Date of Award

2-2018

Document Type

Thesis - Open Access

Committee Chair

Clint R. Balog, Ph.D.

First Committee Member

Katherine A. Moran, Ed.D.

Abstract

The following thesis details a grounded theory methodology (GT) pilot study of preventable adverse drug events (pADEs) in healthcare. This research used the methodological approach to develop a categorical theory for the chief workplace contributors to intra-hospital intensive care unit (ICU) preventable adverse drug events. While this study represents only a foray into the use of GT to explain pADEs, the results implicate specific areas of concern that may be followed up on in future qualitative or quantitative research. Pursuant of a Straussian grounded theory methodology, this study leaned fundamentally on the interview of individuals with first-hand experience with the phenomenon of interest. A total of 10 participants, eight nurses and two physicians, with varying levels of experience and places of employment, were recruited for these interviews. The resultant data were analyzed, coded, and categorized by the researcher to develop a graphical representation of the emergent data categories. That graphical representation materialized in an axial coding paradigm in which four primary categories describe a core phenomenon. The core phenomenon identified in this study as a main cause of pADEs within ICUs was breakdowns in nursing care. The four overarching categories used to describe the core phenomenon were causal conditions (i.e. communication errors, fatigue, a nursing shortage), strategies (i.e. incident reporting, safety processes, staffing strategies), consequences (i.e. nurse burnout, disconnect with management, running out of time), and contextual conditions (i.e. standard practices, patient satisfaction surveys, time of day). These categories were informed by the data and through selective coding, a final theory was drawn. This study concluded that breakdowns in nursing care can be attributed to an incredible workload, which causes nurses to ignore safety processes.

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