Attitudes and Barriers to Incident Reporting for Doctors and Nurses in a University Hospital"s Surgery Departments

Abstract

Purpose: To assess awareness and use of the incident reporting system among doctors and nurses working in hospital surgery departments and to identify the reasons inhibiting incident reporting. Methods: It was used a cross-sectional study design. The study population comprised doctors and nurses working in the surgery departments of a university’s adult and children’s hospital. A form including an incident reporting questionnaire was administered to the population. Results: Compared to doctors, nurses were more aware of the existence of the incident reporting system, filled out more incident reporting forms, and were more knowledgeable about where and how to access the forms and what to do once they were complete. The main barriers to incident reporting were a lack of feedback, completing the form being too time consuming, and the ward being busy. Conclusion: Nurses are more knowledgeable about incident reporting and report more incidents than doctors, who have more concerns. Doctors’ main reason for not reporting incidents is the ward being busy while for nurses it is a lack of feedback.

Keywords

• Barriers, incident, incident reporting, patient safety, reporting, surgery departments

References

1. 1. Chappy S. Perioperative patient safety: a multisite qualitative analysis. AORN J 2006;83:871–897. [CrossRef]
2. 2. Khan FA. The SAFE-T Summit 2018: Implications for the WFSA Safety and Quality of Practice Committee. Update in Anaesthesia 2019;33:11-12. https://www.wfsahq.org/components/com_virtual_ library/media/ba61c6b98c91f1c2a2980599c0a2f9c3-UiA-33-Khan. pdf
3. 3. Nieva VF, Sorra J. Safety culture assessment: a tool for improving patient safety in healthcare organizations. Qual Saf Health Care 2003;12:ii17–ii23. [CrossRef]
4. 4. Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Agency for Healthcare Research and Quality, Rockville, MD; 2008. https://www.ncbi.nlm.nih.gov/books/NBK2651/
5. 5. World Health Organization. World alliance for patient safety: WHO draft guidelines for adverse event reporting and learning systems: from information to action; 2005. https://apps.who.int/iris/bitstream/ handle/10665/69797/WHO-EIP-SPO-QPS-05.3-eng.pdf
6. 6. Ahlberg EL, Elfström J, Borgstedt MR, et al. Learning from incident reporting? Analysis of incidents resulting in patient injuries in a webbased system in Swedish health care. J Patient Saf 2017;1–5. [CrossRef]
7. 7. Pfeiffer Y, Manser T, Wehner T. Conceptualising barriers to incident reporting: a psychological framework. Qual Saf Health Care 2010;19:e60. [CrossRef]
8. 8. Kingston MJ, Evans SM, Smith BJ, Berry JG. Attitudes of doctors and nurses towards incident reporting: a qualitative analysis. Med J Aust 2004;181:36–39. [CrossRef]

9. 9. Kopp BJ, Erstad BL, Allen ME, Theodorou AA, Priestley G. Medication errors and adverse drug events in an intensive care unit: direct observation approach for detection. Crit Care Med 2006;34:415–425. [CrossRef]
10. 10. Chiang HY, Pepper GA. Barriers to nurses’ reporting of medication administration errors in Taiwan. J Nurs Scholarsh 2006;38:392–399. [CrossRef]
11. 11. Evans SM, Berry JG, Smith BJ, et al. Attitudes and barriers to incident reporting: a collaborative hospital study. Qual Saf Health Care 2006;15:39–43. [CrossRef]
12. 12. Engeda EH. Incident reporting behaviours and associated factors among nurses working in Gondar University Comprehensive Specialized Hospital, Northwest Ethiopia. Scientifica 2016;2016:1-7. [CrossRef]
13. 13. George D, HSS A, Hassali A. Medication error reporting: underreporting and acceptability of smartphone application for reporting among health care professionals in Perak, Malaysia. Cureus 2018;10:e2746 [CrossRef]
14. 14. TR Ministry of Health. Sağlıkta Kalite Standartları - Hastane (Versiyon-5; Revizyon-01). Ankara: Sağlık Hizmetleri Genel Müdürlüğü; 2016. https://dosyahastane.saglik.gov.tr/ Eklenti/7273,sks-saglikta-kalite-standartlari-2pdf.pdf?0
15. 15. TR Ministry of Health. Sağlıkta Akreditasyon Standartları - Hastane Seti. Ankara: Sağlık Hizmetleri Genel Müdürlüğü; 2017. https://www. tuseb.gov.tr/uploads/sas_hastane_seti(v2.0-2017)TR.pdf
16. 16. TR Ministry of Health. Güvenlik Raporlama Sistemi 2017 yılı İstatistik ve Analiz Raporu. Ankara: Sağlık Hizmetleri Genel Müdürlüğü; 2018.
17. 17. Brennan TA, Leape LL, Laird NM, Hebert L, Localio, A. R. et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. N Engl J Med 1991; 324:370-376. [CrossRef]
18. 18. de Vries EN, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA. The incidence and nature of in-hospital adverse events: a systematic review. BMJ Quality & Safety 2008; 17:216-223. [CrossRef]
19. 19. Anderson O, Davis R, Hanna GB, Vincent CA. (2013). Surgical adverse events: a systematic review. Am J Surg, 2013; 206:253-262. [CrossRef]
20. 20. Nilsson L, Risberg MB, Montgomery A, Sjödahl R, Schildmeijer K. et al. Preventable adverse events in surgical care in Sweden: a nationwide review of patient notes. Medicine, 2016; 95(11). [CrossRef]
21. 21. Catchpole K, Panesar SS, Russell J, Tang V, Hibbert P, Cleary K. Surgical Safety can be improved through better understanding of incidents reported to a national database. Nat Patient Safety Agency, National Reporting and Learning Service: 2009.
22. 22. Hamilton EC, Pham DH, Minzenmayer AN, Austin MT, Lally KP, et al. Are we missing the near misses in the OR?-underreporting of safety incidents in pediatric surgery. J Surg Res, 2018; 221:336-342. [CrossRef]
23. 23. Hair JF Jr, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis, 7th ed. New Jersey: Pearson Prentice Hall; 2014. https:// is.muni.cz/el/1423/podzim2017/PSY028/um/_Hair_-_Multivariate_ data_analysis_7th_revised.pdf
24. 24. AbuAlRub RF, Al-Akour NA, Alatari NH. Perceptions of reporting practices and barriers to reporting incidents among registered nurses and physicians in accredited and nonaccredited Jordanian hospitals. J Clin Nurs 2015;24:2973–2982. [CrossRef]
25. 25. Whitaker J, Ibrahim F. Incident reporting feedback experience in a UK secondary care setting. Bull Roy Coll Surg Engl 2016;98:82–84. [CrossRef]
26. 26. Altuntaş Turaslan B. Bir Psikiyatri Hastanesinde Hasta Güvenliği Kültürü Düzeyi ve Güvenlik Raporlamanın İncelenmesi (Yüksek Lisans Tezi). İzmir: Ege Üniversitesi, Sağlık Bilimleri Enstitüsü, Psikiyatri Hemşireliği Anabilim Dalı; 2015.
27. 27. Rashed A, Hamdan M. Physicians’ and nurses’ perceptions of and attitudes toward incident reporting in Palestinian hospitals. J Patient Saf 2019;15:212–217. [CrossRef]
28. 28. Hotvedt R, Førde OH. Doctors are to blame for perceived medical adverse events. A cross sectional population study. The Tromsø Study. BMC Health Serv Res 2013;13:46. [CrossRef]
29. 29. Kreckler S, Catchpole K, McCulloch P, Handa A. Factors influencing incident reporting in surgical care. BMJ Qual Saf 2009;18:116–120. [CrossRef]
30. 30. Alboliteeh M, Almughim IM. The knowledge, attitude and practice of physicians and nurses toward adverse event reporting system in primary health care setting. Patient Saf Qual Improv 2017;5:475–481. [CrossRef]
31. 31. Reilly CA, Cullen SW, Watts BV, Mills PD, Paull DE, Marcus SC. How well do incident reporting systems work on inpatient psychiatric units? Jt Comm J Qual Patient Saf 2019;45:63–69. [CrossRef]
32. 32. Semiz Aydın S, Akın S, Işıl Ö. Evaluating the knowledge levels of nurses regarding medication errors and the views of nurses on reporting medication errors. HEAD 2017;14:14–24. [CrossRef]
33. 33. Uçar N, Yıldırım G, Eser D, et al. Determination of Medical Error Reportings at Day and Night Shifts. J Turk Soc Intens Care 2013;11:93– 100. [CrossRef]
34. 34. Coyle YM, Mercer SQ, Murphy-Cullen CL, Schneider GW, Hynan LS. Effectiveness of a graduate medical education program for improving medical event reporting attitude and behavior. Qual Saf Health Care 2005;14:383–388. [CrossRef]
35. 35. Stewart D, Thomas B, MacLure K, et al. Exploring facilitators and barriers to medication error reporting among healthcare professionals in Qatar using the theoretical domains framework: a mixed-methods approach. PloS One 2018;13:e0204987, 1–19. [CrossRef]