AuthorBrittain, Angela Christine
AdvisorCarrington, Jane M.
MetadataShow full item record
PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction, presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractMillions of injuries and over 400,000 deaths occur yearly in the United States (US) from preventable errors (Classen, Griffin, & Berwick, 2017; James, 2013; Makary & Daniel, 2016). The cost of preventable errors has been estimated at roughly $20 billion per year and current statistics confirm that the US spends roughly double that of other high-income countries, despite comparable utilization rates (Papanicolas, Woskie, & Jha, 2018; Rodziewicz & Hipskind, 2019). Most mitigating efforts have been unsuccessfully applied at the bedside without regard for hospital organization complexity (Finn et al., 2018; James, 2013; Kobewka et al., 2017; Zhang et al., 2017). Given that hospitals represent complex systems with many interacting subsystems, an understanding of preventable errors as symptomology of underlying systemic factors is lacking (Begun, Zimmerman, & Dooley, 2003; Braithwaite, Wears, & Hollnagel, 2015; World Health Organization [WHO], 2009). The purpose of this research was to increase understanding of the perceptions of nurses and nursing leaders from magnet-designated and non-magnet-designated hospital organizations regarding what system-level events or circumstances may degrade hospital system health and compromise patient safety. This was underpinned by the Effective System-to-System Communication Framework, which was adapted from the Effective Nurse-to-Nurse Communication Framework and further informed by complexity theory (Capra & Luisi, 2014; Carrington, 2012a; Dekker, 2011; Karwowski, 2012). The sample was drawn magnet-designated and non-magnet designated hospitals in the US. Three staff nurses and three nursing leaders were recruited from magnet-designated hospitals and non-magnet designated hospitals for a total of 12 participants. Sampled participants were those whose work involves medical-surgical units or patients in their respective organizations. The interviews were transcribed verbatim and analyzed by thematic analysis, natural language processing, and the Goodwin statistic (Goodwin & Goodwin, 1985; LIWC.net, n.d.; Morse & Field, 1995).
Degree ProgramGraduate College