ABSTRACT
Frontline nurses encounter operational failures (OFs), or breakdowns in system processes, that hinder care, erode quality, and threaten patient safety. Previous research has relied on external observers to identify OFs; nurses have been passive participants in the identification of system failures that impede their ability to deliver safe and effective care. To better understand frontline nurses' direct experiences with OFs in hospitals, we conducted a multi-site study within a national research network to describe the rate and categories of OFs detected by nurses as they provided direct patient care. Data were collected by 774 nurses working in 67 adult and pediatric medical-surgical units in 23 hospitals. Nurses systematically recorded data about OFs encountered during 10 work shifts over a 20-day period. In total, nurses reported 27,298 OFs over 4,497 shifts, a rate of 6.07 OFs per shift. The highest rate of failures occurred in the category of Equipment/Supplies, and the lowest rate occurred in the category of Physical Unit/Layout. No differences in OF rate were detected based on hospital size, teaching status, or unit type. Given the scale of this study, we conclude that OFs are frequent and varied across system processes, and that organizations may readily obtain crucial information about OFs from frontline nurses. Nurses' detection of OFs could provide organizations with rich, real-time information about system operations to improve organizational reliability. © 2017 Wiley Periodicals, Inc.
Subject(s)
Efficiency, Organizational , Equipment Failure/statistics & numerical data , Nursing Staff, Hospital/organization & administration , Quality Improvement , Critical Care , Cross-Sectional Studies , Humans , Medical-Surgical Nursing/organization & administration , Nurses , Nursing Staff, Hospital/education , Patient Safety , Prospective StudiesABSTRACT
The present study tested whether knowledge of a common source of conflicting visual-haptic stimulation promotes intersensory integration. 40 undergraduates manually felt the size of a square while viewing it through a lens that minified its visual size by half. Participants, however, could experience the haptic and the visual stimulation as emanating from either a common source or different sources. Their subsequent matches of the perceived size were biased by the felt size of the square, irrespective of whether they experienced the intersensory stimulation as coming from one or two sources. These results strengthen previous findings suggesting that the integration of sensory discordant information depends on bottom-up rather than on top-down processes.
