The contribution of nurses to incident disclosure: A narrative review

Harrison, Reema; Birks, Yvonne; Hall, Jill; Bosanquet, Kate; Harden, Melissa; Iedema, Rick

doi:10.1016/j.ijnurstu.2013.07.001

Cited by 16 publications

(16 citation statements)

References 33 publications

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“…Further research is required to better understand why there is a preference for informal disclosure even when an adverse event is moderate or serious and to explore the implications of increasing emphasis on multidisciplinary team in the disclosure of adverse events. 25 Open disclosure is a prominent policy leaver and comprehensively promoted in Australia. The evidence demonstrates disclosure is the ethical and appropriate course of action following an adverse health care event.…”

Section: Discussionmentioning

confidence: 99%

Disclosure of adverse events: a data linkage study reporting patient experiences among Australian adults aged ≥45 years

Walton

Harrison

Smith‐Merry

et al. 2019

Aust. Health Review

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Since Australia initiated national open disclosure standards in 2002, open disclosure policies have been adopted in all Australian states and territories. Yet, research evidence regarding their adoption is limited. The aim of the present study was to determine the frequency with which patients who report an adverse event had information disclosed to them about the incident, including whether they participated in a formal open disclosure process, their experiences of the process and the extent to which these align with the current New South Wales (NSW) policy. A cross-sectional survey about patient experiences of disclosure associated with an adverse event was administered to a random sample of 20000 participants in the 45 and Up Study who were hospitalised in NSW, Australia, between January and June 2014. Of the 18993 eligible potential participants, completed surveys were obtained from 7661 (40% response rate), with 474 (7%) patients reporting an adverse event. Of those who reported an adverse event, a significant majority reported an informal or bedside disclosure (91%; 430/474). Only 79 patients (17%) participated in a formal open disclosure meeting. Most informal disclosures were provided by nurses, with only 25% provided by medical practitioners. Experiences of open disclosure may be enhanced by informing patients of their right to full disclosure in advance of or upon admission to hospital, and recognition of and support for informal or bedside disclosure for appropriate types of incidents. A review of the open disclosure guidelines in relation to the types of adverse events that require formal open disclosure and those more suitable to informal bedside disclosure is indicated. Guidelines for bedside disclosure should be drafted to assist medical practitioners and other health professionals facilitate and improve their communications about adverse events. Alignment of formal disclosure with policy requirements may also be enhanced by training multidisciplinary teams in the process. While open disclosure is required in all cases of serious adverse events, patients' experiences are variable, and lack of, or poor quality disclosures are all too common. This paper presents experiences reported by patients across New South Wales in a large cross-sectional survey. Unlike previous studies of open disclosure, recently hospitalised patients were identified and invited using data linkage with medical records. Findings suggest that most patients receive informal disclosures rather than a process that aligns with the current policy guidance. Experiences of open disclosure may be enhanced by informing patients of their right to full disclosure in advance of or upon admission to hospital, and recognition of and support for informal or bedside disclosure for appropriate types of incidents.

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Section: Discussionmentioning

confidence: 99%

Disclosure of adverse events: a data linkage study reporting patient experiences among Australian adults aged ≥45 years

Walton

Harrison

Smith‐Merry

et al. 2019

Aust. Health Review

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“…It has been identified that nurses support both physicians and patients through error disclosure but that they are not properly prepared to undertake the disclosure themselves if indeed they are even included in the process. 8 Barriers to disclosure include lack of training, hierarchical practice, fear, blame and punitive action. 8 In relation to error disclosure and patients in the rural context, it has also been noted that there might be unique elements such as resources, delays, travel distance and the situation in small rural towns where patients are treated and services are managed by people personally known to the patient.…”

Section: Discussionmentioning

confidence: 99%

Aged‐care nurses in rural Tasmanian clinical settings more likely to think hypothetical medication error would be reported and disclosed compared to hospital and community nurses

Carnes

Kilpatrick

Iedema

2015

Australian J Rural Health

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ObjectiveThis study aims to determine the likelihood that rural nurses perceive a hypothetical medication error would be reported in their workplace.DesignThis employs cross-sectional survey using hypothetical error scenario with varying levels of harm.SettingClinical settings in rural Tasmania.ParticipantsParticipants were 116 eligible surveys received from registered and enrolled nurses.Main outcome measuresFrequency of responses indicating the likelihood that severe, moderate and near miss (no harm) scenario would ‘always’ be reported or disclosed.ResultsEighty per cent of nurses viewed a severe error would ‘always’ be reported, 64.8% a moderate error and 45.7% a near-miss error. In regards to disclosure, 54.7% felt this was ‘always’ likely to occur for a severe error, 44.8% for a moderate error and 26.4% for a near miss. Across all levels of severity, aged-care nurses were more likely than nurses in other settings to view error to ‘always’ be reported (ranging from 72–96%, P = 0.010 to 0.042,) and disclosed (68–88%, P = 0.000). Those in a management role were more likely to view error to ‘always’ be disclosed compared to those in a clinical role (50–77.3%, P = 0.008–0.024).ConclusionFurther research in rural clinical settings is needed to improve the understanding of error management and disclosure.

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“…Practicing within regulatory and professional frameworks (Corey, Corey, Corey, & Callanan, ) impacts the way nurses understand important ethical issues, including promoting patient dignity (Rapport et al., ); disclosure (Harrison et al., ); role development, nursing practice environments (Lim & Bernstein, ); and professional boundaries. Within the context of increasing technological complexity and chronic illness (Redman ), many ethical issues have emerged related to withholding and withdrawing treatment (Albers, Francke, de Veer, Bilsen, & Onwuteaka‐Philipsen, ); treatment access and allocation (White, Jordens, & Kerridge, ); organ transplantation (Tanimizu et al.…”

Section: Professional and Education Regulation And Standardsmentioning

confidence: 99%

“…Within the context of increasing technological complexity and chronic illness (Redman ), many ethical issues have emerged related to withholding and withdrawing treatment (Albers, Francke, de Veer, Bilsen, & Onwuteaka‐Philipsen, ); treatment access and allocation (White, Jordens, & Kerridge, ); organ transplantation (Tanimizu et al. ); genomics (Badzek, Henaghan, Turner, & Monsen, ); quality and safety (Baily, Bottrell, Lynn, & Jennings, ); population ageing and increased diversification of society (Badzek et al., ) and assisted suicide (Harrison et al., ). Furthermore, promoting patient autonomy, delivering care within legal and ethical frameworks, interprofessional communication and monitoring of standards and practices remain prominent ethical considerations (Arries, ).…”

Section: Professional and Education Regulation And Standardsmentioning

confidence: 99%

“…Organisations also seek to shape professional values and behaviours (Lankshear, Kerr, Laschinger, & Wong, 2013 (Rapport et al, 2014); disclosure (Harrison et al, 2014); role development, nursing practice environments (Lim & Bernstein, 2014) (Baily, Bottrell, Lynn, & Jennings, 2006); population ageing and increased diversification of society (Badzek et al, 2013) and assisted suicide (Harrison et al, 2014). Furthermore, promoting patient autonomy, delivering care within legal and ethical frameworks, interprofessional communication and monitoring of standards and practices remain prominent ethical considerations (Arries, 2014).…”

Section: Regulation and Standardsmentioning

confidence: 99%

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A social–ecological framework: A model for addressing ethical practice in nursing

Davidson

Rushton

Kurtz

et al. 2018

Journal of Clinical Nursing

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The contribution of nurses to incident disclosure: A narrative review

Cited by 16 publications

References 33 publications

Disclosure of adverse events: a data linkage study reporting patient experiences among Australian adults aged ≥45 years

Disclosure of adverse events: a data linkage study reporting patient experiences among Australian adults aged ≥45 years

Aged‐care nurses in rural Tasmanian clinical settings more likely to think hypothetical medication error would be reported and disclosed compared to hospital and community nurses

A social–ecological framework: A model for addressing ethical practice in nursing

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