Understanding How Hospital Nurses Address Operational Failures That Impact Patients: An Exploratory Study of...

Area of Science:

• Healthcare Management
• Patient Safety
• Nursing Practice

Background:

• Operational failures in hospitals, including communication breakdowns and equipment malfunctions, frequently disrupt patient care and workflow.
• Current approaches often rely on short-term fixes rather than comprehensive, long-term strategies for these failures.

Purpose of the Study:

• To investigate the impact of operational failures on patients.
• To examine how nurses' problem-solving behaviors change in response to the perceived direct impact of these failures on patients.

Main Methods:

• A qualitative, exploratory study was conducted across 23 wards in five Belgian hospitals.
• Data were gathered through in-depth semi-structured interviews with 26 nurses and a group discussion with 6 ward managers.

Main Results:

• Barriers to effective problem-solving include limited nurse awareness of the broader patient impact, poor communication, and excessive workloads.
• Nurses are more inclined to take corrective action to prevent recurrence when operational failures lead to direct patient harm.
• Enablers for enhanced problem-solving include narrative medicine, improved communication, streamlined reporting, and adequate resources.

Conclusions:

• Addressing operational failures requires enhancing nurses' awareness and implementing supportive strategies.
• A proactive approach, emphasizing nurses' adaptability and learning from outcomes (Safety-II principles), is crucial for building resilient healthcare systems.
• Improving communication, reporting systems, and resource allocation are key to strengthening nurses' problem-solving capabilities and patient safety.