Causes of medical errors and its under-reporting amongst pediatric nurses in Iran: a qualitative study

Health professionals' perceptions of the development needs of incident reporting software: A qualitative systematic review

AIM

To systemically identify and synthesize information on health professionals' and students' perceptions regarding the development needs of incident reporting software.

DESIGN

A systematic review of qualitative studies.

DATA SOURCES

A database search was conducted using Medline, CINAHL, Scopus, Web of Science and Medic without time or language limits in February 2023.

REVIEW METHODS

A total of 4359 studies were identified. Qualitative studies concerning the perceptions of health professionals and students regarding the development needs of incident reporting software were included, based on screening and critical appraisal by two independent reviewers. A thematic synthesis was conducted.

RESULTS

From 10 included studies, five analytical themes were analysed. Health professionals and students desired the following improvements or changes to incident reporting software: (1) the design of reporting software, (2) the anonymity of reporting, (3) the accessibility of reporting software, (4) the classification of fields and answer options and (5) feedback and tracking of reports. Wanted features included suitable reporting forms for various specialized fields that could be integrated into existing hospital information systems. Rapid, user-friendly reporting software using multiple reporting platforms and with flexible fields and predefined answer options was preferred. While anonymous reporting was favoured, the idea of reporting serious incidents with both patient and reporter names was also suggested.

CONCLUSION

Health professionals and students provided concrete insights into the development needs for reporting software. Considering the underreporting of healthcare cases, the perspectives of healthcare professionals must be considered while developing user-friendly reporting tools. Reporting software that facilitates the reporting process could reduce underreporting.

REPORTING METHOD

The ENTREQ reporting guideline was used to support the reporting of this systematic review.

PATIENT OR PUBLIC CONTRIBUTION

There was no patient or public contribution.

PROTOCOL REGISTRATION

The protocol is registered in the International Prospective Register of Systematic Reviews with register number CRD42023393804.

Investigation of Nurses' Wellbeing towards Errors in Clinical Practice-The Role of Resilience

Background and Objectives: The fatigue, stress, and burnout of nurses lead to them frequently making mistakes, which have a negative impact not only on the safety of the patients but also on their psychology. The ability to bounce back from mistakes is crucial for nurses. Nursing staff members' physical and mental health, particularly their depression, is far from ideal, and this ill health is directly correlated with the frequency of self-reported medical errors. The nurses' mental and physical health are also positively correlated with their perception of wellness support at work. This cross-sectional study aimed to investigate the status of nurses' mental and physical health regarding clinical errors and the impact of resilience on coping with these situations. Materials and Methods: A total of 364 healthcare professionals participated in this research; 87.5% of them were females and 12.5% of them were males. Most of the participants were 22-35 years old. The median number of years of employment was nine. Clinical nurses anonymously and voluntarily completed a special structured questionnaire that included questions from different validated tools in order to assess their state of physical and mental wellbeing after events of stress and errors made during their practice. Results: In total, 49.4% of the nurses had made an error on their own, and 73.2% had witnessed an error that someone else had made. At the time of the error, 29.9% of the participants were in charge of more than 20 patients, while 28.9% were responsible for a maximum of three patients. Participants who were 36-45 years old had more resilience (p = 0.049) and experienced fewer negative emotions than participants who were 22-35 years old. The participants who mentioned more positive feelings according to their mental state had greater resilience (p > 0.001). Conclusions: Errors were likely to happen during clinical practice due to nurses' negative experiences. The level of resilience among the nursing population was found to play a very important role not only in making mistakes but also in coping with errors during their daily routine. Wellness and prevention must be given top priority in all healthcare systems across the country in order to promote nurses' optimal health and wellbeing, raise the standard of care, and reduce the likelihood of expensive, avoidable medical errors. Healthcare administrations should promote prevention programs for stress occurrence in order to support nurses' wellbeing maintenance.

Medical errors room: The effect of simulation training on increasing the awareness of nursing students about the medical errors they may encounter in psychiatry clinics

AIM

This study aimed at investigating the effect of simulation training on increasing the awareness of nursing students about medical errors they may encounter in psychiatry clinics.

METHODS

This study was quasi-experimental and included pre-test and post-test control groups. The intervention group (n = 41) was provided with "Medical Errors Room" simulation training while the control group (n = 41) was trained by using the presentation method.

RESULTS

Considering the increase in the awareness of all students about medical errors, it was determined that the awareness of the students in the intervention group was higher than the students in the control group (p < 0.05).

CONCLUSION

It was concluded that with the "Medical Error Room" simulation training, the awareness of nursing students, who will be among the health professionals of the future, about medical errors can be increased.

Medical error and under-reporting causes from the viewpoints of nursing managers: A qualitative study

Background:

Patient safety as a goal can be achieved by reporting medical errors (ME); however, most errors are never reported. The aim of this study is to explore the causes of ME, and the obstacles in reporting them amongst nurses.

Methods:

We conducted semi-structural interviews, with 12 nursing managers in the biggest teaching hospital in southern Iran (2015-2016). The interview guide concentrated on the causes of ME and barriers in reporting them. All face-to-face interviews were recorded and transcribed verbatim and analysed using thematic analysis.

Results:

In this study 4 main themes were extracted for the causes of ME: personal/social characteristics, nonprofessional practice, hospital related factors/organization contextual factors, and poor management. Also, 5 main themes (such as; personal characteristics, fear from reporting, nonprofessional practices, cultural and social factors, and error surveillance system features) were obtained with regards to barriers in reporting.

Conclusions:

ME can be reduced by improving professional practice and better human resource management. Also, reporting errors can be increased by focusing on cultural and social factors.

Common Barriers to Reporting Medical Errors

BACKGROUND

Medical errors are the third leading cause of death in the United States. Reporting of all medical errors is important to better understand the problem and to implement solutions based on root causes. Underreporting of medical errors is a common and a challenging obstacle in the fight for patient safety. The goal of this study is to review common barriers to reporting medical errors.

METHODS

We systematically reviewed the literature by searching the MEDLINE and SCOPUS databases for studies on barriers to reporting medical errors. The preferred reporting items for systematic reviews and meta-analyses guideline was followed in selecting eligible studies.

RESULTS

Thirty studies were included in the final review, 8 of which were from the United States. The majority of the studies used self-administered questionnaires (75%) to collect data. Nurses were the most studied providers (87%), followed by physicians (27%). Fear of consequences is the most reported barrier (63%), followed by lack of feedback (27%) and work climate/culture (27%). Barriers to reporting were highly variable between different centers.