Iran Journal of Nursing

Introduction
Nurses in emergency departments (Eds) are exposed to cognitive failures, which refers to impaired perception, memory, and motor function, which can significantly affect the quality of patient care. These cognitive failures can manifest in various ways, such as difficulty in processing information, remembering critical details, or executing tasks efficiently. It seems that personality traits also affect the occurrence of errors in nurses. There are five big personality traits: Neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness. This study aims to determine the relationship between cognitive failure and personality traits of ED nurses in Urmia, Iran. 

Methods
This descriptive-correlational study was conducted on 165 nurses working in the EDs of hospitals affiliated to Urmia University of Medical Sciences from February to May 2021. Entry criteria were the experience of working in the ED for at least 3 months, having a bachelor’s degree or higher, and having direct contact with patients.
Data were collected using Broadbent’s cognitive failure questionnaire (CFQ) with 25 items and three subscales of forgetfulness, distractibility, and false triggering; and the NEO Five-Factor inventory (NEO-FFI) with 60 items and five domains of neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness.
Descriptive statistics, such as frequency, frequency percentage, mean, and standard deviation, were employed to describe the variables. Data were analyzed with one-way analysis of variance (ANOVA), independent t-test, Pearson correlation test, and multiple regression analysis in SPSS software, version 22. The significant level was set at 0.05.

Results
The mean total score of CFQ was 1.56±0.78. Regarding the dimensions of CFQ, the highest mean score was for the distractibility dimension (1.66±0.77), while the lowest mean score was for the dimension of false triggering (1.42±0.93). Regarding the personality traits, the findings showed that the highest mean score was for the conscientiousness (29.98±6.74), while the lowest mean score was for the neuroticism trait (21.21±6.56).
We found a significant and negative correlation between cognitive failure (and its dimensions) and all personality traits (P<0.001). Furthermore, we identified a significant relationship between nurses’ cognitive failures and other variables, including the use of sedatives (P=0.001), work shift (P<0.001), and satisfaction with salary (P=0.041). 
In the regression model, the personality traits of neuroticism (P=0.006), openness (P=0.002) and conscientiousness (P<0.001) had a significant negative relationship with cognitive failure. The coefficient of determination for the model was 0.558, indicating that 55.8% of the changes in cognitive failure are explained by these three personality traits.

Conclusion
The findings of this study revealed that the cognitive failure level of ED nurses was moderate, indicating that they were experiencing some level of impairment in perception, memory, and motor function. There was a negative significant relationship between cognitive failure and personality traits of ED nurses. The nurses with higher conscientiousness (i.e., a strong sense of responsibility) had lower cognitive failures. On the other hand, the nurses with neuroticism (prone to anxiety, worry, and emotional instability) had more cognitive failures. Overall, the study highlights the importance of considering both cognitive failures and personality traits in the training and support of ED nurses. By addressing these factors, the hospitals should create a more supportive and effective work environment for nurses, to enhance the quality of emergency care.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Iran University of Medical Sciences (Code: IR.IUMS.REC.1399.746). Written informed consent was obtained from the participants

Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors.

Authors' contributions
The authors contributed equally to preparing this article.

Conflict of interest
The authors declare no conflicts of interest.

Acknowledgments
The authors would like to thank all nurses from the emergency departments of selected hospitals who participated in this study.

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