Demystifying the experience of participating in a root cause analysis: A hermeneutic phenomenological study

Appl Nurs Res. 2023 Dec:74:151746. doi: 10.1016/j.apnr.2023.151746. Epub 2023 Oct 26.

Abstract

Aim: This study aimed to explore registered nurses' experience participating in a root cause analysis (RCA) meeting because of their involvement in an adverse event.

Background: An RCA is the most common strategy used by organizations for adverse event investigations. Nursing healthcare professionals directly involved in an adverse event may be asked to participate in the RCA. However, no studies were found in the literature on their experience.

Methods: Semi-structured audio-taped interviews were held with 13 registered nurses who participated in an RCA. Ricoeur's hermeneutic phenomenology guided data analysis.

Results: Two structural elements represented the world of the nurses: 1) Learning about an RCA, and 2) being on the other side of the RCA table. Three phenomenological themes emerged: 1) anticipatory and embodied fear, 2) to speak or not to speak, 3) the aftermath.

Conclusion: Nurses desire RCA education to assist in understanding and support from nurse leaders throughout the process. Healthcare organizations must create a safe and collaborative environment to empower nurses to speak up and have their voices heard during the RCA process.

Implications for nursing leaders: Nurses want to participate in RCA meetings. However, leaders must demystify the RCA process for nurses through education and training.

Keywords: Adverse event; Patient safety investigation; Root cause analysis; Second victim.

MeSH terms

  • Attitude of Health Personnel
  • Health Personnel
  • Hermeneutics
  • Humans
  • Nurses*