Master's Theses

Document Type

Thesis - campus only access

Date of Award

Spring 2004

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

Advisor

Dr. Liane Connelly

Abstract

With the dawn of a new century, the federal government introduced a healthcare agenda designed to capture the spirit of the American public by emphasizing the need for patient safety. Cloaked under the guise of consumer protection, it won the support of Congress and a new era of mandatory reporting was implemented. Nurses share a common goal with other healthcare professionals of identifying provider error, understand its causes, and making system wide changes to reduce risks. Error reporting is a crucial component of this goal. Recent public policy discussions in the United States have explored the risks and benefits of mandatory and voluntary reporting systems to identify the most effective ways to promote candid disclosure of provider error. American healthcare has not accomplished its agenda to reach zero-disparities and the fact remains that we may have moved further away from our goal by implementing the blame and shame game through mandatory reporting. The majority of provider errors do not result from individual recklessness, but from basic system flaws in the way that healthcare delivery is organized (Powers, Maurer, & Wey, 2002). Despite increasing evidence that systems fail, institutions are continuing to assign and emphasize individual blame for errors. Hospital culture demonstrates that an accepted way to deal with the complexity of provider error is to manage the healthcare provider through oversight and discipline as opposed to identifying and resolving the contributing problems (Brown, 2002). In order for healthcare professionals to be able to grow from novice to expert, the healthcare system must undergo a transformational change from a punitive environment to one that internalizes an ongoing quality improvement process. Professionalism is not perfectionism. The notion of a safety culture approach requires commitment to three values: a) continuous quality improvement, b) transformational change and leadership, and c) appreciation for the influence that organizational change can have whether positive or negative. The theoretical framework, which guided this investigation, is Patricia Benner’s theory (1984) From Novice to Expert: Excellence and Power In Clinical Nursing Practice. Reason’s (2000) Incident Analysis model, and Bass’s (1985) theory of Transformational Leadership. The purpose of this investigation was to further explore the possibility of a correlation or relationship between the concepts of transformational leadership and nursing peer review systems in a Midwestern rural acute care facility. The results of the analysis of the presented data suggest that there was not a statistically significant level of correlation between the concepts.

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Rights

© 2004 Lanita Karst Smith

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