Abstract
BACKGROUND: Sentinel events, involving serious injury or death, reveal critical vulnerabilities in clinical practices. Nurses play a key role in identifying errors and contributing factors in such events. However, evidence on the effectiveness of nurse-guided RCA in improving compliance and corrective actions is limited. OBJECTIVE: The aim of our research is to deeply explore the experiences, roles, challenges, and strategies of nurses in guiding RCA. By concentrating on nurses' guidance, we can provide in-depth insights into their unique contributions in the RCA process. METHODS: Twelve participants from a tertiary hospital in southeastern mainland China were selected for the study. A constructivist qualitative research method was used to collect views and opinions from the participants' perspectives through semi-structured face-to-face interviews, and content analysis was applied, the data was further interpreted using thematic analysis. RESULTS: A total of 12 RCAdirectors were included in this study. Analyses revealed four main themes and 11 sub-themes. The main themes were: (1) success in a demanding field requires exceptional skills and abilities (having comprehensive knowledge, empowering capabilities, demonstrating interest and engagement), (2) building strong interpersonal relationships between guides and team leaders (selecting mature and experienced team leaders, building trust and cooperation with team leaders, exerting the guiding role of team leaders in projects), (3) tailored communication strategies in nursing for effective leadership and safety enhancement (navigating complex hierarchies through tailored communication, fostering collaboration through targeted communication strategies, empowering teams through clear and adapted communication) (4) investing effort and overcoming obstacles are key to successful nursing-guided project implementation (investing time and effort in project implementation, addressing obstacles during project advancement). CONCLUSION: We provide new evidence on the critical role of the care coach in RCA programmes, highlighting the importance of competence, communication, trust and collaboration in enhancing team dynamics and improving quality of care and safety outcomes.