Changes in nursing practice: associations with responses to and coping with errors

Authors

  • Mary Karga,

    1. Authors:Mary Karga, PhD, RN, Infection Control Nurse, Patras University Hospital; Panagiotis Kiekkas, PhD, RN, Assistant Professor, Nursing Department, Highest Technological Educational Institute of Patras, Patras; Diamanto Aretha, PhD, MD, Anesthesiologist, Pyrgos Hospital, Pyrgos; Chrisoula Lemonidou, PhD, RN, Professor, Nursing Department, University of Athens, Athens, Greece
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  • Panagiotis Kiekkas,

    1. Authors:Mary Karga, PhD, RN, Infection Control Nurse, Patras University Hospital; Panagiotis Kiekkas, PhD, RN, Assistant Professor, Nursing Department, Highest Technological Educational Institute of Patras, Patras; Diamanto Aretha, PhD, MD, Anesthesiologist, Pyrgos Hospital, Pyrgos; Chrisoula Lemonidou, PhD, RN, Professor, Nursing Department, University of Athens, Athens, Greece
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  • Diamanto Aretha,

    1. Authors:Mary Karga, PhD, RN, Infection Control Nurse, Patras University Hospital; Panagiotis Kiekkas, PhD, RN, Assistant Professor, Nursing Department, Highest Technological Educational Institute of Patras, Patras; Diamanto Aretha, PhD, MD, Anesthesiologist, Pyrgos Hospital, Pyrgos; Chrisoula Lemonidou, PhD, RN, Professor, Nursing Department, University of Athens, Athens, Greece
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  • Chrisoula Lemonidou

    1. Authors:Mary Karga, PhD, RN, Infection Control Nurse, Patras University Hospital; Panagiotis Kiekkas, PhD, RN, Assistant Professor, Nursing Department, Highest Technological Educational Institute of Patras, Patras; Diamanto Aretha, PhD, MD, Anesthesiologist, Pyrgos Hospital, Pyrgos; Chrisoula Lemonidou, PhD, RN, Professor, Nursing Department, University of Athens, Athens, Greece
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Panagiotis Kiekkas, Assistant Professor, 76 Stratigou Konstantinopoulou Str., Aroi, Patras 263-31, Greece. Telephone: +30 2610 274789/+30 2610 369052.
E-mail:kiekkpan@otenet.gr

Abstract

Aims and objective.  To investigate emotional responses of nurses and perceived senior staff responses to errors, error-coping strategies used by nurses and how these are associated with constructive or defensive changes in nursing practice.

Background.  Healthcare professionals have generally reported distressing emotional responses to errors and fear concerns about their consequences. However, errors can also be part of a developmental process, by offering opportunities for learning and leading to constructive changes in clinical practice.

Design.  Prospective, correlational, multicentre study.

Methods.  Five hundred and thirty-six structured questionnaires completed from nurses employed in various hospital departments were considered eligible for data extraction. The revised questionnaire used was evaluated for content validity.

Results.  Data analysis indicated that positive perceived senior staff responses (p = 0·030), accepting error responsibility (p = 0·031) and seeking social support (p = 0·019) predicted constructive changes in nursing practice, while negative perceived senior staff responses (p = 0·040) and error escape-avoidance (p = 0·041) predicted defensive changes.

Conclusions.  Errors promote constructive changes in clinical practice when nurses are encouraged to use adaptive error-coping strategies within a supportive, non-blaming culture.

Relevance to clinical practice.  These findings highlight the role of senior staff in the establishment of a supportive, trustful ward climate, so that nurses can learn from errors, prevent their recurrence and improve patient safety.

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