An Assessment of Errors and Near-Misses From Prelicensure Nursing Students

Background: Approximately one-half of new nurses with less than one year of experience who were involved in adverse patient events identified that their formal education preparation was a causal factor in their error (Saintsing, Gibson & Pennington, 2011). An examination of quality and safety measures of a current hospital based associate degree nursing (ADN) educational program provided data regarding errors committed by prelicensure students. Tracking and analysis of frequency and type of student clinical errors provided for identification of similarities and an opportunity for system evaluation and improvements.

Objectives: To identify the number, types and categories of Student Opportunity for Improvement (SOFI) reports generated by a hospital based ADN program over a four-year period from July 30^th 2012 through July 30^th 2016 and to compare the reports by academic term, the student’s previous healthcare experience, and student age.

Methods: A twenty-four month retrospective comparative design was utilized, in a private, non-profit 2-year ADN program in the northeastern region of the United States with an enrollment of approximately 300 students. The target population was all enrolled prelicensure nursing students between the ages of 18 and 60 who have had a SOFI report filed. A convenience sample was utilized. Students who were dismissed from the program due to either academic or clinical failures but who have had at least one SOFI filed were included in the study population. The number and types of SOFI reports generated with the previously discussed demographic variables were measured.

Results: A total of 266 SOFI forms were examined. One-hundred five SOFI reports were associated with the first two semesters of the program while 161 SOFI reports were associated with semesters 3 and 4. Students that had prior healthcare experience completed 25% of the SOFI forms, and 64.3% of the SOFI forms were associated with students 30 years of age or older. Fifty-one SOFI reports were constructed after an Evening/Weekend curricular change as compared to 30 SOFI reports prior to the change. All differences were statistically significant at an alpha level of 0.05.

Conclusions: The challenge associated with nursing education is building an educational foundation and the promotion of an appropriate culture wherein students can learn from their mistakes and near-misses while the errors/near-misses are caught before they reach the patient. A broader and increased knowledge base regarding the clinical errors and near-misses that are conducted by pre-licensure RN students can only assist faculty with regard to the more thorough preparation of these future providers.