Recent Research About Nursing, February 2012

New studies identify 10 clinical reasoning practices that nurses use to prevent medical errors, and link nurses' long working hours and physical inactivity on the job to obesity.

    • February 26, 2012

How Nurses Think Their Way Clear of Medical Errors

A study in the January 2012 issue of Qualitative Health Research identifies 10 clinical reasoning practices and processes that nurses use to successfully prevent medication errors. The study was conducted by a grantee of the Interdisciplinary Nursing Quality Research Initiative (INQRI), which is funded by the Robert Wood Johnson Foundation.

The study’s authors are Geri Dickson, PhD, RN, founder and executive director of the New Jersey Collaborating Center for Nursing at the Rutgers College of Nursing, and Linda Flynn, PhD, RN, FAAN, professor and associate dean for graduate nursing education at Rutgers. They based their findings on interviews with 50 staff nurses working in medical-surgical units. They identified six categories of patient-focused medication safety practices, and four categories of safety practices that related to managing nurses’ work environment. The 10 categories are: educating patients about the medication prescribed for them; taking into consideration all factors related to the patient, including age, weight, other medications, vital signs and more, to be certain that a particular medication is appropriately prescribed; advocating for patients with the pharmacy; coordinating care with physicians; independently reconciling medications with patients’ records; verifying medications and doses with colleagues; coping with interruptions and distractions; interpreting physicians’ orders; documenting near misses; and communicating openly with physicians, pharmacists and other team members.

“Nurses and patients, working together, are the best line of defense to prevent medication errors from reaching the patient,” Flynn said. “By ensuring that their patients know what medication they’re receiving, in which doses and why, nurses not only empower and inform their patients, they involve them in the health care process and their own care. When patients ask questions about changes in medication dosages or mention that they’ve never been given a particular medication before, it can raise a red flag for the nurse to double-check charts and records, and to check in with her or his physician and pharmacist colleagues.”

Nurses’ Long Hours Contribute to Obesity

Nurses working long hours at jobs that are not physically demanding are considerably more likely to become obese than other nurses, according to a new study from a nurse-led team of researchers.

Together with colleagues, Kihye Han, PhD, RN, a postdoctoral fellow at the University of Maryland School of Nursing, examined data from more than 2,100 female nurses. Relying on estimates of body mass index, the researchers found that about 55 percent of the nurses were obese. Correlating the obesity findings with data about the nurses’ descriptions of their jobs, they concluded that “longer work hours and jobs with lower physical exertion and more limited movement were significantly associated with” obesity. The findings were published in the Journal of Nursing Administration.

“Long work hours and shift work adversely affect quantity and quality of sleep,” Han explained, “which often interferes with adherence to healthy behavior and increases obesity…. Considering that more than half of nurses are overweight or obese, increasing availability of healthy food and providing sufficient time to consume it may reduce the risk of obesity and future health problems.”

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