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To Err Is Human
- 1. To err is human; or not Jennifer Dawn Jones-Locklear University of Phoenix NUR 590B March 12, 2007
Hinweis der Redaktion
- A list of interview questions were sent to risk management and educational departments. The interview questions were designed to be short and to the point. The process of interviewing the managers was met with challenges and conflict from some facilities. Some managers stated that their facility felt that answering the question would be not be appropriate and could cause conflict within the facility. The aspect of confidentiality of staff records was discussed and although no names of employees would ever be discussed one facility declined to be interviewed at all. The goal of the practicum was evaluate the need for further training of new nurses in relationship to accountability. This project evolved into an educational in-service that considered common errors made by new nurses and how to best inform nurses of these errors. In no circumstance did any facility discipline nurses for first infractions but decided to utilize other methods for seeking a solution to the problem.
- As the practicum process began some challenges were faced immediately. Several facilities were in the middle of Joint Commission Surveys and declined to proceed with interviews that had previously been scheduled. This then lead to contacting other facilities that had previously not been scheduled to be interviewed. Since several of the manager contacted were not familiar with myself or with this type of practicum experience they were initially reluctant to speak openly. This however changed when they were assured that information would be kept confidential in that no facility names would be used as part of the teaching project. Due to the fact that risk management information is often only used for facility training and guidance some information was difficult to obtained as it is not kept on file once pertinent information is gleamed. Another major challenge was scheduling to meet with managers. As a full-time employee with a teaching scheduling often meeting with managers required several schedule changes and in some cases resulted in conversation being done via phone or email.
- Implementation of the project took many twist and turns during the process. As nurse experts were interviewed and sought after for advice, the projected became a discussion of how to best help eliminate some of the problems that new nurses faces. The discussion of errors allowed for experts to bring forth information from their own facility and discuss this with nurses from a wide variety of hospital settings. Some common errors were found in each group. Documentation errors being the most prevalent. With some many facilities in the area of this practicum moving to computerized documentation many managers stated that the most common error made was not documenting information correctly. The inability to delegate tasks appropriately was another common error, that resulted in staff members exceeding scope of practice. One manager stated “they do not understand what can and cannot be delegated to certified nursing assistants.” The North Carolina Division of Facility Services has a list of task that can be delegated to assistive personnel. Medication errors occurred most often related to new orders being implemented into the computer system and nurses being uncertain of when the medication was due. Managers and nurses interviewed both felt that this was due to the fact that new nurses have not been exposed to commuter charting early. Another observation was that staff members on some units were still learning the computer system and had little time to spend helping new nurses figure out the system. Due to the unfamiliar environment of computerized charting missed lab studies and missed treatments also occurred. Nurses and mangers felt that more computer training time was needed.
- The process of implementation first began with deciding what type of questions would be asked of those being interviewed. The questions came from a brainstorming session with other nurse educators who were involved in different areas of education as well as different clinical areas. Once questions were determined then managers were contacted. Some wanted a preview of questions sent to them prior to making the decision to interview, and as a result some declined the interview process. Once information was gathered the information was synthesized a copy of information was sent to experts for review and feedback. Feedback from managers ranged from excellent to the need to do minor tweaking. A common thread found between experts was that since educational department currently did in-services that should cover the same information with new hires that the target audience would best be suited for nursing students prior to graduation. As a result of this feedback the target audience was changed to nursing students in the last semester before seeking licensure.
- The value of good networking is invaluable to the professional. Contacts made during the practicum experience allow for life long relationships with others in the professional realm. Networking with professionals and experts in the field also gives opportunity for frank open discussions and ability to obtain advice from others in the profession and even outside the profession.