Highlights
- •Two thirds of oncology nurses reported direct experience with a healthcare error in the past six months.
- •Health system responses to disclosure of errors was inconsistent.
- •There is scope to improve adherence to open disclosure practices.
Abstract
Purpose
Recognition and responses of the health system to healthcare errors are key areas
for improvement in oncology. Despite their role in direct patient care, nurses' perceptions
of errors have rarely been explored. The aim of this study was to determine oncology
nurses’ direct experience of healthcare errors in the previous six months; the circumstances
surrounding the error; and ensuing actions by the healthcare system.
Methods
Cross-sectional survey of nurses who were members of an oncology nursing society and/or
registered or enrolled nurses employed in an oncology setting. Participants indicated
whether they had direct experience (i.e. direct involvement or witnessing) of error(s) in the previous six months. Those who experienced an error indicated
their perceptions of the: cause; location and phase of care; how the error was identified,
who was responsible, level of harm and action(s) taken.
Results
67% (n = 65/97) of nurses who completed the survey had direct experience with at least
one error in the previous six months. According to these nurses, most occurred during
treatment (n = 48, 74%), happened in outpatient clinics (n = 28, 43%) and were related
to chemotherapy (n = 15, 23%). Nurses perceived errors were primarily caused by nurses
(n = 36, 55%) and doctors (n = 27, 42%); and 54% (n = 35) were deemed ‘near-miss’.
Nurses perceived errors were recorded (n = 40, 62%), explained to patients (n = 33,
51%) and an apology provided (n = 32, 49%).
Conclusion
Two-thirds of oncology nurses in this study had direct experience with an error in
the previous six months. Nurses perceived response to errors as inconsistent with
open disclosure standards. Strategies to improve accuracy of measures of error and
response of the health system, including adherence to open disclosure processes, are
required.
Keywords
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Article info
Publication history
Published online: March 09, 2020
Accepted:
February 25,
2020
Received in revised form:
February 5,
2020
Received:
November 12,
2019
Identification
Copyright
© 2020 Elsevier Ltd. All rights reserved.
