348 Research Article Open Access Using Simulation Technology and The Root Cause Analysis Process to Assess Nurse’s Attitude toward Patient Safety Ruth Everett-Thomas 1* , Lee Fong-Hong 2 , Elizabeth Joseph 2 , Marlene Augustine 3 , Ilya Shekhter 4 , Lisa F Rosen 5 and David J Birnbach 6 1 Assistant Professor of Clinicals, University of Miami School of Nursing and Health Studies, USA 2 Department of Education and Development, Jackson Health System, USA 3 Nurse Manager, Jackson Health System, USA 4 Simulation Director, University of Miami Miller School of Medicine, USA 5 Senior Researcher, University of Miami Miller School of Medicine, USA 6 Professor and Vice Provost, University of Miami Miller School of Medicine, USA Received: July 03, 2017; Published: July 14, 2017 *Corresponding author: Ruth Everett-Thomas, Assistant Professor of Clinicals, University of Miami School of Nursing and Health Studies, 5030 Brunson Drive suite 133,Coral Gables, Florida 33146, USA, Tel: ; ; Email: Introduction Every year in the US, a number of patients are harmed (estimated 1.5 million) while receiving care in a hospital because of system or human errors [1,2]. For several decades, healthcare experts, professional organizations and medical institutions have been working diligently to identify solutions that will prevent the recurrence of preventable mistakes (National Patient Safety Foundation [NPSF], 2015; Patient Safety Network [PSNET], 2014). Some of these mishaps have resulted in an unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury (sentinel event) to a patient or patients, not related to the natural course of the patient’s illness (The Joint Commission, 2010). Thus, the TJC recommends that all healthcare organizations conduct a root cause analysis (RCA) to determine the underlying cause of the event and develop a prevention strategy to eliminate any recurrences of the same or similar mistakes (The Joint Commission, 2010). Although RCAs were originally developed by industrial companies to analyze accidents, healthcare organizations routinely use this method as a tool to analyze medical errors [3]. In most instances, a RCA protocol is used to collect data and reconstruct the event through participant interviews and medical record review (NPSF, 2015). These results should identify the sequence of events leading to the error and some possible underlying causes. James Reason’s “Swiss Cheese Model” is commonly used to describe a systemic approach to RCAs. This approach helps to identify both active errors (occurring at the point of interface between humans and complex systems), and latent errors (the hidden problems within health care systems that contribute to adverse events) [4]. One key element of an RCA is to avoid focusing on human mistakes and increase efforts to identify underlying problems that might increase the likelihood of errors [5]. Cite this article: Ruth E-T, Lee F-H, Elizabeth J, Marlene A, Ilya S. Using Simulation Technology and The Root Cause Analysis Process to Assess Nurse’s Attitude toward Patient Safety. Biomed J Sci & Tech Res 1(2)-2017. BJSTR. MS.ID.000192. DOI: 10.26717/BJSTR.2017.01.000192 Abstract Root cause analysis (RCA) provides an important opportunity for healthcare workers to identify the underlying factors that may contribute to medical errors or sentinel events and subsequently prevent their recurrence. Because of its efficacy, The Joint Commission’s (TJC) recommended RCA framework together with In-situ simulation were used to assess nurses’ attitudes toward patient safety immediately after simulation training and six months later. Thirty-three nurses from a hospital setting participated in RCA sessions which included: a lecture, a simulated patient scenario and debriefing. A 36-item “Safety Attitudes: Frontline Perspectives” survey was given before and after each session and six months’ later. Twelve (39%) nurses responded favorably to patient safety initiatives on the first survey, and twenty-nine (89%) responded favorably after six months (p=0.001). A significant number (p=0.003) of nurses perceived that the institution still needs to improve some patient safety measures. Consequently, In-situ simulation may be an effective tool and have lasting benefits for guiding RCA sessions among nurses. Keywords: Root cause analysis; In-situ simulation; Frontline perspective; Patient safety DOI: 10.26717/BJSTR.2017.01.000192 Ruth Everett-Thomas. Biomed J Sci & Tech Res ISSN: 2574-1241