NR 360 CU Workarounds and Their Implications for Patient Safety Essay
- What is a workaround? Identify a workaround (specific to technology used in a hospital setting) that you have used or perhaps seen someone else use, and analyze why you feel this risk-taking behavior was chosen over behavior that conforms to a safety culture. What are the risks? Are there benefits? Why or why not?
- Discuss the current patient safety characteristics used by your current workplace or clinical site. Identify at least three aspects of your workplace or clinical environment that need to be changed with regard to patient safety (including confidentiality), and then suggest strategies for change.
A workaround refers to a temporary fix, or a bypass, of a problem. In other words, it is a way of making something work without completely solving it. A workaround is not always the best or most ethical solution to a problem, and it usually requires you to not follow protocol. McGonigle and Mastrian (2018) described workarounds as risky behaviors.
An example given by Seaman and Erlen (2015) explained that a nurse needed to draw labs on a patient but was not able to print the specimen labels with their user-ID. This nurse’s workaround was to get another nurse to print the labels using their user-ID instead, even though this other nurse was not the one drawing the labs on the patient. Although the patient’s nurse felt uncomfortable doing this, they felt that they had no choice because IT was taking too long to fix the problem, and those labs needed to be drawn as soon as possible.
In the example provided, I feel that this risk-taking behavior was chosen because the nurse was more concerned with getting the labs drawn in a timely matter, rather than having another nurse’s name on the specimens. In this scenario, I feel that the benefit (getting the labs drawn as soon as possible) outweighed the risks, and the nurse only did it with the patient’s best outcome in mind, even though it is not the right thing to do.
I have not started clinicals yet, therefore I cannot discuss patient safety characteristics that I have seen first-hand, but I gathered another example from my research. McGonigle and Mastrian (2018) provided an example where a nurse takes off a patient’s identification wristband and attaches it to the bed instead. The reason for doing this was that the barcode scanner was having a hard time reading the armband on the patient’s small wrist. I feel that this scenario shows a very unsafe workaround because there is a lot of room for error here. The patient might get their bed switched, and the nurse can be giving medications to the wrong patient. A patient armband should always be on the patient’s arm for safety reasons, and I feel that this workaround is completely unacceptable.
Thank you for reading!
McGonigle, D. & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning.
Seaman, J. B., & Erlen, J. A. (2015). Workarounds in the Workplace: A Second Look. Orthopedic nursing, 34(4), 235–242. https://doi.org/10.1097/NOR.0000000000000161