Occupational Stress and Cognitive Failure of Nurses in Clinical Errors in the Teaching Hospitals Affiliated to Iran University of Medical Sciences

Nurses are exposed to significant occupational stress compared to other healthcare professionals, which predisposes them to the risk of cognitive failure and the incidence of clinical errors. The present study aimed to assess the correlation of occupational stress and cognitive failure in the incidence of clinical errors among nurses. This cross-sectional study was conducted on 367 nurses at eight hospitals in Tehran, Iran in 2017. The participants were full-time nurses employed in the selected hospitals with more than six months of clinical experience. Demographic data of the participants were collected, and the scores of occupational stress and cognitive failure and frequency of medical errors were determined using self-administered questionnaires. Moreover, a binary logistic regression model was applied to verify the influential factors in the incidents associated with patient safety among the nurses. In total, there were 367 valid responses, and 19.61% of the nurses had experienced clinical errors. Mean total scores of occupational stress and cognitive failure were 3.48 and 1.98, respectively. According to the binary logistic regression analysis, the most important influential factors in the incidence of clinical errors were the received wages (odds ratio [OR]=0.066), clinical experience (OR=2.114), cognitive failure (OR=3.897), duty-related stressors (OR=2.837), and interpersonal relations associated with stressors (OR=0.340). According to the results, the incidence of clinical errors was influenced by cognitive failure, occupational stress, received wages, and clinical experience. Therefore it is recommended that hospital managers retire the nurses with higher clinical experience and recruit younger nursing staff. In addition, nursing managers should develop and apply appropriate policies and strategies to reduce occupational stress, which in turn diminishes the incidence of clinical errors