DOI: 10.3912/OJIN.Vol21No03Man06
Key Words: Patient safety, medical error, errors, medical-surgical, nurses, error recovery, expertise, certification, workload, scope of practice, educational level
Since the focus on error prevention has not yielded expected results to make healthcare safer, it is reasonable to explore the notion of error recovery. Making healthcare safer is a national mandate, yet little progress has been made to reduce the medical error rate in the past 15 years (Aranaz-Andrés et al., 2011; Landrigan et al., 2010). Since the focus on error prevention has not yielded expected results to make healthcare safer, it is reasonable to explore the notion of error recovery (Gaffney, Hatcher, & Milligan, 2016). Errors are actions that fail to meet their desired outcome (Institute of Medicine, 2000). The recovery process consists of identifying, interrupting, and correcting medical errors to mitigate patient harm. Safety conscious organizations must anticipate that errors will occur and incorporate error recovery strategies into patient safety efforts (Habraken & van der Schaaf, 2010; Helmreich, 2000; Reason, 1990).
The dynamic nature of the healthcare environment requires that nurses practice to the full extent of their education, experience, and role in order to keep patients safe. Patient safety is a core nursing duty. The dynamic nature of the healthcare environment requires that nurses practice to the full extent of their education, experience, and role in order to keep patients safe (American Nurses Association, 2015). Although nurses play a key role in safeguarding patients, little is known about their role in recovering medical errors. Further examination of nurses’ role in the recovery process can provide important insight into positive recovery factors and the optimal utilization of registered nurses (RNs) in order to enhance patient safety.
In this article, we will provide background information to introduce the concept of error recovery, and present our study aims, methods, and results. The discussion section will further consider our results in the context of the important role of medical-surgical nurses and error recovery to enhance patient safety.
Background
Patients interacting with
healthcare organizations have an expectation of safety. Yet, the fundamental mission of the health profession has been challenged with widespread and persistent medical errors. An estimated 98,000 fatalities result from medical errors every year in the United States (IOM, 2000). In addition to causing loss of public confidence, these events have increased patient morbidity and mortality and raised healthcare costs (Pham et al., 2012). The past 10 years have demonstrated a national focus on reducing these adverse events, with an increase in research and prevention. Despite focused efforts on error prevention, minimal progress has been made to make healthcare safer (MacDonald, 2013).
Error Recovery …humans are the critical element of the error recovery process. Building on human factors theories, the Eindhoven Incident Causation Model suggested that errors result from technical, organizational, or human failures (van der Schaaf, 1992). Although the model is one of incident causation, it also proposes that errors can be prevented by adequate system defenses (van der Schaaf & Kanse, 2000). When built-in system defenses are unable to control failures, the flexibility, experience, and intuition of the human operator must stop the unintended chain of events before harm occurs. In this sense, humans are the critical element of the error recovery process (Reason, 2008).
The phenomenon of error recovery as a critical defense against medical errors is relatively new, and the mechanisms involved in the recovery process are not well known (Gaffney et al., 2016). The recovery process is defined as the feature of the human system component to detect, localize, and correct system failures (van der Schaaf & Kanse, 2000). The recovery process consists of three sequential phases. First, an error must be detected. The identification or detection of the
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