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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
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
4I framework of organizational learningNear missesNursesNurse’s rolePatient safetyProblem solvingTertiary care centers

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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.