Volume 13, Issue 2 (6-2025)
J Surg Trauma 2025, 13(2): 55-62 |
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Vagharseyyedin S A, Akbari A. Explaining the Emergency Nurses' Experiences of Near-Miss Events: A Qualitative Study. J Surg Trauma 2025; 13 (2) :55-62
URL: http://jsurgery.bums.ac.ir/article-1-474-en.html
URL: http://jsurgery.bums.ac.ir/article-1-474-en.html
Department of Medical Surgical Nursing, Nursing and Midwifery School, Birjand University of Medical Sciences, Birjand, Iran
Abstract: (112 Views)
Introduction: Near-miss events play a crucial role in identifying opportunities for enhancing the quality and safety of healthcare systems. The hospital emergency department, due to the presence of numerous variables and a high volume of patients, is particularly susceptible to nursing errors and associated adverse outcomes resulting from negligence. The present study aimed to investigate the experiences of emergency nurses regarding near-miss events.
Methods: A qualitative conventional content analysis approach was employed. Using purposive sampling, 15 nurses were recruited from a trauma center affiliated with Birjand University of Medical Sciences, Iran, between June 2021 and November 2022. Data collection was conducted through semi-structured interviews, which were audio-recorded with participants’ informed consent. The interviews were transcribed verbatim into Word documents and subsequently imported into MAXQDA (Version 2020) for systematic organization and analysis.
Results: The study included 15 nurses (53% female, 47% male), with the majority holding a bachelor's degree (87%) and an average of 12.23±5.52 years of work experience. Analysis of the data produced 347 open codes, which were organized into six subcategories and synthesized into three main categories: (1) an unprofessional atmosphere of the workplace, (2) an insufficient culture of learning from near-miss events, and (3) effects of staff personal life on work-life.
Conclusion: The findings highlight the critical need to foster professionalism in nursing, implement robust feedback systems, perform root cause analyses, and develop a structured approach to learning from near-miss events. These strategies can significantly improve the prevention and management of such events.
Methods: A qualitative conventional content analysis approach was employed. Using purposive sampling, 15 nurses were recruited from a trauma center affiliated with Birjand University of Medical Sciences, Iran, between June 2021 and November 2022. Data collection was conducted through semi-structured interviews, which were audio-recorded with participants’ informed consent. The interviews were transcribed verbatim into Word documents and subsequently imported into MAXQDA (Version 2020) for systematic organization and analysis.
Results: The study included 15 nurses (53% female, 47% male), with the majority holding a bachelor's degree (87%) and an average of 12.23±5.52 years of work experience. Analysis of the data produced 347 open codes, which were organized into six subcategories and synthesized into three main categories: (1) an unprofessional atmosphere of the workplace, (2) an insufficient culture of learning from near-miss events, and (3) effects of staff personal life on work-life.
Conclusion: The findings highlight the critical need to foster professionalism in nursing, implement robust feedback systems, perform root cause analyses, and develop a structured approach to learning from near-miss events. These strategies can significantly improve the prevention and management of such events.
Type of Study: Research |
Subject:
Nursing
Received: 2025/04/14 | Accepted: 2025/05/17 | ePublished ahead of print: 2025/06/11 | Published: 2025/06/17
Received: 2025/04/14 | Accepted: 2025/05/17 | ePublished ahead of print: 2025/06/11 | Published: 2025/06/17
References
1. Rodziewicz TL, Hipskind JE. Medical error prevention. StatPearls Treasure Island (FL): StatPearls Publishing. 2019.
2. Domer G, Gallagher TM, Shahabzada S, Sotherland J, Paul EN, Kumar K-N, et al. Patient safety: preventing patient harm and building capacity for patient safety [Internet]. Contemporary Topics in Patient Safety-Volume 1: IntechOpen; 2022. [DOI:10.5772/intechopen.100559]
3. Shrivastava SR, Shrivastava PS. Envisaging patient safety in health-care settings: need of the hour. BLDE Univ J Health Sci. 2021;6(1):100-1. [DOI:10.4103/bjhs.bjhs_48_19]
4. Miladinia M, Mousavi Nouri E. The challenge of medication errors in the emergency department setting. J Emerg Practice Trauma. 2022;8(1):1-2. [DOI:10.34172/jept.2021.19]
5. Gnoni MG, Tornese F, Guglielmi A, Pellicci M, Campo G, De Merich D. Near miss management systems in the industrial sector: A literature review. Saf Sci. 2022;150:105704. [DOI:10.1016/j.ssci.2022.105704]
6. Winkler M, Perlman Y, Westreich S. Reporting near-miss safety events: Impacts and decision-making analysis. Saf Sci. 2019;117:365-74. [DOI:10.1016/j.ssci.2019.04.029]
7. Wagner LM, Capezuti E, Ouslander JG. Reporting near-miss events in nursing homes. Nurs Outlook. 2006;54(2):85-93. [DOI:10.1016/j.outlook.2006.01.003]
8. Sheikhtaheri A. Near misses and their importance for improving patient safety. Iran J Public Health. 2014;43(6):853-4.
9. Balas MC, Scott LD, Rogers AE. The prevalence and nature of errors and near errors reported by hospital staff nurses. Appl Nurs Res. 2004;17(4):224-30. [DOI:10.1016/j.apnr.2004.09.002]
10. Ehsani SR, Cheraghi MA, Nejati A, Salari A, Esmaeilpoor AH, Nejad EM. Medication errors of nurses in the emergency department. J Med Ethics Hist Med. 2013;6:11.
11. Abdalla AA. Nurses are a key to ensure patient safety: A systematic review. Int J Res Studies Med Health Sci. 2017;2(9):10-5.
12. Gaffney TA. Keeping patients safe: The critical role of medical error recovery. Nurs New Perspectives: IntechOpen; 2020. [DOI:10.5772/intechopen.91412]
13. Unver V, Tastan S, Akbayrak N. Medication errors: perspectives of newly graduated and experienced nurses. Int J Nurs Pract. 2012;18(4):317-24. [DOI:10.1111/j.1440-172X.2012.02052.x]
14. Yang Y, Liu H, Sherwood GD. Second-order problem solving: Nurses' perspectives on learning from near misses. Int J Nurs Sci. 2021;8(4):444-52. [DOI:10.1016/j.ijnss.2021.08.001]
15. Griffey RT, Schneider RM, Todorov AA. Near-miss events detected using the Emergency Department trigger Tool. J Patient Saf. 2023;19(2):59-66. [DOI:10.1097/PTS.0000000000001092]
16. Catchpole KR, Giddings AE, Wilkinson M, Hirst G, Dale T, de Leval MR. Improving patient safety by identifying latent failures in successful operations. Surgery. 2007;142(1):102-10. [DOI:10.1016/j.surg.2007.01.033]
17. Khankeh H, Ranjbar M, Khorasani-Zavareh D, Zargham-Boroujeni A, Johansson E. Challenges in conducting qualitative research in health: A conceptual paper. Iran J Nurs Midwifery Res. 2015;20(6):635-41. [DOI:10.4103/1735-9066.170010]
18. Elo S, Kääriäinen M, Kanste O, Pölkki T, Utriainen K, Kyngäs H. Qualitative content analysis: A focus on trustworthiness. SAGE Open. 2014;4(1). [DOI:10.1177/2158244014522633]
19. Kyngäs H, Mikkonen K, Kääriäinen M. The application of content analysis in nursing science research. Springer, Cham; 2020. [DOI:10.1007/978-3-030-30199-6]
20. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107-15. [DOI:10.1111/j.1365-2648.2007.04569.x]
21. Kyngäs H, Kääriäinen M, Elo S. The trustworthiness of content analysis. The Application of Content Analysis in Nursing Science Research. Springer , Cham; 2019: 41-8. [DOI:10.1007/978-3-030-30199-6_5]
22. Cohoon B. Causes of near misses: perceptions of perioperative nurses. AORN J. 2011;93(5):551-65. [DOI:10.1016/j.aorn.2010.02.017]
23. Işci N, Altuntaş S. Effect of professionalism level on tendency to make medical errors in nurses. Florence Nightingale J Nurs. 2019;27(3):241-52. [DOI:10.26650/FNJN397503]
24. Fairbanks RJ, Crittenden CN, O'Gara KG, Wilson MA, Pennington EC, Chin NP, et al. Emergency medical services provider perceptions of the nature of adverse events and near‐misses in out‐of‐hospital care: an ethnographic view. Acad Emerg Med. 2008;15(7):633-40. [DOI:10.1111/j.1553-2712.2008.00147.x]
25. Salimi S, Rahimi J, Bayazidi S. Nurses' experience regarding error reporting process: Findings of a qualitative study. Nurs Midwifery J. 2013;11(6).
26. Vrbnjak D, Denieffe S, O'Gorman C, Pajnkihar M. Barriers to reporting medication errors and near misses among nurses: A systematic review. Int J Nurs Stud. 2016;63:162-78. [DOI:10.1016/j.ijnurstu.2016.08.019]
27. Mousavi R, Aludary H, Rasouli R, Koulivand PH. Design and explanation of medical error control model: A case study in hospitals affiliated to social security organization of Khuzestan province. Neurosci J Shefaye Khatam. 2018;6(3):43-9.
28. Kwak S-K, Ahn J-S, Kim Y-H, editors. The association of job stress, quality of sleep, and the experience of near-miss errors among nurses in general hospitals. Healthcare; 2024;12(6):699. [DOI:10.3390/healthcare12060699]
29. Smits M, Groenewegen PP, Timmermans DR, van der Wal G, Wagner C. The nature and causes of unintended events reported at ten emergency departments. BMC Emerg Med. 2009;9:16. [DOI:10.1186/1471-227X-9-16]
30. Lee J. Understanding nurses' experiences with near‐miss error reporting omissions in large hospitals. Nurs Open. 2021;8(5):2696-704. [DOI:10.1002/nop2.827]
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