Knowing nursing error: Understanding nursing error through nurses' error experiences.

摘要

Although it is recognized that significant under-reporting of nursing error exists, little is known about how nurses learn to recognize and manage nursing error in the clinical setting. Knowledge of this process is a necessary prerequisite to understanding and reducing nursing error, as well as increasing the reporting of error.;Grounded theory methodology in the tradition of Strauss and Corbin (1998) was selected for inquiry into the process through which nurses learn to recognize and manage nursing error over the course of their careers. The sample consisted of 24 nurses from the RN to BSN, MSN, and Ph.D. programs at the University of South Florida and the continuing education programs at Florida Risk Management Institute, Inc. The data was generated through in-depth, confidential interviews with the participant nurses about their error experiences. Triangulation was accomplished through observation of 24 Florida Board of Nursing disciplinary hearings based on the premise that volunteer nurses' and compelled nurses' error stories may be different. Results were validated through review with three participants in the study and one participant from the pilot study.;The resultant grounded theory model is composed of the core process of Evolving Error Expertise and four component processes, Classification of Nursing Error, Recognition of Nursing Error, Causal Analysis of Nursing Error, and Governance of Nursing Error. It is one representation of the basic social process through which nurses may learn to recognize and manage the basic social problem of nursing error.;Knowledge of this process may be utilized for the development of interventions targeted at enhancement of the skills that nurses and nurse managers use to identify and manage errors and error producing situations. The postulated outcome of such targeted interventions will be the reduction of harmful outcomes for both patients and nurses, improved quality of care, and improved performance of nurses. In addition, knowledge of this process may help explain under-reporting of nursing errors.