Paper
Wednesday, July 11, 2007
Exploring Factors that Influence Operating Room Nurses' Error Reporting Preferences
Sherry Espin, PhD, RN, School of Nursing Faculty of Community Services, Ryerson University, Toronto, ON, Canada
As concern over the number of health care errors has risen,
so has interest in the development of reporting mechanisms. However, the
success of these reporting systems rests with individuals using them, and
research has raised doubts about healthcare providers' willingness to report. Further,
this research has focused on error reporting in the context of individual
practice. As a consequence, we do not
know whether these reporting tendencies and attitudes apply in team settings
where responsibility for an error may reside with another discipline or may be
diffused across the team. As many inpatient errors occur in team settings, it
is important to understand how professionals collaborating on interdisciplinary
teams perceive and respond to error reporting in their everyday practice. In a
previous study, we began the process of characterizing nurses' error reporting
preferences using scenarios from the OR team setting. Results demonstrated nurses' dominant rationale
for selective reporting was the perceived boundaries set by their scope of
practice. When nurses did report an error outside their domain of
practice they justified their reporting in terms of the patient's negative
outcome. However, the scenarios used in that study were not specifically
designed to evoke or explicate these two sets of rationales. Thus, the
purpose of this study was to explore the role of scope
of practice and seriousness of outcome in OR nurses' error reporting
preferences. In a grounded theory approach thirteen nurses were
interviewed after reviewing four “error” scenarios ranging in both scope of
practice and seriousness of outcome. Qualitative analysis revealed that
perceived scope of practice was an important influence on reporting preferences
but that seriousness of outcome was at best a secondary consideration. Nurses' selective reporting and their
reasons for this selectiveness have negative implications for safety, since
many errors will likely go unreported.