Paper
Wednesday, July 11, 2007
This presentation is part of : Qualitative Inquiry and Patient Safety: Developing a Deeper Understanding of What We Say, What We Do and Why it Matters
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.