Root cause analysis (RCA) is a structured method used to analyze serious adverse events. The goal of RCA is to identify underlying problems that increase the likelihood of errors while avoiding the trap of focusing on mistakes by individuals. A team focuses on the identification of the errors that occurred. They analyze each error to determine the underlying factors (root causes), than if eliminated, can reduce the risk of similar errors in the future. Next, they put a plan into place, this will than by followed by periodic assessment of the effectiveness of the efforts taken to reduce the risk of any future errors. All patients are entitled to receive safe and appropriate nursing care. They are also entitled to receive care from a competent and knowledgeable nurse. Our roles as RN’s is to provide this safe and competent care. One way to provide this special care is to take part in RCA by recognizing errors and promptly correcting the situation. An example of this includes giving and receiving the correct medications. A very important RCA that has been put into place not only at my place of employment but in all facilities is the five rights of medication administration. Nursing medication errors can and do happen. By implementing the 5 rights every time you pass your patient medications you are reducing the risk for error. By attempting to avoid medication errors you are putting your patient's safety first and patient safety is a top priority in nursing care.
Mengis, J., & Nicolini, D. (2010). Root cause analysis in clinical adverse effects. Nursing Management, 16(9).
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