Nurses' recognition and response to unsafe practice by their peers: A qualitative descriptive analysis

Abstract

Background: Unsafe practice is an important issue for the nursing profession however few studies have sought to identify how nurses recognise and respond to unsafe practice.

Objectives: To identify the behaviours and cues that registered nurses recognise as indications of unsafe practice, perceived factors that contribute to unsafe practice and action nurses take in response.

Design: Qualitative descriptive study.

Settings: New Zealand health care settings.

Participants: New Zealand registered Nurses (n = 13).

Methods: Data were collected via semi-structured interviews and analysis was conducted using constant-comparative and thematic analysis.

Results: Nurses identified a range of behaviours, cues, contributing factors and responses to unsafe practice. Three themes emerged from the data: Uncertainty, 'sensing' unsafe practice and disrupted professionalism.

Conclusion: Understanding the challenges nurses face every day in recognising and responding to unsafe practice in increasingly complex nursing contexts is key to understanding how unsafe practice may be further addressed in clinical practice. Nurses in this study recognised overtly unsafe behaviour and subtle cues as indications of unsafe practice. Participants also identified factors which they perceived contributed to the occurrence of unsafe practice including high workloads and poor skill mix as well as organisational cultures that failed to support safe practice.

Keywords: Behaviours; Cues; Recognition; Reporting; Response; Unsafe practice.