Other Titles

Experienced and novice nurses in the clinical environment

Abstract

Session presented on Tuesday, September 20, 2016:

The numbers of patients in U.S. hospitals experiencing unfavorable, avoidable clinical outcomes continue at an alarming rate despite the development and implementation of patient safety initiatives. Until now, the majority of research into the concept of patient safety employed quantitative method approaches to investigate the possible causes of preventable adverse patient outcomes. There are several possible factors identified from research findings that might impact patient safety: an organization's safety culture, the practice environment of the nurse, and nurse staffing. To date, qualitative exploration of the perspectives of those closest to the patient - bedside nurses - has been overlooked. This study incorporated Glaser's Classical Grounded Theory (CGT) to explore bedside registered nurses' (RNs) perspectives of patient safety to generate a substantive theory that explained or described patient safety from the view point of bedside RNs. In addition to the substantive theory, Exerting Capacity, additional concepts that emerged from the data were two mindsets bedside nurses use to exert their capacity in order to keep their patients safe: 'me-centric' and 'patient centric'. This study is the first of its kind to use CGT as a qualitative methodological approach into the concept of patient safety through the perspectives of bedside RNs in the adult acute hospital setting. CGT is a well-established, rigorous, inductive methodological approach to explore areas of life in which a group of people define their reality through their social interactions (Glaser, 1992), including how they resolve their main concern (Glaser, 1998). Data revealed that the main concern of bedside RNs is indemnifying duty: the RNs' self-ascribed obligation to their patients through guarding or securing against anticipated loss or harm while in their care. From either a 'me-centric' or 'patient-centric' approach, the bedside nurses resolve the main concern of indemnifying duty through their ability to exert their capacity. Exerting capacity describes how the bedside nurses balance their own capacity against the demands of a given situation to fulfill their duty to keep their patients safe. Understanding patient safety from the perspective of bedside RNs helps researchers to better define the RNs' thought processes and actions with respect to keeping their patients safe. Further, this knowledge adds to what is currently known about the concept of patient safety. It is imperative for the leaders of healthcare organizations, including nursing leaders from all levels, to recognize the value of the perspective of patient safety from the viewpoint of the bedside nurse. In addition, the bedside nurse needs to understand the implications of this study's findings and how the approach to keeping patients safe, either from a 'me-centric' or 'patient-centric' mindset, may not be suited for the current work environment. These findings establish the groundwork for future research into the evolving concept of patient safety.

Authors

John M. Leger

Author Details

John Leger, RN

Sigma Membership

Non-member

Lead Author Affiliation

The University of Texas Medical Branch at Galveston, Galveston, Texas, USA

Type

Presentation

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Patient Safety in Adult Acute Care Setting, Bedside Nurse's Perspective, Mindsets of Keeping Patients Safe

Conference Name

Leadership Connection 2016

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2016

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Acquisition

Proxy-submission

Additional Files

download (260 kB)

Share

COinS
 

Exerting capacity: How bedside RNs approach patient safety

Indianapolis, Indiana, USA

Session presented on Tuesday, September 20, 2016:

The numbers of patients in U.S. hospitals experiencing unfavorable, avoidable clinical outcomes continue at an alarming rate despite the development and implementation of patient safety initiatives. Until now, the majority of research into the concept of patient safety employed quantitative method approaches to investigate the possible causes of preventable adverse patient outcomes. There are several possible factors identified from research findings that might impact patient safety: an organization's safety culture, the practice environment of the nurse, and nurse staffing. To date, qualitative exploration of the perspectives of those closest to the patient - bedside nurses - has been overlooked. This study incorporated Glaser's Classical Grounded Theory (CGT) to explore bedside registered nurses' (RNs) perspectives of patient safety to generate a substantive theory that explained or described patient safety from the view point of bedside RNs. In addition to the substantive theory, Exerting Capacity, additional concepts that emerged from the data were two mindsets bedside nurses use to exert their capacity in order to keep their patients safe: 'me-centric' and 'patient centric'. This study is the first of its kind to use CGT as a qualitative methodological approach into the concept of patient safety through the perspectives of bedside RNs in the adult acute hospital setting. CGT is a well-established, rigorous, inductive methodological approach to explore areas of life in which a group of people define their reality through their social interactions (Glaser, 1992), including how they resolve their main concern (Glaser, 1998). Data revealed that the main concern of bedside RNs is indemnifying duty: the RNs' self-ascribed obligation to their patients through guarding or securing against anticipated loss or harm while in their care. From either a 'me-centric' or 'patient-centric' approach, the bedside nurses resolve the main concern of indemnifying duty through their ability to exert their capacity. Exerting capacity describes how the bedside nurses balance their own capacity against the demands of a given situation to fulfill their duty to keep their patients safe. Understanding patient safety from the perspective of bedside RNs helps researchers to better define the RNs' thought processes and actions with respect to keeping their patients safe. Further, this knowledge adds to what is currently known about the concept of patient safety. It is imperative for the leaders of healthcare organizations, including nursing leaders from all levels, to recognize the value of the perspective of patient safety from the viewpoint of the bedside nurse. In addition, the bedside nurse needs to understand the implications of this study's findings and how the approach to keeping patients safe, either from a 'me-centric' or 'patient-centric' mindset, may not be suited for the current work environment. These findings establish the groundwork for future research into the evolving concept of patient safety.