Strategies used by critical care nurses to identify, interrupt, and correct medical errors.
BACKGROUND
Medical errors are common in intensive care units. Nurses are uniquely positioned to identify, interrupt, and correct medical errors and to minimize preventable adverse outcomes. Nurses are increasingly recognized as playing a role in reducing medical errors, but only recently have their error-recovery strategies been described.


OBJECTIVE
To describe error-recovery strategies used by critical care nurses.


METHODS
Data were collected by audio taping focus groups with 20 nurses from 5 critical care units at 2 urban university medical centers and 2 community hospitals on the East and West coasts of the United States. Transcript content was analyzed as recommended by Krueger and Casey.


RESULTS
Analysis of focus group data revealed that nurses in critical care settings use 17 strategies to identify, interrupt, and correct errors. Nurses used 8 strategies to identify errors: knowing the patient, knowing the "players," knowing the plan of care, surveillance, knowing policy/procedure, double-checking, using systematic processes, and questioning. Nurses used 3 strategies to interrupt errors: offering assistance, clarifying, and verbally interrupting. Nurses used 6 strategies to correct errors: persevering, being physically present, reviewing or confirming the plan of care, offering options, referencing standards or experts, and involving another nurse or physician.


CONCLUSIONS
These results reflect the pivotal role that critical care nurses play in the recovery of medical errors and ensuring patient safety. Several error-recovery strategies identified in this study were also reported by emergency nurses, providing further empirical support for nurses' role in the recovery of medical errors as proposed in the Eindhoven model.
School of Nursing, University of Massachusetts, Amherst, MA, USA. Bethann953@aol.com
Elizabeth A
EA
Henneman
Anna
A
Gawlinski
Fidela S
FS
Blank
Philip L
PL
Henneman
Deovina
D
Jordan
Janice B
JB
McKenzie
D000046:Academic Medical Centers; D003422:Critical Care; D017144:Focus Groups; D006764:Hospitals, Community; D006801:Humans; D019300:Medical Errors / Q000517:prevention & control*; D024802:Nurse's Role; D009732:Nursing Care / Q000379:methods*; D009741:Nursing Staff, Hospital; D013637:Tape Recording; D014481:United States