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Second-order problem solving: Nurses' perspectives on learning from near misses.
Yi Yang1, Huaping Liu1, Gwen D Sherwood2
1Peking Union Medical College, School of Nursing, China.
International Journal of Nursing Sciences
|October 11, 2021
Summary
Frontline nurses utilize second-order problem solving to learn from near misses, enhancing patient safety. This approach involves leadership in reporting, analysis, and passionate continuous improvement, despite perceived power limitations.
Area of Science:
- Nursing
- Patient Safety
- Organizational Learning
Background:
- Near misses offer safe learning opportunities for system vulnerabilities.
- Second-order problem solving behavior provides a framework for understanding nurse-led learning from near misses.
Purpose of the Study:
- To explore frontline nurses' perspectives on using second-order problem solving behavior.
- To understand how this behavior facilitates learning from near misses to improve patient safety.
Main Methods:
- Qualitative exploratory study design.
- Semi-structured interviews with 19 frontline nurses in East China.
- Qualitative directed content analysis using Crossan's 4I Framework of Organizational Learning.
Main Results:
- Second-order problem solving involves leading near-miss exposure and cause analysis.
- Nurses balance active and passive roles in improvement projects.
- Continuous improvement is driven by passion, even with perceived low power.
Conclusions:
- Crossan's 4I Framework guides nurses in learning from near misses.
- Nurses play a pivotal role in organizational learning through second-order problem solving.
- Enhanced knowledge, skills, and support are needed to optimize this behavior.
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