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

Objectives: 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. Design: This was a descriptive cross-sectional correlational study.The sampling method was cluster convenience sampling. Surveys were based on the Hospital Survey on Patient Safety (HSOPS). Setting: Three general Hospitals (a small, large and a tertiary center) located in the north and center of Israel. Participants: ICU and inpatient ward nurses working in general hospitals. Main outcome measures: Patient safety culture, reporting medical errors and near miss events, intention to report near miss events, professional seniority. 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.