@article{ref1,
title="Nurse sensemaking for responding to patient and family safety concerns",
journal="Nursing research",
year="2020",
author="Groves, Patricia S. and Bunch, Jacinda L. and Cannava, Kaitlin E. and Sabadosa, Kathryn A. and Williams, Janet K.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Hospitals need to prevent, respond to, and learn from safety risks and  events perceived by patients and families, who in turn rely on nurses to respond to  and report their safety concerns. <br><br>OBJECTIVES: To describe the process by which  bedside nurses evaluate and determine the appropriate response to safety concerns  expressed by patients or their families. <br><br>METHODS: A qualitative design was employed. We recruited inpatient bedside nurses in an 811-bed Midwest academic medical center. Nurses provided demographic information and participated in semistructured  interviews designed to elicit narratives related to evaluation and response to  patient- or family-expressed safety concerns. Data analysis and interpretation were  guided by grounded theory. <br><br>RESULTS: We enrolled 25 nurses representing 22 units. Based on these nurses' experiences, we developed a grounded theory explaining how  nurses evaluate a patient or family safety concern. Nurses make sense of the  patient's or family's safety concern in order to take action. Achieving this goal  requires evaluation of the meaningfulness and reasonableness of the concern, as well  as the potential effect of the concern on the patient. Based on this nursing  evaluation, nurses respond in ways designed to (a) manage emotions, (b) immediately  resolve concerns, (c) involve other team members, and (d) address fear or uncertain  grounding in reality. Nurses reported routinely handling safety concerns at the  bedside without use of incident reporting. <br><br>DISCUSSION: Safety requires an  interpersonal and evaluative nursing process with actions responsive to patient and  family concerns. Safety interventions designed to be used by nurses should be  developed with the dynamic, cognitive, sensemaking nature of nurses' routine safety  work in mind. Being sensitive to the vulnerability of patients, respecting patient  and family input, and understanding the consequences of dismissing patient and  family safety concerns is critical to making sense of the situation and taking  appropriate action to maintain safety. Measuring patient safety or planning  improvement based on patient or family expression of safety concerns would be a  difficult undertaking using only standard approaches. A more complex approach  incorporating direct patient engagement in data collection is necessary to gain a  complete safety picture.<p /> <p>Language: en</p>",
language="en",
issn="0029-6562",
doi="10.1097/NNR.0000000000000487",
url="http://dx.doi.org/10.1097/NNR.0000000000000487"
}