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J Obstet Gynecol Neonatal Nurs. 2006 Nov-Dec;35(6):746-54.

The nurses' experience of barriers to safe practice in the neonatal intensive care unit in Thailand.

Author information

  • 1Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand. jveena@chula.ac.th

Abstract

OBJECTIVE:

To describe barriers nurses experienced in providing safe practice in the neonatal intensive care unit and to investigate area of errors commonly affected when nurses confronted the barriers.

DESIGN:

Qualitative descriptive method.

SETTING:

Randomly selected 4 large neonatal intensive care units in Thailand.

PARTICIPANTS:

Twenty-seven neonatal intensive care unit nurses.

MAIN OUTCOME MEASURES:

A semistructured interview of the nurses' experience of neonatal intensive care unit error, factors forming barriers to safe practice, and neonatal outcome.

RESULTS:

Of 245 error events, neonates were identified to suffer 126 (55.5%) adverse events. Five themes emerged as common factors obstructing nurses from incorporating safety processes into their caring roles: human susceptibility to error, system operating care weakness, problematic medical devices, poor team communication, and situational provocation. Multiple barriers were largely associated with understaffing, a sudden increase in patient acuity, multiple assignments, and an inadequate knowledge of safety in neonatal critical care, which often interacted and influenced their performance when processed to a single error occurrence.

CONCLUSION:

A focus on management of the potential barriers in a system-related human error approach could prevent and intercept future errors in this vulnerable population.

PMID:
17105639
[PubMed - indexed for MEDLINE]
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