title: Is There Light? Well It Depends--A Grounded Theory Study of Nurses, Lighting, and Medication Administration.
abstract: OBJECTIVE
  We know that human vision has limitations, medication administration is a high-risk activity, and some nurses work in environments that do not meet recommended lighting standards. The goal of this study was to inform safe medication administration practices and add evidence for establishing guidelines for lighting decisions by understanding registered nurses' (RNs') decision making about lighting during medication administration.
  
  
  METHODS
  Grounded theory methodology was followed (n = 16). Theoretical sampling was used to ensure that participants represented a variety of backgrounds and hospital settings. Results were validated by three expert researchers. Two of the researchers had significant expertise in medication administration errors.
  
  
  RESULTS
  Data analysis culminated in the substantive theory It Depends. This theory describes a process of frequently automatic decision making about lighting, whose aspects include assessing variation, balancing safety and healing, and RN bias. All RNs expressed concerns about perceived risks in relation to lighting, but had difficulty describing how they confirmed when the correct decision about lighting was made.
  
  
  CONCLUSIONS
  Nurses are often unaware of their reasons for lighting decisions, and there is a need for education and other measures to increase the likelihood that lighting decisions that enhance patient safety are made by nurses.
authors.affiliation: National Center for Cognitive Informatics and Decision Making in Healthcare, University of Texas Health Science Center, Houston School of Biomedical Informatics, Houston, TX.
authors.forename: Krisanne
authors.initials: K
authors.lastname: Graves
authors.affiliation: College of Nursing, Texas Woman's University, Houston, TX.
authors.forename: Lene
authors.initials: L
authors.lastname: Symes
authors.affiliation: College of Nursing, Texas Woman's University, Houston, TX.
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Cesario
authors.affiliation: College of Nursing, Texas Woman's University, Houston, TX.
authors.forename: Ann
authors.initials: A
authors.lastname: Malecha
mesh_terms: D000328:Adult; D000368:Aged; D066296:Grounded Theory; D006801:Humans; D008029:Lighting / Q000009:adverse effects / Q000592:standards*; D008509:Medication Systems / Q000592:standards*; D008875:Middle Aged; D016602:Needlestick Injuries / Q000517:prevention & control / Q000523:psychology; D009726:Nurses / Q000523:psychology / Q000592:standards*; D061214:Patient Safety / Q000592:standards; D013781:Texas
keywords: Automatic mode; decision making; lighting; medication administration; patient safety