Human error risk assessment of clinical care in emergency department with SHERPA approach and nurses safety climate analysis

Human errors have great connection with patient's health and safety in clinical centers. Emergency departments of clinical centers can be deeply effected by human errors due to the importance and speciefity of the clinical process. This study was performed for assessment clinical care related human errors with SHERPA approach and its possible connection with nurse's safety climate.

The study performed on 100 nurses who served in two emergency departments of hospital and also all other departments which the nurses had the major of their experience in emergency department. A standard Safety attitude questionnaire was used for assessment of nurse's affective criteria on human errors rate. All clinical care processes were investigated for imprinting human errors by SHERPA approach and HTA method. All results were analysed by SPSS software.

The results for human error identification and risk assessment by SHERPA approach was depicted for total 10 major processes and 88 major tasks, 610 errors could possibly affect the clinical care program quality and also patients and nurses. Performing drug orders with 148 (24%) was the major emergency department's process. The major types of identified errors were performance errors with 355 errors (58%). The numbers of checking errors were 129 (21%), the identified errors on communication were 54 (9%), the errors on selection were 49 (8%) and finaly, errors on fixing the problems (recovery errors) were 23 (4%). After determining the number and types of identified errors, risk priority number was calculated with stimation of occurance and severity of each risk. The risults demonstrated that from total identified errors, 144 errors (24%) were unacceptable, 194 errors were undesirable, 178 errors (29%) were minor errors with minimum correction needed and there were 94 errors (15%) with no consequences. The results of safety climate questionnaire showed that communication between nurses in clinical centers depends on age, job duration and gender (P-Value < 0.05). Comunication with physicians also depens on gender and job duration (P-Value < 0.05) and the results for nurses safety climate investigation demonstrated that parametrs such as knowledge and communicating with supervisors have most influence for domination of positive safety climate in clinicals centers and hospitals.

Preventing medical errors is a crucial part of ensuring quality patient care. Errors in clinical care and rehabilitation procedures have particular significance in ensuring quality care and patient safety