A case study on how the approach to human error guides the incident reporting among nurses in a hospital setting
Abstract: For over a decade the healthcare industry has attempted to mimic the non-medical industry with the use of incident reporting as one of many tools used to increase patient safety. But often healthcare workers are trained to perfect individual performance and the incident reporting descriptions are frequently weighted with character flaws (Leape, 1997). Human error is viewed as a personal failure instead of a natural course of systemic contribution. This qualitative case study explores how the healthcare systems’ approach to human error can influence the nurses’ perception of human error and how this influence is manifested in the incident reporting culture. This study also encompasses the nurse manager’s view of human error as he/she manages the nurses who self-report or report their peers. And lastly, the just culture concept is discussed as it intertwines with the complexity of incident reporting. Two approaches to human error from safety science literature, the ‘Old View’ vs. ‘New View’ approaches, are used as a guide to portray the possible differences the two approaches institute themselves in the nurses’ understanding of human error. Five registered nurses and three nurse managers were interviewed to explore their depth of knowledge of human error as it establishes into the writing or not writing of incident reports. Key healthcare organizational documents and state laws were analyzed to examine the healthcare systems’ approach to human error and incident reporting and their possible influence on nurses’ perception of human error.
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