Use ‘noncompliant behaviour’ instead. This term is used to refer to healthcare worker actions that are not consistent with approved policy and procedures. In most cases these types of actions put patients at greater risk of adverse events than if the procedure is followed.
Blame (Ref 6)
Assigning blame to an individual for what is perceived as an error or adverse event does not recognize the complexity within the health-care system and the impact of system factors that can lead to errors.
‘Error’ attached to any term except ‘human’ (i.e., ‘human error’) (Ref 6)
e.g. medical, medication, serious, system, organizational
Only humans make ‘errors’. Other qualifying terms are not necessary and oversimplify the action taken/not taken by an individual.
Fault (Ref 6)
Default, defect or blameable imperfection. It is often used to imply blame to an individual when referring to the underlying causes of a patient safety incident.
This term is confusing. It is typically used to refer to an event that nearly harmed a patient. However, its literal definition means an event that caused harm (nearly missed).
It is commonly used for an event that did not reach the patient (e.g., an error was noticed before a subsequent action was carried out). In such a case the proper description would be ‘nearly hit’ or ‘almost harmed’. Close call is the preferred term.
Negligence (Ref 6)
This is a legal term. Its use should be limited to legal proceedings and decisions of the Courts.
These terms are confusing because they could be interpreted either as an event/incident that:
– did not reach the patient (i.e., close call) or
– involved a patient where no harm was detected.
Preventable (Ref 6)
This term should be used with caution, and without implying either negligence or harm. It implies a degree of choice and likelihood of success which may not exist in a situation.
Punish (Ref 6)
This term has very negative connotations for healthcare workers. The preferred term is ‘discipline’.
Reckless (or Recklessness) (Ref 6)
As with ‘negligence’, use should be limited to legal proceedings and decisions of the Courts.
‘Risk’ attached to any other term
e.g., At-risk behavior
‘Serious’ adverse event or ‘serious’ harm
‘Serious’ is subjective and difficult to quantify. Use of this term may lead to confusion as to which events fall into this category (may vary from the provider and patient perspective and between individual patients or providers).
‘Unnecessary’ is subjective, and difficult to quantify. Use of this term may lead to confusion as to what types of harm fall into this category (may vary from the provider and patient perspective). It also implies that if some harm is unnecessary, other types of harm are necessary – a difficult concept to accept.