Hospital nurses’ intention to report near misses, patient safety culture and professional seniority

Abstract

Background Preventable medical errors are the third cause of death after cancer and heart disease. The first step in coping with medical errors in the healthcare system is to develop a culture of patient safety. Reporting medical errors, especially near misses, is one of the chosen methods of dealing with patient safety issues, recommended by the Institute of Medicine. Despite this recommendation, few studies examined the relationship between reporting near misses and improvements in patient safety culture. Intention to report a near miss event is another means to understand the phenomena of reporting, but no studies were found that included this variable and its relationship to safety culture. The aims of this study were to determine the extent nurses reported near miss events; to describe the relationship between patient safety culture, professional seniority and intention to report near misses; and to determine predictors of intention to report near miss events. Methods This was a descriptive cross-sectional study, based on the Hospital Survey on Patient Safety (HSOPS). The target population was ICU and inpatient ward nurses working in general hospitals. The sampling method was cluster convenience sampling. Statistical analysis included descriptive and predictive analyses. Results The sample included 227 nurses. Most nurses rated the patient safety culture components as moderately positive. Approximately 80% stated their intention to report a near miss, however 52.4% indicated that they did not report a near miss event in the past year. A positive correlation was found between all components of the patient safety culture and the intention to report a near miss event. Professional seniority was not related to any safety culture components or intention to report a near-miss event. Three variables predicted intention to report: team work, feedback and communication about errors, and the amount of near misses reported in the last year. Conclusions There is a discrepancy between what nurses describe as their intent to report a near miss event and their actual reporting of an event. Components of safety culture, especially communication openness, teamwork and reported near misses in the last year are significant predictors of the intent to report. Therefore, reinforcement of these components should be encouraged at the policy level to enable nurses to report near misses and thus improve patient safety.

Nurses’ Intentions, Awareness and Barriers in Reporting Adverse Events: A Cross-Sectional Survey in Tertiary Hospitals in China

“…In addition, the score of barriers to reporting adverse events was significantly and positively correlated with reporting intention; that is, the more the nurses perceived barriers to reporting, the less their reporting intention. Of these, reporting culture had the greatest impact on nurses’ intention to report adverse events, consistent with the findings of Yang et al 56 and Toren et al 57 Previous studies have pointed out that fear of discrimination and punishment is the main reason why nurses do not volunteer to report adverse events. 58 , 59 Similar to Lee et al, 60 we also found that the perceptions of reporting benefits influences nurses’ reporting intentions.…”

Factors Influencing Military Nurses' Reporting of Patient Safety Events in South Korea: A Structural Equation Modeling Approach

“…Moreover, safety motivation had no direct effect on patient safety event reporting, which again represents a significant difference from previous studies that posited the influence of safety motivation on safety behavior [19,39]. For example, Toren et al stated that most nurses (80%) demonstrated an intention to report medical errors and near misses, although 53% of them had not reported near misses in the past year [52]. Thus, there was a difference found between participants' reported intentions and their actual near-miss reporting.…”

Nurses' Decisions in Error Reporting and Disclosing Based on Error Scenarios: A Mixed-method Study

“…ror reporting was contingent upon the severity of the consequences to the patients; they would not instead report near-miss cases or errors without consequences, even informally. Toren et al reported a discrepancy between what nurses describe as their intent to report a near-miss event and their actual reporting of an event (35). Nurses fear intimidation, retribution, or punitive measures.…”