Aim Nurses constitute an important group in identifying and preventing errors and risks in health care, but research on their perception of errors is scarce. This paper presents results of a representative study on health care errors, focusing on factors causing and influencing the occurrence of errors as perceived by nurses. Subject and methods The cross-sectional research design comprised descriptive and correlational parts. The sample consisted of 1,100 nurses employed at 30 hospitals and 46 nursing homes in Germany. Data were collected in 2008/ 2009 using a questionnaire listing 21 factors that can potentially cause or influence errors. Participants could choose up to three factors they deem the most important. Differences between the two settings and variables which might have an influence on the perception of error-causing factors were analyzed using cluster-adjusted methods. Results High workload, staff shortage and excessive labour topped the list. Hospital nurses more often chose "workload" and "interruptions" while nursing home nurses more often ranked "lack of knowledge" and "lack of motivation" as the most important. There are some significant variables such as years of professional experience and migration background that could affect nurses' perception. Conclusion The findings support other studies, pointing to workload issues and below-optimum work processes producing errors. Inter-sectoral differences suggest the necessity of sector-specific support in education and on-going training as well as risk and quality management.

Positive secular changes were observed in body height and weight during the past decade (p < 0.01) and century. The increase in BMI at the beginning of the 21st century in comparison to the end of the 20th century may possibly be facilitated by the increased occurrence of overweight, obesity and related diseases in Latvian children. However, the number of underweight children has increased in the last decade as well.

Preventig errors and implementing risk management systems in health and nursing care requires knowledge about nurses' perceptions of errors, such as their handling and their reporting of errors. Whistleblowing is a way of reporting serious deficits by leaving predetermined pathways and addressing persons, institutions or media outside the organisation. In eighteen semi-structured interviews nurses were asked if they could imagine acting as a whistleblower, or if they even had ever blown the whistle before. The scope of their appraisal ranged from strictly disapproving such behaviour (what was done by most of the interviewees) to approving only hesitantly because of personal risks. Central themes were allegiance to the organisation, to the team and to colleagues, responsibility for the patients, and the consideration of personal risks. This corresponds to the results of other studies on whistleblowing, as described in the discussion. Nurses have to be encouraged to accept professional responsibilities as well as organisational ways of error reporting have to be found and to be discussed, e. g. in terms of best practice examples. Whistleblowing should be regarded as an act by which patient advocacy is expressed.

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