A major urban hospital is adopting the practices of high reliability organizations. Which behaviors indicate that nursing staff are incorporating these practices? (Select all that apply.)
1. Staff development trains all on algorithms created to address system errors.
2. Human resources prepares materials to use prior to issuing staff suspensions.
3. Nurse manager intercedes before an error with intravenous medication occurs.
4. Vice president of nursing meets with staff to learn ways to reduce the incidence of sharps occurrences.
5. Staff nurses analyze the steps that occurred to determine why a client had an adverse reaction in the operating room.
Correct Answer: 1, 3, 4, 5
High reliability organizations (HROs) are those that are able to sustain excellent safety records despite operating in very complex, hazardous environments where risk is high for injury to individuals and damage to equipment or environment. Healthcare organizations are modeling their systems after HROs in an effort to improve safety for patients and families. Key concepts of HROs include: sensitivity to operations; reluctance to simplify; preoccupation with failure; deference to expertise, and resilience. Learning algorithms supports resilience. Interceding before an intravenous medication error demonstrates sensitivity to operations. Meeting with staff to learn ways to reduce sharps occurrence demonstrates deference to expertise. Analyzing steps to determine why an adverse reaction occurred demonstrates reluctance to simplify. Preparing materials to use for staff suspensions does not support an HRO.
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