Abstract
M.Cur. (Nursing Science)
The purpose of the research study was to explore and describe the experiences of critical care nurses working in adult critical care units of a private hospital in Gauteng, following their involvement in a sentinel event. This information could enable the researcher to formulate guidelines for support of these nurses. Health care professionals aim to deliver safe, high quality care, but unfortunately, all humans can, and do make mistakes (Wakefield, 2007: 12). Since the report To err is human was released by The Institution of Medicine at Havard University (Kohn, Corrigen & Donaldson,1999), more authors have concluded that it is human to make mistakes (Erasmus, 2008:5). Mistakes in the nursing environment can be seen as sentinel events which could result in unintended harm to the patient (Muller, Bezuidenhout & Jooste, 2006:456). Sentinel events in health care, could lead to the devastating concepts of negligence, malpractice, or unprofessional practice, as nurses are held accountable for their acts and omissions according to Erasmus (2008: 5-6).
The following research questions emerged:
What are the experiences of critical care nurses, following their involvement in a sentinel event, which harmed, or could have resulted in unintended harm to the patient?
What guidelines for support of these nurses could be formulated?
This study was planned in two phases and the objectives of the study were:
Phase 1: To explore and describe the lived experiences of nurses, working in the adult critical care units in a private hospital in Gauteng, following their involvement in a sentinel event, which harmed, or could have resulted in unintended harm to the patient.
Phase 2: To formulate guidelines for support of these nurses, following their involvement in a sentinel event.
A qualitative, exploratory, descriptive and contextual phenomenological research design was used to gain more information regarding critical care nurses` lived experiences, following their involvement in a sentinel event. The study was done in two adult critical care units, in a private hospital in Gauteng. Data was collected by means of six individual in - depth interviews and three naive sketches. Data analysis was done according to Tesch`s open-coding qualitative data analysis method (Creswell, 2007:156).
Two main categories emerged from the data, namely the nurses` experiences following their involvement in a sentinel event and the recommendations towards guidelines for support of these nurses. The first main category was sub categorized as being personal, emotional, social and professional experiences and were found as being positive, as well as negative experiences. In the second main category, recommendations towards guidelines for support of nurses, following their involvement in a sentinel event, were proposed and these recommendations were sub- categorised as being at a personal, professional and organizational level of the nurse.
In view of the findings of this study, the recommended guidelines for support of nurses, following their involvement in a sentinel event included communication, debriefing, in-service training, root cause analysis and organizational support. Consequently, the intent should be to implement these proposed guidelines for support in the hospital under study. If nurses were supported to follow these guidelines, it may help the nurses who had been involved in a sentinel event, to restore their strive for wholeness in body mind and spirit (University of Johannesburg, 2009:1) and these nurses could be able to render holistic nursing care.