Near Misses in Health Care: Nurses Perceptions and Experiences Associated with Omissions, Commissions, Scheduling Misperceptions and Complications with Adherence through the Investigation of Power Distance and Recovery

Monday, 9 November 2015

Luanne Ruth Linnard-Palmer, BSN, MSN, EdD
School of Health and Natural Sciences, Dominican University of California, San Rafael, CA, USA

Medication errors continue to be a major problem (IOM, 1996). Research investigating what factors contribute to medication errors continues in an attempt to reduce the incidence and save lives. A near miss is an incident that could potentially cause harm, but didn’t. Little is known about near misses and research is needed. Nurses’ perceptions, what led up to the incident, and how they went about correcting these incidents (recovery) provide great insights to understanding what near misses are. In nursing, one variable that relates to errors and near misses is the concept of power distance (Hofstede, 1980) and how it affects communication between nurses, colleagues and families.  Power distance is based on the premise that inequality exist between individuals and this perception of power may contribute to errors, near misses, poor adherence and poor compliance with medications. Poor communication is directly linked to medication errors and near misses (Henneman, 2010).

Objectives: The aim of the study was to understand nurse’s perception of errors, recovery processes, the concept of power distance and poor communication that have led to the near-miss incidents.


A survey was either taken online, or filled out by a total of 87 registered nurses and students.


Analysis of the descriptive data is in progress and the results will be shared at the conference via the presentation.


Nurses’ experiences with near misses, recovery and power distance contribute to defining what a near miss is, recovery, prevention and ultimately improve communication and patient’s safety.