Nurses' Perceptions Regarding Disclosure of Patient Safety Incidents in Korea: A Qualitative Study

Abstract

Purpose: The purpose of this study was to determine nurses' perceptions of the disclosure of patient safety incidents (DPSI), which is known to be effective in reducing medical litigation and improving the credibility of medical professionals. Methods: Three focus group discussions were conducted with 20 nurses using semistructured guidelines. Transcribed content including a record of the progress of the focus group discussions and researchers' notes were analyzed using directed content analysis. Results: Most participants thought that DPSI is necessary because of its effectiveness and for ethical justification. However, participants held varied opinions regarding the primary responsibility of DPSI. Participants agreed on the necessity of explaining the incident and expressing sympathy, apologizing, and promising appropriate compensation that are chief components of DPSI. However, they were concerned that it implies a definitive medical error. A closed organizational culture, fear of deteriorating relationships with patients, and concerns about additional work burdens were suggested as barriers to DPSI. However, the establishment of DPSI guidelines and improving the hospital organization culture were raised as facilitators of DPSI. Conclusion: Most nurse participants acknowledged the need for DPSI. To promote DPSI, it is necessary to develop guidelines for DPSI and provide the appropriate training. Improving the hospital organization culture is also critical to facilitate DPSI.

The relationship of moral sensitivity and patient safety attitudes with nursing students’ perceptions of disclosure of patient safety incidents: A cross-sectional study

“…In this study, despite the fact that only around 25% of participants were familiar with open disclosure, the perception of disclosure of patient safety incidents was generally positive. These results are similar to those found in previous studies [13,26,27]. The results of this study differ from those of the previous studies in terms of how likely participants were to determine the importance of open disclosure based on the severity of the incident in question and whether the information would be helpful to the patient and their family.…”

Disclosing and Reporting Practice Errors by Nurses in Residential Long-Term Care Settings: A Systematic Review

“…Improvement in patient safety requires incident reporting by all healthcare staff [63] and depends on support and encouragement [12], appropriate work conditions, supervision, teamwork, and collaboration [64][65][66]. Reducing nurses' concerns regarding reprimands and punishment after reporting practice errors appears to improve error disclosure and reporting [67]. Disciplinary actions, blame cultures, and frustrations due to lack of organizational change after reporting are barriers to reporting and disclosing [23,31].…”

Nurses’ Barriers to Incident Reporting in Patient Safety Culture: A Literature Review

“…This study found a large number of discussions on the barriers to the implementation of patient safety culture. Research on the Disclosure of Patient Safety Incidents (DPSI) revealed that a closed organizational culture, fear of worsening relationships with patients, and concern about workload were among the barriers to DPSI (Choi et al, 2019). Various opinions from the research participants regarding patient safety incidents indicated heavy workload, insufficient time to respond to patients, and even emotional reactions such as shame, guilt, depression, insomnia, avoidance, and career change consideration (Lee et al, 2019).…”