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Nursing workarounds, often seen as risky deviations, can arise from health information technologies and evidence-based protocols. Understanding their complex origins is key to improving patient safety and quality.

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Area of Science:

  • Nursing
  • Health Informatics
  • Patient Safety

Background:

  • Nursing workarounds have gained attention due to increased focus on patient safety and evidence-based practice.
  • The rise of health information technologies (HITs) correlates with increased interest in nursing workarounds.
  • Traditionally, workarounds are viewed negatively as deviations from best practices, potentially risking patient outcomes.

Purpose of the Study:

  • To explore the multifactorial origins of nursing workarounds.
  • To examine how evidence-based protocols and HIT can unintentionally lead to workarounds.
  • To consider the ethical obligations of nurses and leaders in optimizing patient safety through workaround analysis.

Main Methods:

  • Qualitative exploration of nursing workarounds.
  • Analysis of the interplay between HIT, evidence-based protocols, and nursing practice.
  • Examination of ethical considerations for nurses and administrative leaders.

Main Results:

  • Evidence-based protocols and HIT, intended for safety, can paradoxically increase workaround frequency.
  • Workarounds stem from complex interactions, not just individual nursing choices.
  • Ethical obligations necessitate a deeper understanding of workaround drivers.

Conclusions:

  • A narrow view of nursing workarounds is insufficient; multifactorial origins must be addressed.
  • Optimizing patient safety requires understanding how system designs influence nursing practice.
  • Ethical leadership is crucial for mitigating risks associated with nursing workarounds.