Barriers and facilitators to incident reporting in mental healthcare settings: A qualitative study

Abstract

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Voluntary patient safety incidents reporting in forensic psychiatry—What do the reports tell us?

“…This is typical in psychiatric settings, where there are strong traditions of assessing human behaviour and discussing patients' symptoms, which are usually regarded as contributory (risk) factors to violence. It is also consistent with the findings of Archer et al (2020), who discovered two major themes regarding issues faced in mental healthcare settings are "interaction between patient diagnosis and incidents"…”

“…Managers and supervisors can play important roles in promoting a positive patient safety culture that fosters the reporting of and learning from incidents as well as successes. Managers and supervisors should identify factors that act as barriers and facilitators of incident reporting (Archer et al, 2020), and patient participation must be an organizational priority (Vandewalle et al, 2018). Patient safety incident reporting is a key process for organizational learning and development of a safety culture, and incident-reporting systems can be particularly effective if systems have clinical ownership and integration with wider safety programs (Stavropoulou et al, 2015), which is one strategy that promotes an active culture of safety in forensic psychiatry.…”

“…However, it has been shown that inpatient psychiatric care issues are under-researched in comparison to other health inpatient settings (Archer et al, 2020) and there is need for further research (Schwappach & Niederhauser, 2019). For instance, systematic reviews examining interventions to reduce violence in forensic psychiatric patients are still missing (Wolf et al, 2017) and patient-to-patient violence has not yet been adequately addressed in forensic psychiatric care.…”

Medication Safety in Mental Health Hospitals: A Mixed-Methods Analysis of Incidents Reported to the National Reporting and Learning System

“…70,71 However, in mental health settings, staff described that patient aggressive behaviour that associated with mental health diagnosis is linked to the probability of under reporting. 72 Therefore, implementing efficient reporting systems alongside education and training to support a better understanding of the rationale behind reporting is needed. This could be informed by providing an explicit framework of common contributory factors to prompt / support improvement in the incident descriptions provided by staff .…”

The incidence and economic impact of aggression in closed long-stay psychiatric wards

“…Incidence rates for aggression in psychiatry vary, ranging from less than 1 to 60 incidents per patient year in two systematic reviews (Nijman, Palmstierna, et al 2005;Bowers et al 2011). The wide range of estimates may be explained by the fact that incidents are less often documented officially, compared to what is actually experienced by staff members, according to self-reported questionnaires and videos, particularly with regard to verbal aggression (Ferns 2006;Nolan and Citrome 2008;Archer et al 2019). Furthermore, there are large variations in study design (e.g., prospective versus retrospective data collection), differences in how the studies' authors defined aggression (e.g., including or excluding verbal aggression and self-harm), and emphases on different patient populations (e.g., these included acute or long stay wards; open or closed wards; and forensic, mixed, or psychiatric wards).…”