DOI QR코드

DOI QR Code

The Effectiveness of Error Reporting Promoting Strategy on Nurse's Attitude, Patient Safety Culture, Intention to Report and Reporting Rate

오류보고 촉진전략이 간호사의 오류보고에 대한 태도, 환자안전문화, 오류보고의도 및 보고율에 미치는 효과

  • Received : 2009.05.26
  • Accepted : 2010.01.10
  • Published : 2010.04.30

Abstract

Purpose: The purpose of this study was to examine the impact of strategies to promote reporting of errors on nurses' attitude to reporting errors, organizational culture related to patient safety, intention to report and reporting rate in hospital nurses. Methods: A nonequivalent control group non-synchronized design was used for this study. The program was developed and then administered to the experimental group for 12 weeks. Data were analyzed using descriptive analysis, $\chi^2$-test, t-test, and ANCOVA with the SPSS 12.0 program. Results: After the intervention, the experimental group showed significantly higher scores for nurses' attitude to reporting errors (experimental: 20.73 vs control: 20.52, F=5.483, p=.021) and reporting rate (experimental: 3.40 vs control: 1.33, F=1998.083, p<.001). There was no significant difference in some categories for organizational culture and intention to report. Conclusion: The study findings indicate that strategies that promote reporting of errors play an important role in producing positive attitudes to reporting errors and improving behavior of reporting. Further advanced strategies for reporting errors that can lead to improved patient safety should be developed and applied in a broad range of hospitals.

Keywords

References

  1. Dovey, S. M., & Phillips, R. L. (2004). What should we report to medical error reporting systems? Quality &Safety in Health Care, 13, 322-323. https://doi.org/10.1136/qshc.2004.011791
  2. Elder, N. C., Graham, D., Brandt, E., & Hickner, J. (2007). Barriers and motivators for making error reports from family medicine offices: A report from the American Academy of Family Physicians National Research Network (AAFP NRN). Journal of the American Board of Family Medicine, 20, 115-123. https://doi.org/10.3122/jabfm.2007.02.060081
  3. Etchell, E., O'Neill, C., & Bernstein, M. (2003). Patient safety in surgery: Error detection and prevention. World Journal of Surgery, 27, 936-942. https://doi.org/10.1007/s00268-003-7097-2
  4. Feng, X., Bobay, K., & Weiss, M. (2008). Patient safety culture in nursing: A dimensional concept analysis. Journal of Advanced Nursing, 63, 310-319. https://doi.org/10.1111/j.1365-2648.2008.04728.x
  5. Firth-Cozens, J. R., Firth, A., & Booth, S. (2004). Attitudes to and experiences of reporting poor care. Clinical Governance, 8, 331-336.
  6. Force, M. V., Deering, L., Hubbe, J., Andersen, M., Hagemann, B., Cooper-Hahn, M., et al. (2006). Effective strategies to increase reporting of medication errors in hospitals. Journal of Nursing Administration, 36, 34-41. https://doi.org/10.1097/00005110-200601000-00009
  7. Gladstone, J. (1995). Drug administration errors: A study into the factors underlying the occurrence and reporting of drug errors in a district general hospital. Journal of Advanced Nursing, 22, 628-637. https://doi.org/10.1046/j.1365-2648.1995.22040628.x
  8. Grant, M. J., & Larsen, G. Y. (2007). Effect of an anonymous reporting system on near-miss and harmful medical error reporting in a pediatric intensive care unit. Journal of Nursing Care Quality, 22, 213-221. https://doi.org/10.1097/01.NCQ.0000277777.35395.e0
  9. Handler, S. M., Altman, R. L., Perera, S., Hanlon, J. T., Studenski, S. A., Bost, J. E., et al. (2007). A systematic review of the performance characteristics of clinical event monitor signals used to detect adverse drug events in the hospital setting. Journal of the American Medical Informatics Association, 4, 451-458.
  10. Hughes, C. M., & Lapane, K. L. (2006). Nurses' and nursing assistants' perceptions of patient safety culture in nursing homes. International Journal for Quality in Health Care, 18, 281-286. https://doi.org/10.1093/intqhc/mzl020
  11. Kagan, I., & Barnoy, S. (2008). Factors associated with reporting of medication errors by Israeli nurses. Journal of Nursing Care Quality, 23, 353-361. https://doi.org/10.1097/01.NCQ.0000336674.10348.09
  12. Kaissi, A. (2006). An organizational approach to understanding patient safety and medical errors. Health Care Management, 25, 292-305.
  13. Kim, J., An, K., Kim, M. K., & Yoon, S. H. (2007). Nurses' perception of error reporting and patient safety culture in Korea. Western Journal of Nursing Research, 29, 827-844. https://doi.org/10.1177/0193945906297370
  14. Kim, J., & Bates, D. W. (2006). Results of a survey on medical error reporting systems in Korean hospitals. International Journal of Medical Informatics, 75, 148-155. https://doi.org/10.1016/j.ijmedinf.2005.06.005
  15. Kim, M. S., Kim, J. S., Jung, I. S., Kim, Y. H., & Kim, H. J. (2007). The effectiveness of the error reporting promoting program on the nursing error incidence rate in Korean operating rooms. Journal of Korean Academy of Nursing, 37, 185-191.
  16. Kohn, L. T., Corriagan, J. M., & Donaldson, M. S. (2000). To err is human. Building a safer health system. Washingson DC: National Academy Press.
  17. Leape, L. L. (1994). Error in medicine. JAMA, 272, 1851-1857. https://doi.org/10.1001/jama.272.23.1851
  18. Mekhjian, H. S., Bentley, T. D., Ahmand, A., & Marsh, G. (2004). Development of a web based event reporting system in an academic environment. Journal of the American Medical Informatics Association, 11, 11-18.
  19. Milch, C. E., Salem, D. N., Pauker, S. G., Lundquist, T. G., Kumar, S., & Chen, J. (2006). Voluntary electronic reporting of medical errors and adverse events. An analysis of 92,547 reports from 26 acute care hospitals. Journal of General Internal Medicine, 21, 165-170.
  20. Osborne, J., Blais, K., & Hayes, J. S. (1999). Nurses' perceptions: When is it a medication error? Journal of Nursing Administration, 29(4), 33-38. https://doi.org/10.1097/00005110-199904000-00011
  21. Paradis, A. R., Stewart, V. T., Bayley, K. B., Brown, A., & Bennett, A. J. (2009). Excess cost and length of stay associated with voluntary patient safety event reports in hospitals. American Journal of Medical Quality, 24, 53-60.
  22. Park, S., & Kwon, I. G. (2007). Factors influencing nurses' clinical decision making -Focusing on critical thinking disposition-. Journal of Korean Academy of Nursing, 37, 863-871.
  23. Robinson, A. R., Hohmann, K. B., Rifkin, J. I., Topp, D., Gilroy, C. M., Pickard, J. A., et al. (2002). Physician and public opinions on quality of health care and the problem of medical errors. Archives of Internal Medicine, 162, 2186-2190. https://doi.org/10.1001/archinte.162.19.2186
  24. Sexton, J. B., Thomas, E. J., & Helmreich, R. L. (2000). Error, stress and teamwork in medicine and aviation; Cross-sectional surveys. BMJ, 320(7237), 745-749. https://doi.org/10.1136/bmj.320.7237.745
  25. Sorra, J., Nieva, V., Fastman, B. R., Kaplan, H., Schreiber, G., & King, M. (2008). Staff attitudes about event reporting and patient safety culture in hospital transfusion services. Transfusion, 48, 1934-1942. https://doi.org/10.1111/j.1537-2995.2008.01761.x
  26. Suresh, G., Horbar, J. D., Plsek, P., Gray, J., Edwards, W. H., Shrono, P. H., et al. (2004). Voluntary anonymous reporting of medical errors for neonatal intensive care. Pediatrics, 113, 1609-1618. https://doi.org/10.1542/peds.113.6.1609
  27. Thompson, C., & Dowding, D. (2004). Awareness and prevention of error in clinical decision-making. Nursing Times, 100(23), 40-43.
  28. Throckmorton, T., & Etchegaray, J. (2007). Factors affecting incident reporting by registered nurses: The relationship of perceptions of the environment for reporting errors, knowledge of the nursing practice act, and demographics on intent to report errors. Journal of Perianesthesia Nursing, 22, 400-412. https://doi.org/10.1016/j.jopan.2007.09.006
  29. Undre, S., Sevdalis, N., Healey, A. N., Darzi, A., & Vincent, C. A. (2007). Observational teamwork assessment for surgery (OTAS): Refinement and application in urological surgery. World Journal of Surgery, 31, 1373-1381. https://doi.org/10.1007/s00268-007-9053-z
  30. Weingart, S. N., Callanan, L. D., & Aronson, M. D. (2001). A physician-based voluntary reporting system for adverse event and medical errors. Journal of General Internal Medicine, 16, 809-814. https://doi.org/10.1046/j.1525-1497.2001.10231.x

Cited by

  1. 환자안전보고 촉진 교육프로그램의 개발 및 평가 vol.13, pp.1, 2010, https://doi.org/10.5762/kais.2012.13.1.284
  2. 한국형 노인요양시설 환자안전문화 측정도구 개발 및 평가 vol.43, pp.3, 2010, https://doi.org/10.4040/jkan.2013.43.3.379
  3. 간호사가 인지한 투약오류관리풍토와 오류보고의도의 관계에서 변혁적 리더십의 역할 vol.25, pp.6, 2010, https://doi.org/10.7475/kjan.2012.24.6.633
  4. 간호사가 인식한 조직의 특성과 투약오류보고장애요인간의 정준상관관계 vol.15, pp.2, 2010, https://doi.org/10.5762/kais.2014.15.2.979
  5. 간호사가 인식한 조직의 특성과 투약오류보고장애요인간의 정준상관관계 vol.15, pp.2, 2010, https://doi.org/10.5762/kais.2014.15.2.979
  6. 대학병원과 중소병원 간호사의 환자안전문화에 대한인식과 환자안전간호활동의 비교연구 vol.21, pp.4, 2015, https://doi.org/10.11111/jkana.2015.21.4.405
  7. 투약오류보고장애요인과 투약오류보고의도의 관계에서 수간호사의 안전 관련 변혁적 리더십의 매개, 완충효과 vol.27, pp.6, 2015, https://doi.org/10.7475/kjan.2015.27.6.673
  8. 간호대학생의 입원아동 안전간호활동 인식 영향 요인 vol.23, pp.4, 2010, https://doi.org/10.4094/chnr.2017.23.4.534
  9. 간호사의 사건보고와 안전분위기 인지에 대한 융합연구 vol.9, pp.4, 2010, https://doi.org/10.15207/jkcs.2018.9.4.443
  10. 중소병원 간호사의 환자안전 간호활동 영향 요인 vol.20, pp.5, 2010, https://doi.org/10.5762/kais.2019.20.5.118
  11. Patient safety culture among nurses working in Palestinian governmental hospital: a pathway to a new policy vol.19, pp.1, 2010, https://doi.org/10.1186/s12913-019-4374-9
  12. 요양병원 간호사의 공감만족 관련요인-환자안전문화 중심으로 vol.33, pp.3, 2010, https://doi.org/10.5932/jkphn.2019.33.3.379
  13. The impact of patient safety culture and the leader coaching behaviour of nurses on the intention to report errors: a cross-sectional survey vol.19, pp.1, 2020, https://doi.org/10.1186/s12912-020-00472-4
  14. The influence of nurse leadership style on the culture of patient safety incident reporting: a systematic review vol.27, pp.6, 2010, https://doi.org/10.12968/bjhc.2020.0083
  15. 임상간호사의 투약오류보고 의도에 영향을 미치는 요인 vol.14, pp.3, 2010, https://doi.org/10.34250/jkccn.2021.14.3.62
  16. Psychological Safety as a Mediator of the Relationship Between Inclusive Leadership and Nurse Voice Behaviors and Error Reporting vol.53, pp.6, 2010, https://doi.org/10.1111/jnu.12689