Occupational therapists' responses to practice errors in physical rehabilitation settings

OBJECTIVE. Errors occur in all health care professions. Practice errors, however, have not been systematically examined in occupational therapy. The purpose of this study was to examine occupational therapists' responses to practice errors in physical rehabilitation settings. METHOD. A qualitative focus group research method was used in this study and a total of 35 occupational therapists from four different states who had practice experience in physical rehabilitation settings participated in four focus groups. Focus group discussions were transcribed verbatim and analyzed by two investigators of the study. Qualitative software program, NUD*IST Vivo was used to aid the data analysis process. RESULTS. Five major themes were generated from the data regarding practice errors, which included (1) Concept of practice error: It is against our standards; (2) Perceived causes of practice error: Not just an individual matter; (3) Emotional responses: I felt horrible; (4) Impact on practice: Doing things differently; and (5) Management of practice error: Being honest and taking initiative. Occupational therapists perceived practice error from a broad perspective and identified physical and psychosocial issues as practice error. CONCLUSION. Most practice errors described by participants appeared to be preventable. Despite the tremendous emotional distress in reaction to making an error, participants valued the learning in the experience and made constructive practice changes. Findings of the study have implications for current educational training programs and practice such as the development of clinical reasoning related to patient safety and assertiveness training for hierarchical situations.