Nursing students' errors in clinical learning. Qualitative outcomes in Mixed Methods Research

Santos, Ana Paula Sousa

doi:10.1590/0034-7167-2018-0592

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Revista Brasileira de Enfermagem

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Brasil

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Sumário

ORIGINAL ARTICLE • Rev. Bras. Enferm. 72 (1) • Jan-Feb 2019 • https://doi.org/10.1590/0034-7167-2018-0592 copy

Nursing students' errors in clinical learning. Qualitative outcomes in Mixed Methods Research

Erros dos estudantes de enfermagem em aprendizagem clínica. Resultados qualitativos em investigação de métodos mistos

Errores de los estudiantes de enfermería en aprendizaje clínico. Resultados cualitativos en investigación de métodos mixtos

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze factors associated with nursing students' errors during clinical learning, and their perceptions regarding these events and the opportunity for learning and development provided by them.

Method:

Convergent Mixed Method design according Creswell and Clark. Qualitative dimension included face to face and internet interviews. Data analysis followed Miles and Huberman method.

Results:

Nursing student's errors were revealed according to their perceptions. They occurred in all phases of the nursing process and in transversal skills. Errors were acknowledged as learning and developmental opportunities.

Final considerations:

Students acknowledged their errors and ascribe to themselves reasons and what could have prevented what happened. Mixed Method was a very adequate design to study phenomena. Qualitative dimension was essential to reveal and achieve the objectives. Suggestions founded on the findings are presented.

Descriptors:
Nursing Research; Education, Nursing; Students, Nursing; Medical, Errors; Qualitative Research

Category	Subcat. 1	Subcat. 2	Subcat. 3	Unit of analysis	Place
Contributions to error	Student himself/herslfelf	Fadigue		"With the last patient with a vesical probe that I had, I associated with my exhaustion. During my internship I was all wrapped up emotionally.	E2-2: L62-64; 97-98
				"Above all it was tiredness. I was not able of more. [...] I was really tired [...]."	E2-5: L30 31; 37-38; 66-77

Category	Subcategory 1	Subcategory 2	Examples - students' words/report
Errors in Implementing Care	Implementation of the procedures according to respective standard.		[...] make a dressing in the wrong way. [...] disinfected the surgical wound in a reversed manner. (E2-15: L32; 35; 38-39)
	Rationale of the procedures in nursing care.		There were moments of lack of knowledge either in pathologies and medication. (E4-32: L10-11; 53)
	Carry out planned care in a timely manner.		Patient was half shift without food, there was no need for that. (E2-6: 158-159; 211-213)
Medication Errors			For example a patient had a medication at eight and at noon. A certain dose at eight and a certain dose at twelve and I switched doses. [...] The one at noon I gave at eight and the one at eight I gave at twelve. [...]. (E2-6: L14-16: 18-19; 27-28) I did not verify that I took a bottle of bicarbonate. I know the intention was to get distilled water. (E4-9: L4-6)
Error in Needs identification	Identification of the patient's needs through the clinical process.		So I went to check if that patient really had prescribed acetaminophen. She had but it was in SOS. I did not check the last administration. (E4-42: L50-55)
Error in Needs identification	Identification of patient's needs through observation.		I was still not very accustomed to the numbering of the bed, and instead of going to a patient, I went to the next one. (E4-29: L5; 7-8)
Errors in Transversal Skills	Performance independent of the mentor's guidance		The reasoning being slowed down, the hand not sure. Mentor must help. (E2-8: L106-107) [The error was] not asking mentor for help on find the artery. (E2-24: L73-74)
Errors in Care Planning	Definition of Nursing Diagnostics according patient's needs in his different dimensions	Priorities establishment	[...] upon arriving at the ward I went directly to the nursing room to obtain the necessary forms for admission. It was a great failure for me not to have gone to my patient immediately [...] I had failed because I did not set the right priority. (E2-12: L25-29; 34-35)
Errors in Care Planning		Lack of attendance to patient	I left patient alone in the shower [...]. (E2-11: L19-20; 22-23)
Errors in Care Evaluation	Elaboration of records with useful information continuity of care.		I evaluated it and did recorded it and she [mentor] asked, "if you have done it why didn't you recorded it?" What I observed or performed I did not record [...] It took me a lot of time to hit records. (E2-5: L168-170; 175; 179)

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[1] Corresponding Author Ana Paula Sousa Santos E-mail: ana.ps.santos@uac.pt