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Enacting high reliability principles while caring for people with Ebola Virus Disease - 27/09/18

Doi : 10.1016/j.ajic.2018.04.208 
Bonnie Mowinski Jennings, PhD, RN, FAAN a, * , Katherine A. Yeager, PhD, RN, FAAN a, Nancye R. Feistritzer, DNP, RN b, Mary M. Gullatte, PhD, RN, FAAN c, Kristy K. Martyn, PhD, RN, FAAN a
a Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 
b Emory University Hospital, Emory Wesley Woods Hospital, Atlanta, GA 
c Nursing Innovation and Research, Emory Healthcare, Inc., Atlanta, GA 

*Address correspondence to Bonnie Mowinski Jennings, PhD, RN, Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, NE, Room 224, Atlanta, GA 30322. (B.M. Jennings).Nell Hodgson Woodruff School of NursingEmory University1520 Clifton Road, NE, Room 224AtlantaGA30322

Highlights

•
Infection prevention and control (IPC) are safety issues for patients and staff.
•
A culture of safety was established by enacting high reliability (HR) principles.
•
HR principles helped protect staff caring for patients with Ebola Virus Disease.
•
HR principles might also enhance IPC under ordinary care conditions.

El texto completo de este artículo está disponible en PDF.

Abstract

Background

Fear surrounds Ebola Virus Disease (EVD) because it is highly infectious. Yet members of the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital (EUH) had to overcome that fear when caring for patients with EVD.

Purpose

The analysis reported here illustrates how the members of EUH's SCDU tacitly enacted high reliability (HR) principles while caring for patients with EVD.

Methods

A qualitative study was conducted to describe the experience of members of the EUH SCDU who worked with EVD patients in 2014. We completed 17 semi-structured interviews involving registered nurses, physicians, and support personnel (eg, laboratory technicians). Interview recordings were transcribed and analyzed using conventional content analysis. Exploring HR principles was not among the questions guiding this exploration, but the participants repeatedly described concepts related to HR.

Results

The goal of the SCDU team was to save patients' lives while protecting their own lives. Rigorous training and meeting high standards were required to make the team. The fear surrounding EVD set in motion the enactment of HR principles. HR principles served to alleviate failures or breakdowns in infection prevention and control, thus keeping patients and staff safe.

Conclusions

These findings illustrate that it is possible to move HR principles from theory to practice in high-risk situations. HR principles were essential to safety and to infection prevention and control.

El texto completo de este artículo está disponible en PDF.

Key Words : Infection control, High reliability, Qualitative research


Esquema


 Conflicts of interest: None to report.
 Funding: This work was funded by the American Nurses Foundation as the Stryker Medical Research Award Scholar and the Sayre Memorial Scholar in 2015 (ANF 5087): B. Jennings, PI. We had additional funding support from the Alpha Epsilon Chapter of Sigma Theta Tau International, awarded to K. Yeager.


© 2018  Association for Professionals in Infection Control and Epidemiology, Inc.. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 46 - N° 10

P. 1167-1173 - octobre 2018 Regresar al número
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