electronic critical incident reporting systems are now increasingly used in hospitals, predominantly in anesthesia. However, studies systematically analyzing critical incidents are scarce. Our aim was to describe content and causes of critical incidents in our Clinic for Internal Medicine.ResultsWe retrospectively analyzed all critical incidents reported during a 54-months period. Between implementation and analysis, 456 incidents were reported anonymously in the commercially available platform-independent, web-based critical incident reporting system. All incidents were analyzed according to the reporting profession, time point during hospitalization process, content and potential causes.Most incidents occurred on medical wards (80%). The most frequent type of incidents was medication errors (62%). These incidents primarily occurred when prescribing and/or administering drugs (30% and 29% of medication errors respectively). So-called, human errors’, i.e. occurring without apparent external factor, were the most frequently indicated cause of critical incidents (56%) followed by insufficient communication (26%). These problems primarily occurred between different groups of health care professionals and between different departments. The described types and reasons of critical incidents remained stable during the observation period.ConclusionsThe findings of our analysis of the character and type of critical incidents occurring in a tertiary care clinic for internal medicine reported in an anonymous, voluntary, electronic reporting system suggest that strategies to improve communication and medication delivery are most promising to avoid critical incidents.

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Section: Discussionmentioning

confidence: 99%

Critical incidents in a tertiary care clinic for internal medicine

Scharein

Trendelenburg

2013

BMC Res Notes

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“…This means that the researcher, inductively and based on the purpose, searches for behaviors and from there establishes meaning-bearing units that -on a descriptive level -lead to subcategories, categories and main areas. Then, a few years into the 2000s, studies in nursing developed the analysis work to separate what the participants experienced (descriptions) and what steps they subsequently took (actions) [16][17][18]. This entailed two different data analyses with associated result descriptions even if the analyses were dependent on one another and was carried out at the same time [4].…”

Section: Discussionmentioning

confidence: 99%

Critical Incident Technique applied in nursing and healthcare sciences

Fridlund¹

2017

2471-6529

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the development and current status of the CIT, with focus on its fundamental definitions, guidelines, and pros and cons when applied in nursing and healthcare sciences. BackgroundLike all qualitative methods, CIT has an established history, which in this case goes back to World War II. The psychologist John Flanagan was the head of the military aviation psychology programmer and studied pilot behavior in connection with critical incidents that arose in aviation missions during training or battle against the enemy. An unacceptably large number of pilots failed in their missions, which is why his interest was partly directed at studying the pilots' experiences of critical incidents (descriptions) and partly at observing what steps they took to handle them (actions). Flanagan analyzed the critical incident after success or failure by "working backwards" -retrospectively, which means studying what has already happened afterwards -to thereby identify the specific behavior that led to a positive or negative result (outcome or consequence). In terms of data collection, it is a matter of supporting or getting the participant to remember and describe real incidents, and not how things could have been or turned out. In other words, it is about the participant's "real" and experienced world. There are accordingly two focuses behind CIT: the researcher intends to identify the participant's capacity based on his/her actions in the critical incident and to determine whether the consequence of the actions constitute a significantpositive or negative -contribution [8,9]. MethodA theoretical reasoning based on the original literature and with the support of updated literature relevant to the CIT was used in order to describe, explain, compare, reflect and implicate the development of CIT. Concepts and terminology developmentFlanagan established the concept of CIT, but over the years, several other terms have been used both in and outside of nursing, such as "Critical Incident Analysis", "Critical Incident Reflection", "Critical Incident Exercise" and "Significant Event Technique" [3,10,11]. There are probably many reasons why the terminology has changed over the years, but one crucial reason AbstractPurpose: The aim of this study was to elucidate the development and current status of the critical incident technique (CIT), with focus on its fundamental definitions, guidelines, and pros and cons when applied in nursing and healthcare sciences. Method:A theoretical reasoning based on the original literature and with the support of updated literature relevant to the CIT was used. Results:A critical incident is a retrospective story generating an activity, a behaviour which, due to its retrospective perspective, can only be deemed critical in hindsight. The incident is critical if there is a major human activity which is sufficient to allow conclusions and predictions. The story has a clear beginning and a clear end, and its impact needs to be clear with a significant outcome, either positively or negatively. The CIT-procedure, still...

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“…There is a significant lack of research focusing on the patient's situation when being transferred between ICUs. This argument is supported by Barratt et al (2012) and Gustafsson, Wennerholm, and Fridlund (2010), who ask for a broader and deeper understanding of the area, calling for further research addressing the patient's perspective. Focusing on the patient's situation, the current study addresses this gap, helping promote a caring atmosphere during transfers.…”

Section: Internal and External Transfermentioning

confidence: 99%

The Patient’s Situation During Interhospital Intensive Care Unit-to-Unit Transfers: A Hermeneutical Observational Study

et al. 2019

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Interhospital intensive care unit-to-unit transfers are an increasing phenomenon, earlier mainly studied from a patient safety perspective. Using data from video recordings and participant observations, the aim was to explore and interpret the observed nature of the patient’s situation during interhospital intensive care unit-to-unit transfers. Data collection from eight transfers resulted in over 7 hours of video material and field notes. Using a hermeneutical approach, three themes emerged: being visible and invisible; being in a constantly changing space; and being a fettered body in constant motion. The patient’s situation can be viewed as an involuntary journey, one where the patient exists in a constantly changing space drifting in and out of the health personnel’s attention and where movements from the journey become part of the patient’s body. Interhospital transfers of vulnerable patients emerge as a complex task, challenging the health personnel’s ability to maintain a caring atmosphere around these patients.

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Worries and concerns experienced by nurse specialists during inter-hospital transports of critically ill patients: A critical incident study

Cited by 22 publications

References 20 publications

Critical incidents in a tertiary care clinic for internal medicine

Critical incidents in a tertiary care clinic for internal medicine

Critical Incident Technique applied in nursing and healthcare sciences

The Patient’s Situation During Interhospital Intensive Care Unit-to-Unit Transfers: A Hermeneutical Observational Study

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