Biomedical subjects

C E Meurier

Publications and source records attributed to C E Meurier.

4 recordsLinked to original sources

PubMed1998

The quality of assessment of patients with chest pain: the development of a questionnaire to audit the nursing assessment record of patients with chest pain.

The quality of nursing and medical records has been a source of concern for many years (Audit Commission 1995). This study has two main purposes: firstly, to design an audit questionnaire to evaluate the quality of nursing assessment records of patients with chest pain; and secondly, to make some tentative conclusions about the quality of nursing assessment of patients with a chest pain in order to pinpoint areas that need further study. A sample of 30 patients was selected for this study on the basis of some well-defined inclusion criteria. The nursing assessment notes of these patients were evaluated using the audit questionnaire. It was found that the questionnaire was effective in gleaning appropriate information from the nursing notes to be able to derive some tentative conclusions about the quality of nursing assessment of patients with chest pain, i.e., on the whole nursing assessment was found to be superficially carried out, potentially making errors of omission and commission likely to occur. The inter-rater reliability of the questionnaire was found to be good. The questionnaire also seems to measure what it purports to measure (i.e. has content validity). However, this needs to be further checked by using a larger sample.

Adult↗

PubMed1998

Nurses' responses to severity dependent errors: a study of the causal attributions made by nurses following an error.

Attribution theory attempts to understand how people explain events and their own role in them, particularly events which are unusual or unpleasant. Based on previous studies on attributions, it was suggested that nurses would make more external attributions (i.e. blaming others or the environment) following an error with a serious outcome than one with a non-serious outcome. This would in turn suggest that they might be less likely to respond constructively and learn from serious errors. Sixty nurses were approached for this study. They were divided into two groups. One group (30 subjects) completed a questionnaire on the responses to a description of an error with a non-serious outcome and the second group (also 30 subjects) responded to questions to an identical error but with a serious outcome. The findings from this study indicated that nurses behaved in an atypical manner in response to making an error. Although both groups of nurses tended to make slightly more internal attributions for the error, indicating that they are likely to take responsibility for their error, those nurses in the serious outcome condition blamed themselves more for the error. This may be due to the strong professional ethos which exists amongst nurses that expects them to take responsibility for their actions. This would inevitably include any error that they may make in the course of giving care. The conclusion that can be drawn is that nurses might be quite receptive to making constructive changes in their practice following an error, provided this situation is managed properly.

Humans↗

PubMed1998

Perception of causes of omissions in the assessment of patients with chest pain.

There is growing evidence that errors and omissions often occur in the nursing assessment and care of patients. As yet, the impact of audit has been insufficient to correct these deficiencies, possibly because audit does not primarily focus on the causes of deficiencies. The purpose of this study was to examine the perceived causes of omissions in the assessment of patients with chest pain and to compare these with omissions detected in an audit of the assessment records. The type of attributions nurses used to explain the causes of the omissions was also investigated. Following an audit of the assessment records of patients with chest pain, 88 nurses were invited to answer a 51-item questionnaire relating to the types of omissions which occurred in the assessment of patients with chest pain. The results showed a marked discrepancy between the frequency of reported omissions and those found in the assessment records. The most common causes of omissions reported by the nurses were patients' condition, work overload, lack of time, poor assessment documentation, not realizing that the assessment had not been fully carried out and different nurses being involved in the assessment of patients. Nurses overwhelmingly attributed the causes of omissions to external or environmental factors rather than internal ones such as lack of knowledge or fatigue, which have implications for the types of strategies that might be used to improve care.

Adult↗

PubMed1997

Learning from errors in nursing practice.

Little attention is paid to the issue of errors in nursing practice. Staff are reluctant to discuss or publicize them. However, as clinical audit and quality management become more important and established in the health service, there is now a greater need to investigate and monitor the incidence of errors. The purpose of this study was to examine the causes and consequences of errors as well as the potential for errors to initiate changes in practice. One hundred and twenty-nine nurses answered a 22-item questionnaire relating to an error they had made. Nurses reported that the most common causes of errors were lack of knowledge or information, work overload, stressful atmosphere and lack of support from senior staff. Nurses were found to have recourse to a number of coping strategies in the aftermath of the error. Accepting responsibility and planful problem-solving were found to lead to positive changes in practice, whereas distancing and self-controlling strategies were associated with defensive changes, particularly with a tendency not to divulge the error. The findings also showed that errors had the potential to effect learning. The study suggests the need for staff to be encouraged to accept responsibility for their error within the framework of support. Strategies should be developed so that errors can be managed in a more constructive manner.

Adaptation, Psychological↗