Recognising and responding to 'cutting corners' when providing nursing care: a qualitative study.
OBJECTIVE
The aim of this study is to report on a key finding of a larger study investigating the 'gaps' in patient care that registered nurses encounter during the course of their practice. A key finding of this larger study was that 'cutting corners' was a gap discerned by nurses.


BACKGROUND
'Cutting corners' has been characterised as a 'violation' and threat to patient safety, although there is a paucity of research on this issue.


METHODS
Naturalistic inquiry using a qualitative exploratory descriptive approach.


METHODS
Data were collected from a purposeful sample of 71 registered nurses from emergency department, critical care, perioperative, rehabilitation and transitional care and neurosciences settings in Australia and analysed using content and thematic analysis strategies.


RESULTS
Cutting corners was a common practice that encompassed (1) the partial or complete omission of patient care, (2) delays in providing care and (3) the failure to do things correctly. Corners were cut in patient assessment, essential nursing care, the care of central venous catheters and medication administration. The practice of cutting corners was perceived as contributing to preventable adverse events.


CONCLUSIONS
The study found that cutting corners created gaps that contributed to unfinished nursing care and preventable adverse events. The findings of the study raise the possibility that cutting corners is a salient but underinvestigated characteristic of nursing practice. Further research and inquiry are needed to deepen understanding of cutting corners and its impact on patient safety.


CONCLUSIONS
Identifying the nature and implications of cutting corners when providing nursing care is an important contributing factor to improving patient safety and quality care.
School of Nursing and Midwifery, Deakin University, Geelong, Vic., Australia.
Angela
A
Jones
School of Nursing and Midwifery, Deakin University, Geelong, Vic., Australia.
Megan-Jane
MJ
Johnstone
School of Nursing and Midwifery, Deakin University, Geelong, Vic., Australia.
Maxine
M
Duke
D001315:Australia; D004636:Emergency Service, Hospital; D019983:Guideline Adherence; D006801:Humans; D061214:Patient Safety; D057184:Practice Patterns, Nurses'; D036301:Qualitative Research; D011787:Quality of Health Care
cutting corners; discontinuities in care; human factors; nurses; patient safety; violations