Application of root cause analysis to reduce adverse events in emergency nursing

Objective To explore the effects of root cause analysis in emergency nursing on reduction of adverse events.

Methods The quality of emergency care and the incidence of adverse events among 50 emergency nursing staff in the emergency department of a hospital were compared, before (January 2017-December 2017)and after (January 2018-December 2018)implementation of root cause analysis method. Based on baseline survey, the characteristics, extreme causes and root causes of adverse nursing events were analyzed before implementation, and the corresponding improvement measures were proposed in January 2018.

Results After the implementation of root cause analysis, the nursing quality scores(element quality, middle-term quality and final quality)of 50 subjects were significantly higher than those before the implementation, and the difference was statistically significant(P < 0.05). From January to December 2017, there were 40 grade Ⅰ and Ⅱ adverse events reported by hospital emergency nursing staff, accounting for 8.72% of the total nursing adverse events in the hospital; after root cause analysis and improvement measures were implemented, there were 12 adverse events in emergency care during January to December 2018, accounting for 1.65% of the total nursing adverse events in the hospital; the difference of adverse events was statistically significant before and after the implementation(P < 0.05).

Conclusion Root cause analysis can improve the quality of emergency care and reduce the incidence of nursing adverse events.