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      Near-miss organizational learning in nursing within a tertiary hospital: a mixed methods study

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          Abstract

          Background

          Near-miss organizational learning is important for perspective and proactive risk management. Although nursing organizations are the largest component of the healthcare system and act as the final safety barrier, there is little research about the current status of near-miss organizational learning. Thus, we conducted this study to explore near-miss organizational learning in a Chinese nursing organization and offer suggestions for future improvement.

          Methods

          This was a mixed methods study with an explanatory sequence. It was conducted in a Chinese nursing organization of a tertiary hospital under the guidance of the 4I Framework of Organizational Learning. The quantitative study surveyed 600 nurses by simple random sampling. Then, we applied purposive sampling to recruit 16 nurses across managerial levels from low-, middle- and high-scored nursing units and conducted semi-structured interviews. Descriptive statistics, structured equation modelling and content analysis were applied in the data analysis. The Good Reporting of A Mixed Methods Study (GRAMMS) checklist was used to report this study.

          Results

          Only 33% of participants correctly recognized near-misses, and 4% of participants always reported near-misses. The 4I Framework of Organizational Learning was verified in the surveyed nursing organization (χ 2 = 0.775, p = 0.379, RMSEA < 0.01). The current organizational learning behaviour was not conducive to near-miss organizational learning due to poor group-level learning ( β GG = 0.284) and poor learning absorption ( β Misalignment= -0.339). In addition, the researchers developed 13 codes, 9 categories and 5 themes to depict near-miss organizational learning, which were characterized by nurses’ unfamiliarity with near-misses, preferences and the dominance of first-order problem-solving behaviour, the suspension of near-miss learning at the group level and poor learning absorption.

          Conclusion

          The performance of near-miss organizational learning is unsatisfactory across all levels in surveyed nursing organization, especially with regard to group-level learning and poor learning absorption. Our research findings offer a scientific and comprehensive description of near-miss organizational learning and shed light on how to measure and improve near-miss organizational learning in the future.

          Supplementary information

          The online version contains supplementary material available at 10.1186/s12912-022-01071-1.

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          Most cited references32

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          Determining Sample Size for Research Activities

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            An Organizational Learning Framework: From Intuition to Institution

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              Recall bias in epidemiologic studies

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                Author and article information

                Contributors
                huapingliu@pumc.edu.cn
                Journal
                BMC Nurs
                BMC Nurs
                BMC Nursing
                BioMed Central (London )
                1472-6955
                16 November 2022
                16 November 2022
                2022
                : 21
                : 315
                Affiliations
                [1 ]GRID grid.506261.6, ISNI 0000 0001 0706 7839, School of Nursing, , Chinese Academy of Medical Sciences & Peking Union Medical College, ; 33 Ba Da Chu Rd. Shijingshan District, 100144 Beijing, China
                [2 ]GRID grid.413432.3, ISNI 0000 0004 1798 5993, Department of Nursing, , The Second Affiliated Hospital of University of South China, ; Hengyang, Hunan Province China
                [3 ]GRID grid.412017.1, ISNI 0000 0001 0266 8918, School of Nursing, , The University of South China, ; Hengyang, Hunan Province China
                Article
                1071
                10.1186/s12912-022-01071-1
                9667619
                36380309
                02d63dbf-dcb2-4ea1-b12b-e6c5ee2c594a
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 6 January 2022
                : 5 October 2022
                : 10 October 2022
                Funding
                Funded by: None
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Nursing
                near-miss,organizational learning,nursing organization,mixed methods study
                Nursing
                near-miss, organizational learning, nursing organization, mixed methods study

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