Study: Reluctance to Speak Up Encourages Medical
TUESDAY, March 22 (HealthDay News) -- Nurses often don't speak
up about incompetent colleagues or when they see fellow health-care
workers making mistakes that could harm patients, new research
In recent years, many hospitals have taken steps to reduce
medical errors through measures such as checklists, patient handoff
protocols, computerized order entry systems and automated
But the study, which included 6,500 nurses and nurse managers
across the United States, found that too often, nurses don't alert
their colleagues when they see a safety measure being violated.
About 85 percent of nurses said a safety measure had warned them
about a problem that might have been missed and could have resulted
in patient harm. However, 58 percent of these workers admitted that
even though they received the warning, they failed to speak up and
solve the problem.
More than 80 percent of nurses said they had concerns about
three "undiscussable" issues demonstrated by colleagues: dangerous
shortcuts, incompetence and disrespect, the investigators
On the issue of shortcuts, more than 50 percent of the study
participants said they had witnessed events in which dangerous
shortcuts led to near misses or caused harm to patients, but only
17 percent of those nurses discussed their concerns with
The study also found that more than one-third of participants
reported witnessing incompetence that had led to a near miss or
actual harm to a patient, but only 11 percent of these witnesses
confronted the colleague that they considered incompetent.
The third "undiscussable" issue, disrespect, was cited as the
reason why more than half of the study participants could not get
others to listen to them or value their professional opinion. Only
16 percent of those who felt ignored actually confronted their
disrespectful colleague, the study noted.
The findings show that while safety measures can help prevent
medical errors, cultures of silence in U.S. hospitals may undermine
their effectiveness, the researchers noted.
"The report confirms that tools don't create safety; people do. Safety tools will never compensate for communication failures in the hospital," David Maxfield, vice president of research at VitalSmarts and lead researcher of the study, said in a news release from the American Association of Critical-Care Nurses.
The American Association of Critical-Care Nurses and the
Association of periOperative Registered Nurses partnered with
VitalSmarts, a corporate training and organizational performance
consulting firm, in an attempt to see how communication barriers
can lead to medical errors.
The study, "The Silent Treatment," was to be released March
Because this study was presented at a briefing, the data and
conclusions should be viewed as preliminary until published in a
The U.S. Centers for Disease Control and Prevention offers
patient safety tips.
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