Attitudes of Internal Medicine Nurses, Surgical Nurses and Midwives towards Reporting of Clinical Adverse Events

Nurses' adverse event reporting attitudes and related factors: a cross-sectional study in maternal and child specialized hospitals in China

Objective

To investigate the current situation of nurses' attitude toward adverse event reporting and identify its related factors in maternal and child specialized hospitals.

Methods

A questionnaire survey was conducted among 943 nurses in 18 second-level and above maternal and child specialized hospitals in Sichuan province in China. The questionnaire included general information and the Chinese version of Reporting of Clinical Adverse Effects Scale (C-RoCAES).

Results

The total score of adverse events reported by nurses was 63.98 ± 8.77. The scores of the dimensions from high to low were reporting standard (3.13 ± 0.46), reporting impact (2.80 ± 0.54), reporting purpose (1.98 ± 0.66), and reporting environment (1.98 ± 0.42). Educational background (β = -1.87, p < 0.001), professional title (β = -3.51, p < 0.001), and adverse event experience (β = -7.05, p < 0.001) were the positively associated with higher levels of nurses' attitude toward adverse event reporting in maternal and child specialized hospitals (p < 0.05).

Conclusion

The attitude of nurses in maternal and child specialized hospitals to report adverse events is at the middle level. Hospital managers should improve the reporting standards for adverse events, improve the hospital safety culture, strengthen the relevant training for nurses with low education and low professional titles, so as to improve nurses' awareness of adverse event reporting and reporting rate.

Perceptions of Clinical Adverse Event Reporting by Nurses and Midwives

The level of safety in healthcare units is mainly characterized by the occurrence of medical adverse events. The aim of the study was to present the experiences of reporting clinical adverse events and the perceptions of nurses working in internal medicine wards, surgical wards and midwives on these issues. The cross-sectional survey was conducted from October 2022 to April 2023. The study used the Author's Survey Questionnaire and sampling by assessment was applied. The study included nurses working in internal medicine wards and surgical wards as well as midwives at nine hospitals in a large provincial city in Poland, amounting to 745 participants. A one-way analysis of variance ANOVA and a post-hoc test (Fisher's NIR) were used. The significance level (p) did not exceed 0.05. Nurses working in surgical wards, internal medicine wards and midwives thought that clinical adverse events should be reported, and perceived this as an important and useful activity in ensuring patient safety. The most common adverse events reported by respondents were falls F(2.742) = 52.07; p = 0.001, bedsores F(2.742) = 19.62; p = 0.001, patient disappearances F(2.742) = 3.98; p = 0.019, and hospital-acquired infections F(2.742) = 3.88; p = 0.021. The most frequently selected factors influencing the abandonment of adverse event reporting were excessively complex paperwork, no or little harm to the patient or a fear of the negative consequences. The study suggests that an important way to overcome the barriers to nurses and midwives reporting adverse events would be to create a supportive atmosphere in which they could report errors and the reasons for them honestly and without fear, and to improve the way adverse events are reported at the personal and institutional levels.