Despite many safeguards, nurses make the majority of medication administration errors. The purpose of our research was to investigate the perceived causes for such errors and to better understand how nurses deal with them. We performed an interpretive analysis of 158 accounts by nurses who made self-identified medication errors. We found common themes among these accounts. First, although nurses admitted responsibility for errors, they simultaneously identified a variety of external contributing factors. Second, nurses' accounts were often framed in terms of "being new," with the underlying background expectancy of inexperience. Third, emotionally devastating visceral responses to errors were common and often incongruent with error severity. Fourth, nurses had to deal with fear. Fifth, nurses voiced frustrations with technologies and regulations. Sixth, embedded within many of the accounts was a "lessons learned" theme, through which nurses developed "personal rules" as a result of an error. We conclude with suggestions for additional research.
A large body of empirical research documents the adverse mental health consequences of workplace bullying. However, less is known about gender and race differences in the processes that link workplace bullying and poor mental health. In the current study, we use structural equation modeling of survey data from the 2010 Health and Retirement Study (N = 2292) and draw on stress process theory to examine coworker support as a buffering mechanism against workplace bullying, and gender and race differences in the relationships between bullying and psychological distress. The results of the analysis indicate that coworker support serves as a protective buffer against workplace bullying, although the buffering effect is relatively small. We also find that the effects of workplace bullying more heavily impact women and persons of color. Specifically, women and African American individuals in our sample were less protected from the buffering mechanism of co-worker social support.
Further study is needed to more fully understand this phenomenon and to discover appropriate support mechanisms and interventions to minimize the harm to nurses.
Despite efforts to reduce the incidence of perioperative medication errors, these errors continue to be a problem. We examined written accounts from 16 nurses who discussed medication errors in the perioperative environment and 11 nurses who provided additional information about perioperative errors, nursing education, and the state of health care. Preoperative medication errors were the most frequently reported perioperative medication errors. Other reported errors involved intraoperative medication administration, IV sedation, and "close call" events. Reasons for errors included production pressure, complacency, and failure to follow established routines. We also identified evidence of self-blame and lack of understanding between nursing units and specialty areas. We compared attitudes and opinions of nurses working in perioperative settings with those of nurses working in non-perioperative areas and found both similarities and differences in the perceptions of medication errors and why they occur.
Errors generally caused emotional distress in the error maker. Overall, perceived treatment after the error reflected supportive environments, where nurses were generally treated with respect, fair treatment, and understanding. Opportunities for nursing education include second victim awareness and reinforcing professional practice standards. [J Nurs Educ. 2018;57(5):275-280.].
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