Nurses' perspectives on workarounds in clinical practice: A phenomenological analysis.

Area of Science:

• Nursing Practice
• Healthcare Management
• Patient Safety

Background:

• Workarounds in clinical settings involve non-compliance with established procedures, potentially impacting patient safety.
• The increasing frequency of these practices necessitates a thorough examination of their contributing factors.

Purpose of the Study:

• To investigate the phenomenon of workarounds from a nursing perspective.
• To identify factors influencing nurses' non-compliant actions with institutional protocols.

Main Methods:

• A descriptive phenomenological design using Colaizzi's analysis.
• In-depth interviews with 16 nurses, audio-recorded, transcribed, and analyzed using NVivo 12 software.
• Data analysis involved extracting significant statements, formulating meanings, and aggregating themes.

Main Results:

• Four major themes emerged: "living the profession in saved times," "perceiving contingencies as a guide to action," "sense of personal responsibility," and "emotional aspects."
• 17 sub-themes were identified, illustrating the multifaceted nature of nursing workarounds.

Conclusions:

• Workarounds are often initiated by nurses to overcome obstacles to efficient and timely patient care.
• Nurses' confidence, gained through experience, influences their willingness to take responsibility for efficiency gains.
• Findings can guide clinical leadership in addressing workarounds and reconciling protocols with real-world practice, benefiting both management and patient-centered care.