A consideration for using workers' heuristics to improve safety rules based on relationships between creative mental sets and rule-violating actions

This paper reports on the relationships between creative mental sets and rule-violating actions using questionnaires answered by 218 nursing workers. An exploratory factor analysis was conducted. The results revealed five factors of creative mental sets: curiosity, minutiae, inquiry, sensitivity, and courage. In addition, rule-violating actions were found to consist of three factors: violation of regulations, violation of local rules, and self-style. The results of multiple regression analyses showed a negative relation between curiosity and regular rule violation. Negative correlations were observed among minutiae, inquiry, and local rule violation. Furthermore, the mean score of local rule violation of a person who thinks that it is important for the work environment to offer high and excellent care is significantly higher than that of those who think that other environmental considerations are more important. The result elucidated the necessity of using workers' heuristics in the process of improving safety rules as well as improving their acceptability to workers. This point is important and applicable not only in the field of patient safety management systems, but also in other fields. (C) 2010 Elsevier Ltd. All rights reserved.