Error Modes in Nursing Practice: Theoretical Foundations and Applications
Research on “error modes” in nursing sits at the intersection of human factors, cognitive psychology, and patient safety science. In nursing, error modes are typically understood as recurrent patterns or types of failure (e.g., action, communication, knowledge errors) that arise under specific task and system conditions, rather than as isolated individual mistakes.
Key Theoretical Roots Underpinning Error Modes in Nursing
Theoretical/conceptual root | Contribution to “error modes” in nursing | Citations |
|---|---|---|
Human error theory / cognitive psychology | Distinguishes slips, lapses, mistakes; emphasizes limits of attention, “pre‑packed solutions,” and multifactorial causation in complex systems, arguing blame is often misplaced on individuals and defenses must be system‑oriented (Armitage, 2009) | (Armitage, 2009) |
Eindhoven model of error | Separates human acts from technical, organizational, and latent factors; used to classify nursing failure modes and link them to underlying causes (Taleghani et al., 2016; Henneman et al., 2010) | (Taleghani et al., 2016; Henneman et al., 2010) |
Nursing Errors in Clinical Management Model (NECM) | Provides a task- and process-based taxonomy of nursing errors (communication, care process, administrative, knowledge/skill) used to classify failure modes in emergency surgery and other high‑risk settings (Taleghani et al., 2016) | (Taleghani et al., 2016) |
Failure Mode and Effects Analysis (FMEA / HFMEA / SHERPA) | Adapts engineering risk methods to healthcare to prospectively identify failure modes, their effects, and risk priority; SHERPA adds a structured error mode checklist (e.g., action, communication) for nursing tasks (Monfaredi et al., 2021; Taleghani et al., 2016; Haroun et al., 2021) | (Monfaredi et al., 2021; Taleghani et al., 2016; Haroun et al., 2021) |
Challenge–threat theory (motivational/cognitive) | Frames error orientation (how nurses think about and respond to errors) as part of a challenge vs. threat appraisal that shapes innovation and learning from mistakes (Guiyue & Xiaoqin, 2025) | (Guiyue & Xiaoqin, 2025) |
Root Cause Analysis & Bayesian networks | Treat error modes as observable outcomes in a causal network linking conditional (e.g., fatigue, time pressure) and organizational factors (e.g., staffing, policies), enabling prediction and prevention strategies (Jin et al., 2022) | (Jin et al., 2022) |
Figure 1: Major theoretical frameworks informing nursing error modes.
How These Theories Shape Current “Error Mode” Work in Nursing
1. Taxonomies of nursing error modes
HFMEA and NECM have been combined to classify hundreds of potential failure modes in emergency surgery processes into communication, care process, administrative, and knowledge/skill error categories, highlighting that care-process errors are most frequent (Taleghani et al., 2016).
SHERPA applies an explicit error mode checklist in emergency departments, identifying high frequencies of action errors and far fewer communication errors in nursing tasks (Monfaredi et al., 2021).
2. Systems and human‑factors perspective
Human error theory emphasizes that in complex environments such as hospitals, causation is multi‑factorial, shaped by local conditions and latent system failures, and that the response should prioritize “error wisdom” and organizational resilience over blame (Armitage, 2009).
Large observational and questionnaire studies link error occurrence to workload, staffing, inadequate guidelines, and organizational culture, rather than only individual failings (Meurier et al., 1997; Coelho et al., 2024; Pappa et al., 2024).
3. Error orientation, reporting, and recovery
Network analysis work conceptualizes error orientation (thinking about errors, communicating them, learning from them, risk‑taking around errors) as a psychological construct that interacts with self‑efficacy to drive innovative behavior, turning errors into learning opportunities rather than purely negative events (Guiyue & Xiaoqin, 2025).
Integrative reviews of voluntary error reporting show that nurses’ beliefs, emotions, and perceived organizational responses (supportive vs. punitive) strongly shape whether error modes are surfaced or remain hidden (Woo & Avery, 2021).
Grounded theory studies in emergency and critical care units describe error recovery as a process of situational analysis and error removal, where nurses’ decisions about disclosure versus concealment are influenced by concern for patient safety and protection of professional identity, again echoing human error and systems theories (Abbaszadeh et al., 2021; Nasrabadi et al., 2017; Ghezeljeh et al., 2023).
4. Prospective risk analysis and redesign
Using FMEA in blood sampling and other procedures, teams enumerate and score failure modes, then develop corrective themes such as process redesign, technology support, and safety culture initiatives to reduce high‑risk error modes (Haroun et al., 2021).
Bayesian modeling of medication communication errors quantitatively links six error modes to 12 conditional and five organizational factors, providing a probabilistic view of how system changes could lower the likelihood of particular error modes (Jin et al., 2022).
Synthesis
Taken together, current nursing “error modes” work builds on:
Human error and cognitive theories (slips/mistakes, latent failures, non‑blame systems) (Armitage, 2009).
Human factors and engineering risk methods (FMEA, HFMEA, SHERPA, NECM, Eindhoven, RCA) to identify and categorize error modes within complex nursing tasks (Monfaredi et al., 2021; Taleghani et al., 2016; Henneman et al., 2010; Jin et al., 2022; Haroun et al., 2021).
Motivational and organizational theories (challenge–threat, safety culture, error orientation, voluntary reporting) that explain how nurses perceive, report, and learn from those error modes (Guiyue & Xiaoqin, 2025; Woo & Avery, 2021; Pappa et al., 2024; Ghezeljeh et al., 2023).
This combined theoretical base underpins modern, system‑focused approaches to analyzing and preventing nursing error modes rather than treating them as isolated personal failures.
These search results were found and analyzed using Consensus, an AI-powered search engine for research. Try it at https://consensus.app. © 2026 Consensus NLP, Inc. Personal, non-commercial use only; redistribution requires copyright holders’ consent.
References
Abbaszadeh, A., Borhani, F., Ajri-Khamesloo, F., Afshar, F., Tabatabaeifar, S., & Ajri-Khameslou, M. (2021). Explaining the process of dealing with nursing errors in the emergency department: A grounded theory study.. International emergency nursing, 59, 101066. https://doi.org/10.1016/j.ienj.2021.101066
Meurier, C., Vincent, C., & Parmar, D. (1997). Learning from errors in nursing practice.. Journal of advanced nursing, 26 1, 111-9. https://doi.org/10.1046/j.1365-2648.1997.1997026111.x
, G., & , X. (2025). Network analysis of the relationship between error orientation, self-efficacy, and innovative behavior in nurses. Scientific Reports, 15. https://doi.org/10.1038/s41598-025-87736-8
Monfaredi, S., Gaeeni, M., Koohpaei, A., & Khandan, M. (2021). Identification and assessment of nursing task errors in emergency department using SHERPA technique and offering remedial strategies.. International emergency nursing, 59, 101103. https://doi.org/10.1016/j.ienj.2021.101103
Woo, M., & Avery, M. (2021). Nurses’ experiences in voluntary error reporting: An integrative literature review. International Journal of Nursing Sciences, 8, 453 - 469. https://doi.org/10.1016/j.ijnss.2021.07.004
Coelho, F., Furtado, L., Mendonça, N., Soares, H., Duarte, H., Costeira, C., Santos, C., & Sousa, J. (2024). Predisposing Factors to Medication Errors by Nurses and Prevention Strategies: A Scoping Review of Recent Literature. Nursing Reports, 14, 1553 - 1569. https://doi.org/10.3390/nursrep14030117
Armitage, G. (2009). Human error theory: relevance to nurse management.. Journal of nursing management, 17 2, 193-202. https://doi.org/10.1111/j.1365-2834.2009.00970.x
Taleghani, Y., Rezaei, F., & Sheikhbardsiri, H. (2016). Risk assessment of the emergency processes: Healthcare failure mode and effect analysis.. World journal of emergency medicine, 7 2, 97-105. https://doi.org/10.5847/wjem.j.1920-8642.2016.02.003
Henneman, E., Gawlinski, A., Blank, F., Henneman, P., Jordan, D., & McKenzie, J. (2010). Strategies used by critical care nurses to identify, interrupt, and correct medical errors.. American journal of critical care : an official publication, American Association of Critical-Care Nurses, 19 6, 500-9. https://doi.org/10.4037/ajcc2010167
Nasrabadi, A., Peyrovi, H., & Valiee, S. (2017). Nurses' Error Management in Critical Care Units: A Qualitative Study. Critical Care Nursing Quarterly, 40, 89–98. https://doi.org/10.1097/cnq.0000000000000145
Jin, H., Qu, Q., Zhao, Y., Gong, Z., Fu, Q., Chi, X., & Duffy, V. (2022). Investigating the factors leading to medication communication errors from organizational and working conditional perspectives. International Journal of Industrial Ergonomics. https://doi.org/10.1016/j.ergon.2022.103342
Haroun, A., Al-Ruzzieh, M., Hussien, N., Masa'ad, A., Hassoneh, R., Alrub, G., & Ayaad, O. (2021). Using Failure Mode and Effects Analysis in Improving Nursing Blood Sampling at an International Specialized Cancer Center. Asian Pacific Journal of Cancer Prevention : APJCP, 22, 1247 - 1254. https://doi.org/10.31557/apjcp.2021.22.4.1247
Pappa, D., Evangelou, E., Koutelekos, I., Dousis, E., Margari, N., Toulia, G., Stavropoulou, A., Koreli, A., Theodoratou, M., Bilali, A., Chasaki, K., Zartaloudi, A., & Dafogianni, C. (2024). The TERCAP Tool: Investigation of Nursing Errors in Greek Hospitals. Hospitals. https://doi.org/10.3390/hospitals1010011
Ghezeljeh, N., Farahani, M., & Ladani, F. (2023). “Attempting to protect self and patient”: A grounded theory study of error recovery by intensive care nurses. Nursing Open, 10, 4690 - 4704. https://doi.org/10.1002/nop2.1719