Incident Reporting Culture in the Critical Care Units: Barriers, and Suggestions for Improvement from Nurses’ Perspectives

Background: Critically ill patients are highly susceptible to unintended harm and benefit from incident reporting as an important first step in improving patient safety. Nurses are responsible for maintaining the safety culture, however, several barriers hinder their ability to ensure that patients remain safe. One of these barriers is underreporting or failure to report the incidents or the adverse effects. Aim: Determine the barriers that hinder incident reporting and strategies to improve these barriers as the critical care nurses perceive them. Design: A mixed study design was used to conduct the study. Sample: data were collected from all nurses (251) who worked in the main university hospital. Tool: An incident reporting survey was developed by the researcher to collect the required data and it comprises of four sections; sections 1, 2, and 3 were used to collect the quantitative data, and section 4 was used to collect the qualitative data. Results: The most significant barriers perceived by the nurses as barriers that hindered the reporting of the incidents were categorized into lack of awareness, fear, and worries about disciplinary action, litigation, being tracked down, blaming, and losing support from their colleagues, heavy workload, and other organizational or system-related barriers. Conclusion: Based on the results of the current study, can be concluded that the most significant barriers were lack of awareness (incident reporting-related knowledge), fear and worries, workload, limited time, and other organizational or system barriers. Additionally, the nurses' suggestions to those barriers were reporting anonymously, providing feedback, creating an incident reporting culture, making the procedure more simple, promoting a blame-free environment orienting the nurses regarding what and how to report, increasing the nurses' salaries, and hiring new nurses to overcome the heavy workload. Recommendation: Consider all the barriers mentioned by the nurses to incident reporting in the workplace and the suggested strategies to overcome or solve these barriers a priority of the managers and policymakers of the critical care units to maintain the quality of care and patient safety.