The Private World of Nursing Related to Incident Reporting
During the 1990s governments, professionals and the public in general have had brought to their attention that incidents in healthcare are occurring in larger numbers than had ever been imagined and are costing tax-payers large amounts of money. Research sponsored by governments has tried to identify some objective evidence of the number of incidents and types of incidents that occur and to put forward some tools to assist with the risk management of incidents. The purpose of this project was to explore the experience of nurses related to incident reporting. The reporting of incidents is important as it identifies professional risks for nurses. A descriptive qualitative approach was the methodology used and individual interviews of five senior nurses was the method of data collection. Attention was given to finding out about the supports for and barriers against nurses in reporting incidents; the outcomes for nurses of incident reporting; and the organisational culture and scope of 'professional' behaviour of nurses around incident reporting. The findings revealed that nurses identified themselves as the major reporters of incidents. They considered there was not 'a level playing field' for all professionals around who, how and why incidents were reported, investigated and within the post incident processes. The nurses reported that they made daily decisions about what was an incident, and whether to report events as incidents. They identified aids and supports to the decisions they made such as the medium for reporting and fear of what happened when the incident form left the nurse and went to management. A number of significant implications were identified for nursing, management and organisations in this research. Nurses need to feel they work in organisations which have a culture of safety around incident reporting. Management need to clearly communicate policies, processes and organisational expectations related to incident reporting. This should include how incidents will be reported, investigated and the purposes for which management use incident reporting information. It is also important that adequate structures are in place to support nurses when an incident occurs as incidents when they occur have stressful consequences for the nurses who are involved. Professional nursing bodies need to give consideration to the development of clear guidelines on the legal and professional accountability of nurses related to incident reporting including the limitations of this accountability. When processes are clear a more effective approach can be taken to incident reporting, learning can occur and this will prevent the recurrence of some incidents.