Objective: The results of a study that explores the phenomenon of near misses in selected patient care settings to delineate staff perceptions and processes of care associated with their occurrence will be presented.
Design: qualitative analysis, exploratory study
Population/Sample: The following three cohorts will be convened. Cohort 1- discipline specific groups of nurses (staff nurses, clinical leaders, resource nurses and nursing unit director on the clinical units) physicians (attending on the clinical units) and pharmacists (staff pharmacists on the clinical units; Cohort 2 -mixed health professionals; and Cohort 3- patient/family groups.
Concepts/Variables: Currently, there is lack of consensus about what near miss indicators to measure or how to measure them; lack of conceptual underpinnings for a working definition of near miss to guide research and clinical practice, and data regarding the meaning and context of near misses as a health care phenomenon have yet to be documented.
Methods: In this study, focus group data will be used to describe the nature and scope of near misses from a consumer and health care team perspective. Perceptions among nurses, other health care providers and patients/families regarding what constitutes near miss events, safe processes, risks, indicators for measurement, and desired patient outcomes will be elicited. Content analysis involving transcription, coding, categories, and thematic analysis (developed by D. Affonso, 1R18NR02678-01, NINR/National Institutes of Health, 1990-1996) will be implemented.
Findings: Findings from the focus group data will be presented.
Conclusions/Implications: Structuring health services to be more accountable and innovative in the health care system by designing practice environments as more open venues for new ideas and models of patient care builds safer patient care practices. This exploratory study is designed to provide foundational knowledge that will stimulate further research studies investigating near misses in health care.
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