Incidents related to nursing and their main background factors

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Purpose and methods :A mail survey was conducted to understand medical incidents from the viewpoint of living conditions based on patients' basic desires, and investigate the background factors contributing to individual cases. Subjects were nurses at 154 university hospitals nationwide (Study 1) and students at 35 nursing schools (Study 2). The incidents/accidents were measured by 37 nursing items for one month starting on September 1, 2001 for Study 1, and 30 items in the practical training period (6-7 months) for Study 2.Results:Study 1 had 5,304 valid responses (from 78 hospitals), of which 5.2% reported incidents and 0.98% accidents. High frequency items included "Inadvertently speaking louder than necessary when treating patients in a shared room" (22.9%), "worry about an examination cart that rolls noisily" (21.5%), and "shining a flashlight in patients' faces on night rounds" (15.4%). The incidents/accidents occurred on the day shift in 64.3% of cases, late night in 24.0%, and evening in 10.1%. Study 2 had 1,176 valid responses (30 schools). Common incidents/accidents were "inappropriate water temperature in sponge baths" (42.4%), "incomplete sterilization" (39.7%), "forgetting to replace bed rail after changing patients' positions" (37.7%), and "the mercury column falling over on the bed during blood pressure measurement" (37.7%). In Study 1, those with a high risk of causing an accident were those who did not really consider the meaning of their nursing actions ; who had a rough, impatient, or irritable personality ; who were inexperienced ; and who worked in internal medicine, and in Study 2 those who did not really consider the meaning of their nursing actions or had a rough personality.Discussion :Personality was related to incidents/accidents, and it is suggested that incorporating activities to help students understand their own personalities and act carefully would be effective in preventing medical accidents