Nurses’ Perception of Their Role in Patient Safety

Nurses’ Perception of Their Role in Patient Safety by Janeane Walker MSN, University of Phoenix, 2006 BSN, Washington Adventist University, 2002 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Nursing Leadership Walden University May 2018 Abstract Despite efforts to ensure patient safety in the United States, patients are being harmed by preventable errors. There is a gap in the literature from the nurse’s perspective as to why medical errors continue to occur despite having evidence-based safety strategies available. The purpose of this constructivist grounded theory study was to develop a theory explaining nurses’ perception of their role in patient safety and why medical errors are still occurring despite implementation of evidence-based safety strategies. The systems engineering initiative for patient safety (SEIPS) model provided the conceptual framework for the study. Data collection included interviews with 11 nurses who worked in a Magnet designated hospital. Data were sorted and analyzed using the constant comparative method. Three themes emerged: technology, work environment, and human factors. These themes aligned with components of the SEIPS model. An emphasis on how technology adds to the nurses’ workload compounded with a busy work environment was noted as a contributing factor for bypassing safety systems. The bypass model theory was derived from the themes to describe the conditions that nurses work inDespite efforts to ensure patient safety in the United States, patients are being harmed by preventable errors. There is a gap in the literature from the nurse’s perspective as to why medical errors continue to occur despite having evidence-based safety strategies available. The purpose of this constructivist grounded theory study was to develop a theory explaining nurses’ perception of their role in patient safety and why medical errors are still occurring despite implementation of evidence-based safety strategies. The systems engineering initiative for patient safety (SEIPS) model provided the conceptual framework for the study. Data collection included interviews with 11 nurses who worked in a Magnet designated hospital. Data were sorted and analyzed using the constant comparative method. Three themes emerged: technology, work environment, and human factors. These themes aligned with components of the SEIPS model. An emphasis on how technology adds to the nurses’ workload compounded with a busy work environment was noted as a contributing factor for bypassing safety systems. The bypass model theory was derived from the themes to describe the conditions that nurses work in that result in bypassing safety systems. Further research needs to go beyond engaging nurses with the implementation of health IT system by examining long-term impacts on workflow as changes are being made. Addressing the reasons why safety measures are bypassed can affect positive social change which will improve the quality and safety of patient care outcomes. Nurses’ Perception of Their Role in Patient Safety by Janeane Walker MSN, University of Phoenix, 2006 BSN, Washington Adventist University, 2002 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Nursing Leadership Walden University May 2018 Dedication This dissertation is dedicated to my biggest cheerleader, my mom Barbara Walker. She has truly been an inspiration throughout my academic career. I am grateful for her patience, wisdom, and support. I would also like to thank my brothers, David and Marcus, for always being supportive of me. This has truly been an experience I will never forget. Acknowledgments I would like to take the time to thank my chair, Dr. Hussey, and my committee member, Dr. Wheeler, for their guidance throughout my dissertation study. It was truly a privilege to learn from and work with them during my time at Walden. I would like to thank Dr. Garner for being my university research reviewer. It took a community of supportive people to encourage and mentor me during my dissertation journey, so I would also like to thank my classmate, Lorelle Wuerz, for her support during my time at Walden, especially during our residencies, as well as Jennifer Hayakawa who mentored me through the IRB process and the data collection phase.