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Inattentional blindness and failures to rescue the deteriorating patient in critical care, emergency and perioperative settings: four case scenarios

Jones, Angela and Johnstone, Megan-Jane 2016, Inattentional blindness and failures to rescue the deteriorating patient in critical care, emergency and perioperative settings: four case scenarios, Australian critical care, vol. 30, pp. 1-5, doi: 10.1016/j.aucc.2016.09.005.

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Title Inattentional blindness and failures to rescue the deteriorating patient in critical care, emergency and perioperative settings: four case scenarios
Author(s) Jones, Angela
Johnstone, Megan-Jane
Journal name Australian critical care
Volume number 30
Start page 1
End page 5
Total pages 5
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-10-05
ISSN 1036-7314
1878-1721
Keyword(s) critical care unit
emergency department
failure to rescue
health care
human factors engineering
inattentional blindness
nurses
patient safety
perioperative
Summary BACKGROUND: Failure to identify and respond to clinical deterioration is an important measure of patient safety, hospital performance and quality of care. Although studies have identified the role of patient, system and human factors in failure to rescue events, the role of 'inattentional blindness' as a possible contributing factor has been overlooked. OBJECTIVES: To explore the nature and possible patient safety implications of inattentional blindness in critical care, emergency and perioperative nursing contexts. METHODS: Analysis of four case scenarios drawn from a naturalistic inquiry investigating how nurses identify and manage gaps (discontinuities) in care. Data were collected via in-depth interviews from a purposeful sample of 71 nurses, of which 20 were critical care nurses, 19 were emergency nurses and 16 were perioperative nurses. Case scenarios were identified, selected and analysed using inattentional blindness as an interpretive frame. RESULTS: The four case scenarios presented here suggest that failures to recognise and act upon patient observations suggestive of clinical deterioration could be explained by inattentional blindness. In all but one of the cases reported, vital signs were measured and recorded on a regular basis. However, teams of nurses and doctors failed to 'see' the early signs of clinical deterioration. The high-stress, high-complexity nature of the clinical settings in which these cases occurred coupled with high cognitive workload, noise and frequent interruptions create the conditions for inattentional blindness. CONCLUSIONS: The case scenarios considered in this report raise the possibility that inattentional blindness is a salient but overlooked human factor in failure to rescue events across the critical care spectrum. Further comparative cross-disciplinary research is warranted to enable a better understanding of the nature and possible patient safety implications of inattentional blindness in critical care nursing contexts.
Language eng
DOI 10.1016/j.aucc.2016.09.005
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
1110 Nursing
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, Australian College of Critical Care Nurses
Persistent URL http://hdl.handle.net/10536/DRO/DU:30089498

Document type: Journal Article
Collection: School of Nursing and Midwifery
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