I början av år 2020 drabbades världen av ett virus som orsakade sjukdomen Covid-19. WHO klassade virus utbrottet som en pandemi. I Sverige införde Folkhälsomyndigheten och Regeringen en mängd rekommendationer, restriktioner och förbud i syfte att dämpa smittspridningen och upprätthålla vårdens kapacitet. Intensivvården (IVA) var speciellt utsatt och tvingades till stora omställningar. Hur påverkade denna exceptionella händelse våra patienter som drabbades av Covid-19 och var i behov av intensivvård? Upprätthölls patientsäkerheten och sjukvårdens strukturerade arbetssätt gällande vårdskador trots den stor omställning som genomförde till följd av pandemin?    Syftet var att kartlägga och beskriva avvikelserapporteringen för patienter med Covid-19 som vårdades på IVA under pandemins andra och tredje våg.   En kvantitativ design med data från avvikelsehantering gällande patienter med Covid-19 som vårdandes på IVA på ett sjukhus i Västsverige. Totalt vårdades 180 patienter under vald tidsperiod och 74 avvikelser granskades. Data analyserade med deskriptiv statistik och jämförande statistik.    Resultatet visar en minskad rapportering av vårdrelaterade avvikelser under pandemin våg två och tre. Detta skiljer sig till viss del från Corona kommissionens rapport som konstaterar ett ökat antal avvikelser korrelerat till de långa vårdtiderna. Resultatet visar också att antalet avvikelserapporter i relationen till antal vårddygn minskades under denna tidsperiod samt att en förskjutning mellan avvikelse-kategorier sågs där arbetsskada/personskada ökade med sju gånger. Resultatet får stöd av Corona kommissionen som konstaterade flera förändringar i avvikelserapporteringen både avseende antalet rapporterade avvikelser och gällande innehåll.   Resultatet bidrar med kunskap om hur sjuksköterskans arbete kan påverkas av förändrade arbetsförhållanden samt att befästa arbetsrutiner såsom avvikelserapportering påverkas. För att klarlägga bakomliggande orsaker till att det skrevs färre avvikelser behöver resultatet följas upp med fler studier. Det är viktigt att skapa förutsättningar för specialistsjuksköterskor att även under exceptionella förhållande få möjlighet att rapportera samt arbeta strukturerat för en säker vård. / At the beginning of 2020, the world was hit by a virus that caused the disease Covid-19. The WHO classified the virus outbreak as a pandemic. In Sweden, the Public Health Authority and the Government introduced a number of recommendations, restrictions and prohibitions with the aim of curbing the spread of infection and maintaining the capacity of healthcare. The intensive care unit (ICU) was particularly vulnerable and was forced to make major changes. How did this exceptional event affect our patients affected by Covid-19 and in need of intensive care? Was patient safety and the healthcare system's structured way of working regarding care injuries maintained despite the major changes that took place as a result of the pandemic?  The aim was to map and describe reporting errors for patients with Covid-19 who were cared for in the ICU during the second and third waves of the pandemic.  A quantitative design with data from deviation management regarding patients with Covid-19 in intensive care at a hospital in western Sweden. A total of 180 patients were treated during the selected time period and 74 reported errors were reviewed. Data were analyzed using descriptive statistics and comparative statistics.  The result shows a reduced number of reports of care-related errors during the pandemic waves 2 and 3. This differs to some extent from the Corona Commission's report which notes an increased number of reported errors correlated to the long care times. The result also shows that the number of reported errors in relation to the number of care days was reduced during this time period and that a shift between reported error categories was seen where occupational injury/personal injury increased by seven times. The result is supported by the Corona Commission, which found several changes in the nonconformance reporting, both in terms of the number of reported non-conformities but also in the relevant content.  The result contributes with knowledge about how the nurse's work is affected by changed working conditions and that consolidating work routines such as reporting errors is affected. In order to clarify the underlying reasons why there were fewer reporting errors, the results need to be followed up with more studies. It is important to create the conditions for specialist nurses to have the opportunity to report and work structured for safe care, even under exceptional conditions.

Indiana University-Purdue University Indianapolis (IUPUI) / This qualitative study was successful in utilization of grounded theory methodology to ascertain nurses’ decision-making processes following their awareness of having made a medical error, as well as how and/or if they corrected and reported the error. Significant literature documents the existence of medical errors; however, this unique study interviewed thirty nurses from adult intensive care units seeking to discover through a detailed interview process their individual stories and experiences, which were then analyzed for common themes. Common themes led to the development of a theoretical model of thought processes regarding error reporting when nurses made an error. Within this theoretical model are multiple processes that outline a shared, time-orientated sequence of events nurses encounter before, during, and after an error. One common theme was the error occurred during a busy day when they had been doing something unfamiliar. Each nurse expressed personal anguish at the realization she had made an error, she sought to understand why the error happened and what corrective action was needed. Whether the error was reported on or told about depended on each unit’s expectation and what needed to be done to protect the patient. If there was no perceived patient harm, errors were not reported. Even for reported errors, no one followed-up with the nurses in this study. Nurses were left on their own to reflect on what had happened and to consider what could be done to prevent error recurrence. The overall impact of the process of and the recovery from the error led to learning from the error that persisted throughout her nursing career. Findings from this study illuminate the unique viewpoint of licensed nurses’ experiences with errors and have the potential to influence how the prevention of, notification about and resolution of errors are dealt with in the clinical setting. Further research is needed to answer multiple questions that will contribute to nursing knowledge about error reporting activities and the means to continue to improve error-reporting rates