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Exploring perceptions of perinatal nurses towards incident reporting : a qualitative study

University of British Columbia

Patient safety has received greater attention in response to the release of reports estimating a significant number of incidents (adverse events or near misses) occur during inpatient hospital stays. Improving the safety of our health care system requires a greater understanding of the types of incidents and their underlying causes. Nurses are recognized as the discipline most likely to report incidents in practice due to their front line role in patient care. Perinatal nurses are of specific interest as they are well recognized as playing an active role in the identification and reporting of incidents that occur in inpatient perinatal settings. This descriptive qualitative study explored perinatal nurses’ perceptions about reporting incidents in practice and also identified factors that facilitate or act as barriers towards incident reporting. Data were collected in focus groups (n=16) consisting of perinatal nurses employed on labour and delivery units within one Health Authority in the province of BC. Audiotaped data were transcribed and analyzed using constant comparison. Four main themes and 12 subthemes were identified. The main themes were: nature of incidents, how incidents happen, barriers to incident reporting, and facilitating factors for incident reporting. The subthemes included: descriptions of incidents, determining what qualifies as an incidents, litigation, decision making, dynamics, fatigue, time, reporting tools, unit culture, learning, practice improvement, and professional identity. The perinatal nurses indicated the types of incidents that occurred in their practice area were unique to their practice setting. They felt these incidents were mostly related to outcomes and were to some degree out of their control. They did not view incidents involving medications as an issue They identified team dynamics as influencing the safety of perinatal units, because poor team dynamics were often associated with negative patient outcomes. Fatigue, lack of time to report incidents, reporting tools and the negative reactions/responses of team members were identified as barriers to incident reporting. Facilitating factors to incident reporting were professional responsibility, learning opportunities created by incident reports, and observing change on their units in response to incident reports. The themes had implications for nursing practice, administration, education, and research.

Text

2010-08-30

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/27916

Nursing

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/