440827Iran University of Medical Sciences, Iran.
Nurs Ethics. 2021 Feb;28(1):131-144. doi: 10.1177/0969733020952100. Epub 2020 Sep 28.
Error communication includes both reporting errors to superiors and disclosing their consequences to patients and their families. It significantly contributes to error prevention and safety improvement. Yet, some errors in intensive care units are not communicated.
The aim of the present study was to explore factors affecting error communication in intensive care units.
This qualitative study was conducted in 2019. Participants were 17 critical care nurses purposively recruited from the intensive care units of 2 public hospitals affiliated to Iran University of Medical Sciences, Tehran, Iran. Data were collected through in-depth semi-structured interviews and were analyzed through the conventional content analysis method proposed by Graneheim and Lundman.
The Ethics Committee of Iran University of Medical Sciences, Tehran, Iran approved the study (code: IR.IUMS. REC.1397.792). Participants were informed about the study aim and methods and were ensured of data confidentiality. They were free to withdraw from the study at will. Written informed consent was obtained from all of them.
Factors affecting error communication in intensive care units fell into four main categories, namely the culture of error communication (subcategories were error communication organizational atmosphere, clarity of processes and guidelines, managerial support for nurses, and learning organization), the consequences of errors for nurses and nursing (subcategories were fear over being stigmatized as incompetent, fear over punishment, and fear over negative judgments about nursing), the consequences of errors for patients (subcategories were monitoring the effects of errors on patients and predicting the effects of errors on patients), and ethical and professional characteristics (subcategories were ethical characteristics and inter-professional relationships).
The results of this study show many factors affect error communication, some facilitate and some prohibit it. Organizational factors such as the culture of error communication and the consequences of error communication for the nurse and the patient, as well as individual and professional characteristics, including ethical characteristics and interprofessional relationship, influence this process.
Errors confront nurses with ethical challenges and make them assess error consequences and then, communicate or hide them based on the results of their assessments. Health authorities can promote nurses' error communication through creating a supportive environment for them, developing clear error communication processes and guidelines, and providing them with education about the principles of ethical practice.
错误沟通包括向上级报告错误和向患者及其家属披露错误后果。它对预防错误和提高安全性有重要作用。然而，一些重症监护病房的错误并没有得到沟通。
本研究旨在探讨影响重症监护病房错误沟通的因素。
这是一项 2019 年进行的定性研究。参与者是从伊朗德黑兰医科大学附属的 2 家公立医院的重症监护病房中有意招募的 17 名重症监护护士。数据通过深入的半结构化访谈收集，并通过 Graneheim 和 Lundman 提出的常规内容分析方法进行分析。
伊朗德黑兰医科大学伦理委员会批准了这项研究（编号：IR.IUMS.REC.1397.792）。研究目的和方法告知了参与者，并保证了数据的保密性。他们可以随时自愿退出研究。所有参与者均签署了书面知情同意书。
影响重症监护病房错误沟通的因素分为四个主要类别，即错误沟通文化（子类别包括错误沟通组织氛围、流程和指南的清晰度、护士长对护士的支持以及学习型组织）、错误对护士和护理的后果（子类别包括害怕被视为不称职、害怕惩罚以及害怕对护理的负面评价）、错误对患者的后果（子类别包括监测错误对患者的影响以及预测错误对患者的影响）和伦理和专业特征（子类别包括伦理特征和专业间关系）。
本研究结果表明，许多因素会影响错误沟通，有些因素促进沟通，有些因素则阻碍沟通。组织因素，如错误沟通文化以及错误沟通对护士和患者的后果，以及个人和专业特征，包括伦理特征和专业间关系，都会影响这一过程。
错误使护士面临伦理挑战，使他们评估错误后果，然后根据评估结果进行沟通或隐瞒。卫生当局可以通过为护士创造一个支持性的环境、制定明确的错误沟通流程和指南以及为他们提供伦理实践原则的教育，来促进护士的错误沟通。
