Error in ICU: Repurcussions and Defense Mechanisms
Error in ICU: Repurcussions and Defense Mechanisms
Since our sample is focused on two ICUs, we are cautious concerning the generalization of our findings, and we are conscious that some specificities inherent in the service (organization, atmosphere of the service, length of time worked in the service, initial and continuous training of the staff, policy of security of care, etc.) can have an impact on our qualitative data.
It should also be pointed out that some dimensions of the experience of error can be missing from our analysis for various reasons:
Finally, 30% of the patients died as a result of the error. In effect, the qualitative analysis did not allow us to measure if the seriousness of the error (in terms of consequences for the patient) impacts the intensity of the professionals' emotional experience. It would be interesting to investigate this in a future study to identify situations that are vulnerable to error and would require a specific support for the professional.
Limitations
Since our sample is focused on two ICUs, we are cautious concerning the generalization of our findings, and we are conscious that some specificities inherent in the service (organization, atmosphere of the service, length of time worked in the service, initial and continuous training of the staff, policy of security of care, etc.) can have an impact on our qualitative data.
It should also be pointed out that some dimensions of the experience of error can be missing from our analysis for various reasons:
Our study mainly dealt with professionals who wanted to talk about their error. It is likely that there were professionals suffering or in denial because of a bad experience who did not want to discuss it.
Despite the confidentiality of the interviews and the impartiality of the interviewers, we could not be sure that there was no social desirability bias in the responses, particularly concerning a topic such as error.
This study deals with an experience which has already been subjected to modifications over time. We can assume that a range of defense mechanisms have already been implemented and modified the current perception of reality. Consequently, one wonders about themes absent from the interviews, such as the fear of legal proceedings and complaints lodged by the patient or the patient's family.
Finally, 30% of the patients died as a result of the error. In effect, the qualitative analysis did not allow us to measure if the seriousness of the error (in terms of consequences for the patient) impacts the intensity of the professionals' emotional experience. It would be interesting to investigate this in a future study to identify situations that are vulnerable to error and would require a specific support for the professional.