What do reckless

An example of a mental slip is transposing the numbers of a medication dose. Omissions or forgetting to take certain steps in a process are examples of mental lapses. Incorrectly programming a new infusion pump following the directions used for an older pump is an example of a rule-based mistake. Human error is either endogenous random human error , which arises within an individual from a random and unpredictable cognitive event, or exogenous system-based human error , in which some feature of the environment contributes to a failure in cognitive processes.

The risk of endogenous errors is increased by negative personal performance shaping factors such as anxiety and stress, fatigue, preoccupation and distractibility, fear and dread, sensory deficits, and other psychosocial factors. The risk of exogenous errors is increased by negative system or environmental performance shaping factors, such as low lighting, interruptions and physical distractions, fatiguing staffing patterns, technology glitches, the absence of job aids e.

As negative performance shaping factors increase in scope and intensity, the probability of human error increases significantly. Perceptual biases also contribute to both endogenous and exogenous errors. Examples of perceptual biases include confirmation bias seeing what you believe , change blindness inability to detect changes in plain view , and inattentional blindness inability to see information because attention is focused elsewhere. Cognitive biases may influence how individuals respond to an error.

Examples of cognitive biases include hindsight bias tendency to see past events as predictable , normalcy bias it will never happen here , and severity bias tendency to base the severity of the response on the outcome.

Since human errors are inevitable, they are best managed within a Just Culture through system redesign to make the system human error-proof or error-resistant. System redesign often requires the integration of high-leverage strategies e. Discipline, including counseling, is not warranted or effective to address human error because erring individuals did not intend the action or any undesirable outcome that resulted.

In a Just Culture, the only just option is to console the individual who made the error and to redesign systems to prevent future errors. Furthermore, the potential or actual severity of the error outcome should play no role in determining how individuals are treated, even when patients are harmed. Individuals should know that they will be treated fairly when they report their mistakes, and that they will be accountable for the quality of their choices, not the human error itself or the severity of its outcome.

At-risk behaviors are different from human errors. They are behavioral choices that are made when individuals have lost the perception of risk associated with the choice or mistakenly believe the risk to be insignificant or justified. Why we drift. It is human nature to drift away from strict procedural compliance and to develop unsafe habits for which we fail to see the risk. Human behavior runs counter to safety because the rewards for risk taking e. As a result, even the most educated and careful individuals will learn to master dangerous shortcuts, particularly when faced with an unanticipated system problem e.

Over time, the risk associated with these behaviors fades and the entire culture becomes tolerant to these risks. In fact, the more experienced you are at what you do, the less likely you are to recognize that you are in a risky situation when engaging in at-risk behavior. For example, if you are an experienced pharmacist, you may rush past drug interaction messages with barely a notice, rely on a historical weight to verify a weight-based drug dose, and scan the barcode on the first container several times when multiple containers are required to prepare an admixture.

If you are an experienced nurse, you may not think twice about programming an infusion pump outside the drug library, preparing intravenous IV admixtures instead of waiting for pharmacy to dispense them, and removing medications via override from an automated dispensing cabinet ADC outside of an emergency. Successful outcomes foster continuance and tolerance to the risks, particularly when colleagues look the other way or begin imitating the at-risk behavior. Upside down consequences.

When organizational tolerance to risk is high, safe behavioral choices may actually invoke criticism, and at-risk behaviors may invoke rewards.

A nurse who takes longer to administer medications may be criticized, even if the additional time is attributed to safe practice habits and patient education. But a nurse who can handle six new admissions during a shift may be admired, and others may follow her example, even if dangerous shortcuts may have been taken to accomplish the work.

In fact, shortcuts like these and many others could even be labeled as efficient behavior. Underlying system causes. Most at-risk behaviors are precipitated by large and small system failures that individuals must work around, often daily, to get the job done.

A medication needed for a patient is missing on the unit; access to the ADC is crowded and time-consuming; the new barcode scanner has a high rate of scanning failures. The list of system failures is varied and long, often making it difficult or impossible to execute tasks as designed. We expect individuals to use critical thinking skills to navigate around systems or processes when they do not work well in the moment, and we praise and reward individuals when they do. Thus, individuals are often satisfied, even proud, with their abilities to deliver patient care despite obstacles, even when it means taking shortcuts, breaching procedures, or working around the system as designed.

Unfortunately, individuals responding to dysfunctional systems by failing to follow a policy or procedure are often inappropriately disciplined, especially if an error happens. Subconscious decisions and silent risk monitor. Another reason that humans drift is that we are illogical decision makers. The human brain is capable of subconscious and conscious reasoning. From the Editors at Merriam-Webster. Phrases Related to reckless reckless driving with reckless abandon. Style: MLA.

English Language Learners Definition of reckless. Kids Definition of reckless. Legal Definition of reckless. Get Word of the Day daily email! Test Your Vocabulary. Test your visual vocabulary with our question challenge!

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