Patients’ safety in adult ICUs: Registered nurses’ attitudes to critical incident reporting

摘要

Globally, patients’ safety is a major concern, with ongoing attempts to address the challenge of critical incident reporting. Patients in Intensive Care Units (ICUs) are highly dependent, more prone to unintentional harm, and could benefit from incident reporting as the essential first step for improving patient safety. The study aimed to describe the perceptions of registered nurses towards incident reporting, prior to developing and implementing an intervention goaled to improve incident reporting in adult ICUs in tertiary level provincial hospitals in KwaZulu-Natal, South Africa. A non-experimental quantitative descriptive survey using a two-part self-administered questionnaire [demographics and 20-item Incident Reporting Culture Questionnaire (IRCQ) subdivided into four factors], administered to registered nurses (N?=?127) [ICU specialist (N?=?63) and non-specialist (N?=?64)]. Data were analysed using IBM SPSSv24. Response rate was 79.75% (n?=?101), with most respondents 41– 50 years old with 1–5 years ICU experience, and 59.4% held an ICU qualification. In the past 12 months 63.4% had not reported any incident. Unpleasant collegial atmosphere (Factor 3) with tension and disharmony were reported, and significant associations shown between Factor 3 and ICU qualification. For the total IRCQ score, 50.5% had an effective attitude towards incident reporting. While the respondents knew about the reporting system, punishment, blaming and lack of confidentiality were major barriers. A positive non-punitive, blame free, incident reporting culture in ICU could decrease patient vulnerability and lower legal claims on the health budget, contributing to meeting the South African National Core Standards for health and responding to WHO patient safety goals.