A Systematic Review of Nursing Practice Workarounds

Area of Science:

• Healthcare systems research
• Nursing informatics
• Patient safety science

Background:

• Nursing practice workarounds (NPWs) present significant challenges in healthcare.
• NPWs can hinder efficiency, patient safety, and system design.
• A systematic review of NPW literature was previously lacking.

Purpose of the Study:

• To systematically review and synthesize evidence on NPW definitions, contexts, and prevention strategies.
• To develop a framework for understanding NPWs and their implications for clinical practice.
• To identify gaps and guide future research in NPW.

Main Methods:

• Systematic literature review adhering to PRISMA guidelines.
• Searched databases: Academic Search, MEDLINE, PubMed, CINAHL, Google Scholar (2013-2020).
• Included 13 studies, screened for relevance and quality.

Main Results:

• Thirteen studies were included, exhibiting varied NPW definitions and limited theoretical basis.
• NPWs frequently occurred during new technology implementation (46%) and medication administration (31%).
• Contributing factors included workplace stressors and workflow obstructions; prevention strategies involved open communication and proactive process management.

Conclusions:

• The review offers critical insights for nurses and administrators on managing NPWs.
• Proactive communication and system improvements are essential for preventing NPWs related to new technologies and processes.
• Further research is needed to explore NPW causes, consequences, and effective interventions, particularly in critical care settings.