Study of Errors among Nursing Students

Ella Koren, Shoshana Goldberg, Ann Shinder-Nekhamkin, Lilit Traister, Shoshi Fridman, Sima Azuly, Rachel Sharabani

Abstract


The study of errors in the health system today is a topic of considerable interest aimed at reducing errors through analysis of the phenomenon and the conclusions reached. Errors that occur frequently among health professionals have also been observed among nursing students. True, in most cases they are actually “near errors,” but these could be a future indicator of therapeutic reality and the effect of nurses’ work environment on their personal performance. There are two different approaches to such errors: (a) The EPP (error prone person) approach lays full responsibility at the door of the individual involved in the error, whether a student, nurse, doctor, or pharmacist. According to this approach, handling consists purely in identifying and penalizing the guilty party. (b) The EPE (error prone environment) approach emphasizes the environment as a primary contributory factor to errors. The environment as an abstract concept includes components and processes of interpersonal communications, work relations, human engineering, workload, pressures, technical apparatus, and new technologies. The objective of the present study was to examine the role played by factors in and components of personal performance as compared to elements and features of the environment. The study was based on both of the aforementioned approaches, which, when combined, enable a comprehensive understanding of the phenomenon of errors among the student population as well as a comparison of factors contributing to human error and to error deriving from the environment. The theoretical basis of the study was a model that combined both approaches: one focusing on the individual and his or her personal performance and the other focusing on the work environment. The findings emphasize the work environment of health professionals as an EPE. However, errors could have been avoided by means of strict adherence to practical procedures. The authors examined error events in the administration of medication by nursing students during 1999-2006 using narrative analysis and the qualitative triangulation method. The findings result in a recommendation to reconsider the mode of approaching errors in educational processes, the handling of errors in the clinical field, and improvement of the safety climate. [Full text only in Hebrew]

Full Text:

PDF