Occupational Therapists' Perspectives on Practice Errors in Geriatric Practice Settings

A qualitative meta-synthesis about challenges experienced in occupational therapy practice

“…Restricted resources and high workload resulted in a greater possibility of errors due to being 'too rushed, short on time, so busy and [having] too many patients' (Scheirton et al, 2003: 311). Regulatory requirements blinkered clinical reasoning (Lohman et al, 2003), resulted in a high documentation burden and less face-to-face time with clients (Lloyd et al, 2007;Seah et al, 2011). a These papers were reporting findings which constituted part of a larger study, which may have contributed to the lack of detail given and subsequent lower quality rating.…”

“…In their exploration of errors in practice, Scheirton et al (2003) found that it was crucial for occupational therapists to share their emotional response to making errors, and seek help to work through the implications of the incident (Lohman et al, 2003). For all occupational therapists, being open to supervision and observation from colleagues was important for the development of clinical reasoning (Morley, 2009) as well as being able to learn from mistakes (Lohman et al, 2003). Sweeney et al (2001) revealed that new graduates did not always trust colleagues and may not willingly open up and share their worries.…”

“…The meta-synthesis highlighted that the undermining or over-ruling of the occupational therapists' autonomy by colleagues resulted in a reduction of confidence (Freeman et al, 2009;Hasselkus and Dickie, 1994). For example, Lohman et al (2003) found that occupational therapists were intimidated by and reluctant to question doctors, leading to some judgement errors (Scheirton et al, 2003). Occupational therapists appeared to struggle with asserting their role and having confidence in their identity (Robertson, 2012).…”

Improving Client Safety: Strategies to Prevent and Reduce Practice Errors in Occupational Therapy

“…Starting in 2001, with the support of the Health Future Foundation and the National Patient Safety Foundation, we initiated a series of research studies to examine the phenomenon of practice errors in occupational therapy and physical therapy practice. Previous studies in occupational therapy suggested that occupational therapists make errors in practice and that the errors they make vary considerably (Lohman, Mu, & Scheirton, 2004;Mu et al, 2006;Scheirton et al, 2003), ranging from minor errors (e.g., ripping fingernails or causing patient fatigue) to severe ones (e.g., rupturing tendons or leaving a hot pack on too long, resulting in burns; Mu et al, 2006). Errors can be classified as technical errors or moral errors.…”

“…Technical errors concern methods, skills, or approaches that lead to physical harm to clients-for example, exceeding client limitations after a hip replacement. Moral errors relate to behaviors that undermine the practitioner-client relationship or are ethically inconsistent-for example, providing an unneeded service to obtain payment or being untruthful by exaggerating the level of function that can be accomplished through therapy (Lohman et al, 2004;Mu, Lohman, & Scheirton, 2005).…”