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Not Overstepping Professional Boundaries: The Challenging Role of Nurses in Simulated Error Disclosures

Jeffs, Lianne PhD, RN; Espin, Sherry PhD, RN; Rorabeck, Lisa BA; Shannon, Sarah E. PhD, RN; Robins, Lynne PhD; Levinson, Wendy MD; Gallagher, Thomas H. MD; Gladkova, Olga PhD; Lingard, Lorelei PhD

doi: 10.1097/NCQ.0b013e31822abf81

This article provides findings on the role of the nurse in simulated team-based error disclosures. Triangulation of 3 qualitative data sets revealed that a tension exists for nurses in the error disclosure process as they attempt to balance professional boundaries. Study findings point to multilevel strategies including cultural, structural, and educational approaches to enhancing the key roles that nurses need to play in error disclosure to patients and families.

St. Michael's Hospital (Dr Jeffs) and Daphne Cockwell School of Nursing, Ryerson University, (Dr Espin, Ms Rorabeck and Dr Gladkova), Toronto, Ontario, Canada; Biobehavioral Nursing and Health Systems, University of Washington, Seattle (Dr Shannon) and Department of Medical Education, University of Washington (Dr Robins), Seattle; Department of Medicine, University of Toronto (Dr Levinson), Toronto, Ontario, Canada; Division of General Internal Medicine, University of Washington (Dr Gallagher), Seattle; and The Centre for Education Research and Innovation at the Schulich School of Medicine & Dentistry, University of Western Ontario (Dr Lingard), London, Ontario, Canada.

Correspondence: Lianne Jeffs, PhD, RN St. Michael's Hospital, Room 5-060 Bond Wing, 30 Bond St, Toronto, Ontario M5B 1W8, Canada (

Funding was provided for this study by the Canadian Patient Safety Institute Research Competition 2006.

The authors declare no conflict of interest.

Accepted for publication: June 23, 2011.

© 2011 Lippincott Williams & Wilkins, Inc.