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

Full 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.

Author information

Author/s: Jirapaet, Veena (V); Jirapaet, Kriangsak (K); Sopajaree, Chompunut (C);

Affiliation: Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand. jveena(-atsign-)chula.ac.th

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG (J Obstet Gynecol Neonatal Nurs), published in United States. (Language: eng)

Reference: -2006 Nov-Dec; vol 35 (issue 6) : pp 746-54

Dates: Created 2006/11/19; Completed 2006/12/29;

PMID: 17105639, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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