| You et al., 2015 [13] South Korea |
To identify reasons for MAE and why they are unreported and estimate the percentage of MAEs actually reported among hospital nurses. |
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1) fear of blame associated with adverse health implications to patients; 2) an increased emphasis placed on MAE as benchmark to determine quality of delivered nursing care; 3) fear of adverse consequences associated with that error; 4) not wanting nursing administrators to hold them as solely responsible for the error instead of evaluating the medication system. |
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| Chiang et al., 2010 [17] China |
To examine the factors that influence the failure to report medication adverse events by nurses. |
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337 (47%) participating nurses had failed to report self- or coworker-MAEs and 376 nurses (52.4%) had not failed to report.
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Fear, perception of nursing quality, and nursing professional development were identified as barriers that contributed to failure to report by nurses.
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Administration and reporting process were not identified as barriers of error reporting.
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| Qin et al., 2015 [34] China |
To analyze the behaviors of nurses toward reporting safety events, the barriers to reporting, and the correlations of these aspects with hospital safety culture. |
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Nurses' preferred reporting styles were as followed, informing leader” (63.0%–76.4%), informing doctor (41.8%–81.8%), “documentation” (49.1%–54.1%).
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Managerial and collegial perception, and reporting procedures played as key barriers to error reporting.
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Reasons for not reporting error as identified by nurses:
1) fear of receiving patients' complaint; 2) fear of being reprimanded; 3) fear of implication to future employment; 4)wanting to protect their colleagues; 5) fear that news will spread, and the press will write about it; 6) not wanting to be an incompetent nurse. |
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| Hung et al., 2015 [35] China |
To explore the effects of nurses' attitudes and intentions regarding medication administration error reporting on actual reporting behaviour. |
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The findings indicated that nurses' attitudes and intentions towards MAE reporting are positive, but the actual reporting rates are low.
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Nurse managers' and co-workers’ attitudes are major factors contributing nurses' attitudes towards medication administration error reporting.
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Nurses' attitudes also influenced their intention to report medication administration errors; however, no connection was found between intention and actual reporting behaviour.
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| Yung et al., 2016 [36] China |
To explore the attitudes and perceived barriers to reporting medication administration errors and to understand the characteristics of – and nurses' feelings – about error reports. |
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Nurses' possessed positive attitudes in error reporting. 88.9% prefer to engage in verbal reporting with head nurse (67.6%), colleagues (55.6%).
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83.0% of nurses experience self-recrimination after reporting, 63.4% experienced uneasiness if they choose not to report.
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Barriers towards engaging in error reporting were:
1) fear of being distrusted by a patient and their family;
2) fear of administrators taking the error report as evidence to justify issuing a negative evaluation of the culpable staff; 3) fear of in patient–nurse disputes.
• Reasons for not reporting error were: 1) patients were not harmed (83.3%); 2) the error was not known to anyone except the involving personnel (45.1%). |
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| Farag et al., 2017 [37] United States |
To examine the relationship among work environment, social capital and nurses' willingness to report medication errors. |
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Most nurses (71.8%) were very likely to report errors with high potential for patient harm.
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54.9% of them were very likely to report errors that reached the patients but had no potential harm, and only 25.4% of nurses were very likely to report errors that were near missed.
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Willingness of Emergency Department nurses to engage in reporting increases when feedback pertaining to the error committed was received, and when the manager adopted appropriate leadership style.
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| Mjadu & Jarvis 2018 [38] South Africa |
To describe the perceptions of registered nurses towards critical incident reporting in adult ICUs in three tertiary level provincial hospitals. |
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While 50.5% had an effective attitude towards incident reporting, 63.4% of nurses had not reported any error for the past 12 months.
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Despite nurses knew about the reporting system, major barriers towards error reporting as identified by nurses were: 1) collegial atmosphere of unpleasantness characterized by blame and punishment; 2)lack of confidentiality.
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| Afolalu et al., 2020 [39] Nigeria |
To compare doctors' and nurses' perceptions of factors influencing medical error reporting. |
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The proportion of doctors (53.3%) not reporting error is higher as compared to nurses (39.3%).
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Barriers of error reporting identified by nurses: 1) the emphasis of individual blame (79.6%); 2)lack of confidentiality (60.8%); 2)supervisor's inappropriate responses (58.7%); 4) patient's loss of trust (56.1%);
5) no point reporting that does not cause harm (53.7%).3) getting feedback (70.5%). |
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| Kim et al., 2011 [40] South Korea |
To identify the types of medication errors that occur in nursing practice and the nurses' perceptions of medication errors and reporting |
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Low reporting rate with only 28.3% of participants submit an incident report, despite 63.6% of participants had been involved in medication errors once or more in the past month.
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Reasons for nurses not reporting errors were: 1) afraid of being a troublemaker (46.7%); 2)not aware of the importance of reporting, even in minor errors (25.0%); 3)wanting to cover up for the co-workers involved (10.9%).
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| Chiang et al., 2019 [41] China |
To test the hypothesized model for hospital nurses' voluntariness of incident reporting and determine the extent which reporting culture factors, nursing safety practices, and work perceptions predict VIR. |
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More than half of nurses (nearly 60%) did not display voluntary attitude towards reporting of errors and near misses.
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Nurses' voluntary incident reporting was influenced by reporting culture (collegial atmosphere of punishment, confidentiality, provision of feedback and learning from error), nursing safety practice, and perception of work (workload and job satisfaction).
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| Rashed & Hamdan 2019 [42] Palestine |
To assess the attitudes of physicians and nurses toward incident reporting in Palestinian hospitals. |
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Physicians were 2.1 time more likely to report incidents than nurses.
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Top three perceived barriers of incident reporting identified by nurses: 1)lack of feedback about reported medical errors (70.7%); 2)reporting is a method through which to pinpoint blame (67.2%); 3) lack of supervisor support to those who report error (50.5%.).
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Top three fear of reporting consequences identified by nurses were: 1)fear of administrative sanctioning (77.7%); fear of malpractice litigation (72.4%); 3) fear that their own competence may be questioned (71%).
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| AbuAlRub et al., 2015 [43] Jordan |
To explore the awareness of the IR system, IR practices and barriers to IR among Jordanian staff nurses and physicians. |
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1) felt pointless to report on near misses (69.0%); 2) not receiving any feedback (64.5%); 3) fear of receiving disciplinary actions (68.9%); 4) felt that reporting is unlikely to lead to system change (66.1%); 5) forgetting to report due to being busy (63.2%). |
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| Mansouri et al., 2019) [44] Iran |
To assess nurses' views about major barriers to reporting errors and adverse events in intensive care units. |
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Majority of nurses (70.9%) failed to report errors despite having to commit them.
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Three main areas that prevented nurses from reporting error were: 1)fear of consequences after reporting – fear of collegial blame, fear of reputation loss, and fear of being labelled as incompetent; 2) procedural barriers - lack of knowledge about the procedure, certain error considered as trivial, hence not reporting; 3) management barriers – blame culture, lack of feedback, facing of inappropriate reaction from manager.
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| Toruner & Uysal 2012 [45] Turkey |
To determine the perspective of pediatric nurses regarding the causes, reporting, and prevention of medication errors. |
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Despite majority of pediatric nurses (88%) made use of the error notification system, yet less than half (48%) of the errors were notified by nurses.
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Top three barriers of error reporting for nurses were:
1) fear of potential blaming of nurses in case of adverse outcome for the patient (53%); 2)fear of losing credibility of the team (50%); 3) fear of disciplinary proceedings (42%). |
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| Dirik et al., 2018 [46] Turkey |
To investigate hospital nurses' involvement in the identification and reporting of medication errors in Turkey. |
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Nurses were reluctant to report error despite able to identify the errors. and when the error was reported, it is usually to physicians.
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Common reasons why nurses not reporting error were:
1) afraid of being perceived as incompetent by their peers (71.9%); 2) fear of being punished by their managers (66.7%); 3) not aware of committing the error (66%); 4) patient was not harmed by the error (63.5%); 5) not wanting to facing negative reaction from patients & relatives (62.5%). |
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| Hammoudi et al., 2018 [47] Saudi Arabia |
To explore factors that influence the occurrence of MAEs and error reporting by nurses. |
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1) nurses felt reporting and contacting physicians were time consuming; 2) individuals blamed instead of the system by nursing administrator for its commission; 3) lack of positive feedback for correct medication administration; 5) focus predominantly placed on errors as determinant for quality of nursing care. |
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| Moumtzoglou 2010 [48] Greece |
To explore the reasons why Greek nurses are reluctant to report adverse events. |
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Nurses' impeding factors for reporting of adverse events concerns with cultural aspect such as professional, national and organizational cultures, as well as structural issues of healthcare practices such as safety system, rules, and procedures.
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The reasons cited by more than 50% of nurses for not reporting adverse events were:1)fear of the press; 2) fear that the error will be reported to nursing licensing board; 3)cumbersome of handling adverse event; 4)not confidence in bringing up the event; 5) fear of facing complaints by patients.
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| Nasiri et al., 2020 [49] Iran |
To determine factors affecting the failure to report medical errors in teaching hospitals affiliated to Iran. |
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Most important factors leading to failure to report medical errors as identified by nurses were:1) management related factor – lack of organizational support, failure to receive positive feedback, focusing on the person committing the error, inappropriate response of authorities relating to error severity; 2) nurse related factor – fear of legal issue, fear of being blamed by nursing authorities and physician, fear of incompetence stigma, fear of negative effects of error concerning economic losses; 3) factors related to reporting process – forgetting to report error, neglecting to report error, unclear definition of error. |
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| Rutledge et al., 2018 [50] United States |
To report MER barriers among hospital nurses. |
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Top four barriers of error reporting were:1) extra time involved in documenting a medication error (48.2%); 2) system for forms used to report medication errors are long and time-consuming (35.9%); 3) Fear of liability or lawsuits (34.3%); 4) Fear of being blamed (32.8%). |
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| Yang et al., 2020 [51] China |
To identify nurses' perceptions of patient safety emphasis, face-saving, power distance, and fear of medication error reporting and to explore face-saving and power distance as the underlying mechanisms for cultural factors in the relationship between nurses' perceptions of safety emphasis and fear of MER. |
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Nurses' fear of medication error reporting is strongly associated with their cultural background, especially face-saving (social esteem and social identity) and power distance (social hierarchy that defines disparity power between the subordinates and their superior).
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When comparing the specific mediators' indirect effects, face-saving was found to be more powerful mediator than power distance.
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| Lee et al., 2016 [52] China |
To identify which factors affect the intentions of nursing staff to report incidents using theory of planned behavior, organizational behavior. |
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Psychological safety, subjective norm and perceived behavioral control correlates with nurses' intention towards error reporting. 1)Psychosocial safety is characterized by just culture with no punishment when error was reported. 2) Perceived behavioral control characterized by nurses' possessing of sufficient knowledge, abilities, and resources. 3) Subjective norm was characterized by managerial and collegial response towards their reporting. |
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