Research Chronicle, 2006 - School of Nursing - University of North ...

Funding the Future of Nursing Research:
Doctoral Student Grants
The School of Nursing (SON) doctoral students had a banner year for
funding awards. Support for the studies comes from a variety of
places – the American Nurses Foundation, Aspect Medical, Inc., the
National Institute of Nursing Research, National Institutes of Health
Study On When Medication Errors Occur Yields Interesting Results
As many as 98,000 people die in U.S. hospitals each year due to
medical errors, according to the 2000 report from the Institute of
Medicine, “To Err is Human: Building a Safer Health System.” Two
out of every 100 hospital admissions experiences a medicationrelated
mistake, the report’s results also state, and these medication
errors account for roughly 7,000 error-related deaths annually.
Protecting patients’ safety is a high priority. Yun Kyung Chang,
PhD, MPH, a recent doctoral graduate, conducted an American
Nurses Foundation-funded study on the circumstances that lead
nurses to identify and report medical errors.
Accurate identification and reporting of errors is essential to
improving care systems and reducing future errors. Chang found
that more medication errors were reported in work environments
where nurses believed they could admit their mistakes without fear
than in those workplaces where they faced reprisal. Medication
errors also were reported more frequently in work environments
where nurses faced fewer distractions.
“Rather than just seeing underreporting of errors when nurses
keep their mistakes secret, I believe we are seeing underdetection
where nurses can’t report a mistake because they aren’t aware
they’ve made one,” Chang said. “Substantial underdetection could
be possible when nurses are working in busy, stressful environments.
This is something we need to monitor.”
Chang analyzed data from the Outcomes Research in Nursing
Project (ORNA-II), a study funded by the NINR, NIH that identifies
critical hospital and nursing unit variables that must be considered
when organizing and delivering care. The information collected
comes from 286 nursing units in 146 randomly selected JCAHOaccredited
hospitals across the country. SON faculty member
Barbara Mark, PhD, RN, FAAN, is the principal investigator on the
ORNA-II project.
(NINR, NIH), the American Association of Critical Care Nurses, Sigma
Theta Tau, and the Center for Innovation in Health Disparities
Research (CIHDR). This plethora of grants funds work in intensive
care, palliative care, cancer care and medication error research.
The findings are important,
Chang said, because they highlight
the need to rethink how medication
errors are classified and measured
and the need to develop better
reporting systems. With new
classifications and measurements in
place, there can be better analysis of
the causes of and factors related to
medication mistakes.
Chang blended portions of two
different theoretical models, the human error model and the
organizational learning model, for her study. The human error
model focuses on fixing systems that both permit mistakes and
make them more difficult to detect and correct. The organizational
learning model concentrates on managing mistakes after they
happen, and a part of this model looks at the learning climate.
Chang integrated part of the organizational learning model with the
human error model to create a new model that tests the role the
learning environment plays in the relationship between work
environment and medication errors.
Assessing How Women Live Based on Their
Perceived Risk of Breast Cancer
SON doctoral student, Denise Spector, BS, MS, MPH, is looking
at how white and African American women with close female
relatives who have breast cancer view their own risk for the
disease. She is also studying what, if any, lifestyle behavior
changes they make to potentially reduce their risk. Her work is
described in greater detail on page 13.
THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL SCHOOL OF NURSING
RESEARCH CHRONICLE 2006–2007
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