Failure to rescue: is the phenomenon present in long term care? : a qualitative descriptive study
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[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] This qualitative descriptive study explored whether failure to rescue (FTR) was present in long term care (LTC) and resulted in a description of the phenomena as it exists in that setting. An additional outcome was a description of factors that help or hinder nurses in LTC in keeping their residents safe from harm caused by medical mistakes. FTR is defined as the failure of a clinician to provide surveillance, detect a signal and take action in order to prevent a medical mistake that leads to harm. Focus groups and interviews were conducted to gather data. Thirty-one participants consisting of registered nurses, licensed practical nurses, and certified nursing assistants were included in the sample. The participants were located in five skilled nursing facilities in the Midwest. A model of FTR was used to assist participants in understanding and talking about the FTR process. Three themes emerged from the data: (a) I know my residents, (b) I can't get help, and (c) the end of life is complicated. The implications of this study are: (a) FTR is not limited to acute care settings (b) nurses express feelings of moral distress while working in LTC, and (c) communication between nurses in LTC and outside providers is of concern. Further research is suggested on: (a) comparing urban LTC settings with rural LTC settings, (b) moral distress in LTC, (c) the use of the FTR model in nursing education and (d) communication between emergency medical technicians and emergency department staff.
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