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Operational Failures Detected by Frontline Acute Care Nurses
Author(s) -
Stevens Kathleen R.,
Engh Eileen P.,
TubbsCooley Heather,
Conley Deborah Marks,
Cupit Tammy,
D'Errico Ellen,
DiNapoli Pam,
Fischer Joleen Lynn,
Freed Ruth,
Kotzer Anne Marie,
Lindgren Carolyn L.,
Marino Marie Ann,
Mestas Lisa,
Perdue Jessica,
Powers Rebekah,
Radovich Patricia,
Rice Karen,
Riley Linda P.,
Rosenfeld Peri,
Roussel Linda,
RyanWenger Nancy A.,
SearleLeach Linda,
Shonka Nicole M.,
Smith Vicki L.,
Sweatt Laura,
TownsendGervis Mary,
Wathen Ellen,
Withycombe Janice S.
Publication year - 2017
Publication title -
research in nursing and health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.836
H-Index - 85
eISSN - 1098-240X
pISSN - 0160-6891
DOI - 10.1002/nur.21791
Subject(s) - acute care , nursing , patient safety , medicine , unit (ring theory) , patient care , medical emergency , reliability (semiconductor) , quality (philosophy) , psychology , health care , power (physics) , philosophy , physics , mathematics education , epistemology , quantum mechanics , economics , economic growth
Frontline nurses encounter operational failures (OFs), or breakdowns in system processes, that hinder care, erode quality, and threaten patient safety. Previous research has relied on external observers to identify OFs; nurses have been passive participants in the identification of system failures that impede their ability to deliver safe and effective care. To better understand frontline nurses' direct experiences with OFs in hospitals, we conducted a multi‐site study within a national research network to describe the rate and categories of OFs detected by nurses as they provided direct patient care. Data were collected by 774 nurses working in 67 adult and pediatric medical‐surgical units in 23 hospitals. Nurses systematically recorded data about OFs encountered during 10 work shifts over a 20‐day period. In total, nurses reported 27,298 OFs over 4,497 shifts, a rate of 6.07 OFs per shift. The highest rate of failures occurred in the category of Equipment/Supplies, and the lowest rate occurred in the category of Physical Unit/Layout. No differences in OF rate were detected based on hospital size, teaching status, or unit type. Given the scale of this study, we conclude that OFs are frequent and varied across system processes, and that organizations may readily obtain crucial information about OFs from frontline nurses. Nurses' detection of OFs could provide organizations with rich, real‐time information about system operations to improve organizational reliability. © 2017 Wiley Periodicals, Inc.