Health

New Instrument Examines Emotional Impact of Nursing Errors

By Cathy Cruise

While various systems for reporting medical errors are available to health care workers, a new instrument created by a George Mason University doctoral student explores the problem from a novel angle—by what role emotions play in error reporting.

Mason nursing professor Margaret Rodan with her PhD student Ellen Swartout review details of the survey instrument Swartout created. Photo by Evan Cantwell.

Mason nursing professor Margaret Rodan with her PhD student Ellen Swartout review details of the survey instrument Swartout created. Photo by Evan Cantwell.

Ellen Swartwout, a PhD in nursing administration candidate, has developed an instrument that measures the emotional response experienced by nurses after the discovery of an error in clinical practice. Collaborating with her doctoral committee chair Margaret Rodan, associate professor at George Mason’s School of Nursing and assistant dean for the master’s division, Swartwout created an online survey that asks respondents to recall a work-related error and relate their emotional response to it.

“Ellen’s work is about the astonishment where a nurse realizes a mistake and then has this disbelief, this anxiety and fear,” Rodan says. Swartwout’s survey was sent in the fall to more than 8,000 nurses in Maryland; Washington, D.C.; and Virginia. It focuses on five domains of response: disbelief, anxiety, fear, shame, and guilt, and solicits information on disclosures and colleague support.

Most mistakes involve medication dosing, followed by procedural, transcription, communication, and patient identification errors. According to the research, Swartwout says, about half of these errors are never reported.

“Historically, there’s been a culture of silence and blame around errors,” she says. “But if we don’t know about mistakes, we can’t learn from them. We have to get to the root of why they occur and decide how to fix the system so they don’t happen again.”

Swartwout was selected for a research seed grant from the American Organization of Nurse Executives (AONE) for her dissertation study. She will be awarded the grant at the AONE national conference in March.

Although Swartwout created the error-reporting instrument for her dissertation fulfillment, she envisions the tool one day being used in actual practice. Data on the survey were collected from November 2012 through February. Swartwout plans to compile the full results by spring 2013.

This article originally appeared in a slightly different form in Dimensions, the magazine of the College of Health and Human Services.

To read more stories about Mason, check out the university’s News site.

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