Identification and assessment of nursing task errors in emergency department using SHERPA technique and offering remedial strategies

Background: Improving health care quality is a global concern, and providing patients with safe healthcare is a WHO Patient Safety priority. The technological revolution in health services has highlighted the role of human factors in committing such errors, and since the number of medical errors, including nursing errors, increases on a daily basis. Objectives: This research aimed to identify the causes of Nursing Task Errors in Emergency Department Using SHERPA Technique and adopt strategies to prevent and reduce them. Participants were 47 nurses (24 women and 23 men), who worked morning, evening and night shifts. The nurses were taught the methodology and talked about the objective of the study; they were then interviewed and observed for six months while working. This way, their tasks and subtasks were demarcated and the Hierarchical Task Analysis (HTA) was performed. SHERPA Error Mode Checklist was used to identify errors and their various types and then risk assessment was conducted. Results: A total of 45 tasks, 234 subtasks, and 326 errors in regard to nursing activities were identified in the emergency department, with the highest frequency for action errors (61.34%) and the lowest for communication errors (1.84%). Also, there were 7.24 errors per task. The highest and lowest number of errors were at the 'unfavorable' (19.07%) and,'acceptable (safe)' (6.15%) risk levels, respectively. Based on the finding staff training, workload elimination,work process modification and updating guidelines are recommended. Conclusion: The results of present study were also submitted to the University Medical Executive management Committee to make individual, educational and organizational reforms (guidelines and instructions) in order to optimize the situation.