The courage to speak out: A study describing nurses' attitudes to report unsafe practices in patient care
Aim To identify workplace factors that influence patient advocacy among registered nurses (RNs) and their willingness to report unsafe practices. Background A prior study by Black illustrated that 34% of respondents were aware of conditions that may have caused patient harm but had not reported the...
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Published in | Journal of nursing management Vol. 27; no. 6; pp. 1176 - 1181 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Hindawi Limited
01.09.2019
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Subjects | |
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Abstract | Aim
To identify workplace factors that influence patient advocacy among registered nurses (RNs) and their willingness to report unsafe practices.
Background
A prior study by Black illustrated that 34% of respondents were aware of conditions that may have caused patient harm but had not reported the issue. The most common reasons identified for failing to report issues were fear of retaliation and a belief that nothing would prevail from the reports.
Method
Using Black's study as a model, reporting data were collected from a sample of RNs actively practicing in acute care hospitals.
Results
While reasons for reporting are consistent with Black's study, data suggest that a nurse's experiences and working environment are prime factors in their willingness to report patient care issues.
Conclusion
Although RNs may not have personally experienced workplace retaliation, fear of retaliation when reporting unsafe patient care practices still exists. Nursing leadership's ability to facilitate a culture of safety by proactively addressing unsafe practices fosters a level of comfort for patient advocacy and willingness to report issues. Education, professional associations and existing protection laws are available resources which contribute to organizational support systems.
Implications for Nursing Management
The findings of this study are consistent with the literature in that organizations need to create a supportive workplace environment whereby, through collective input and leadership, reporting protocols are in place that empower RNs to report unsafe conditions. Direct care nurses are positioned, especially well to identify and speak up regarding conditions that may result in near misses or actual adverse events. Therefore, it is the responsibility, and duty, of nursing management to create and facilitate reporting systems that will be utilized without fear of retaliation and that will contribute to a culture of safety and patient advocacy. |
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AbstractList | Aim
To identify workplace factors that influence patient advocacy among registered nurses (RNs) and their willingness to report unsafe practices.
Background
A prior study by Black illustrated that 34% of respondents were aware of conditions that may have caused patient harm but had not reported the issue. The most common reasons identified for failing to report issues were fear of retaliation and a belief that nothing would prevail from the reports.
Method
Using Black's study as a model, reporting data were collected from a sample of RNs actively practicing in acute care hospitals.
Results
While reasons for reporting are consistent with Black's study, data suggest that a nurse's experiences and working environment are prime factors in their willingness to report patient care issues.
Conclusion
Although RNs may not have personally experienced workplace retaliation, fear of retaliation when reporting unsafe patient care practices still exists. Nursing leadership's ability to facilitate a culture of safety by proactively addressing unsafe practices fosters a level of comfort for patient advocacy and willingness to report issues. Education, professional associations and existing protection laws are available resources which contribute to organizational support systems.
Implications for Nursing Management
The findings of this study are consistent with the literature in that organizations need to create a supportive workplace environment whereby, through collective input and leadership, reporting protocols are in place that empower RNs to report unsafe conditions. Direct care nurses are positioned, especially well to identify and speak up regarding conditions that may result in near misses or actual adverse events. Therefore, it is the responsibility, and duty, of nursing management to create and facilitate reporting systems that will be utilized without fear of retaliation and that will contribute to a culture of safety and patient advocacy. To identify workplace factors that influence patient advocacy among registered nurses (RNs) and their willingness to report unsafe practices. A prior study by Black illustrated that 34% of respondents were aware of conditions that may have caused patient harm but had not reported the issue. The most common reasons identified for failing to report issues were fear of retaliation and a belief that nothing would prevail from the reports. Using Black's study as a model, reporting data were collected from a sample of RNs actively practicing in acute care hospitals. While reasons for reporting are consistent with Black's study, data suggest that a nurse's experiences and working environment are prime factors in their willingness to report patient care issues. Although RNs may not have personally experienced workplace retaliation, fear of retaliation when reporting unsafe patient care practices still exists. Nursing leadership's ability to facilitate a culture of safety by proactively addressing unsafe practices fosters a level of comfort for patient advocacy and willingness to report issues. Education, professional associations and existing protection laws are available resources which contribute to organizational support systems. The findings of this study are consistent with the literature in that organizations need to create a supportive workplace environment whereby, through collective input and leadership, reporting protocols are in place that empower RNs to report unsafe conditions. Direct care nurses are positioned, especially well to identify and speak up regarding conditions that may result in near misses or actual adverse events. Therefore, it is the responsibility, and duty, of nursing management to create and facilitate reporting systems that will be utilized without fear of retaliation and that will contribute to a culture of safety and patient advocacy. AIMTo identify workplace factors that influence patient advocacy among registered nurses (RNs) and their willingness to report unsafe practices. BACKGROUNDA prior study by Black illustrated that 34% of respondents were aware of conditions that may have caused patient harm but had not reported the issue. The most common reasons identified for failing to report issues were fear of retaliation and a belief that nothing would prevail from the reports. METHODUsing Black's study as a model, reporting data were collected from a sample of RNs actively practicing in acute care hospitals. RESULTSWhile reasons for reporting are consistent with Black's study, data suggest that a nurse's experiences and working environment are prime factors in their willingness to report patient care issues. CONCLUSIONAlthough RNs may not have personally experienced workplace retaliation, fear of retaliation when reporting unsafe patient care practices still exists. Nursing leadership's ability to facilitate a culture of safety by proactively addressing unsafe practices fosters a level of comfort for patient advocacy and willingness to report issues. Education, professional associations and existing protection laws are available resources which contribute to organizational support systems. IMPLICATIONS FOR NURSING MANAGEMENTThe findings of this study are consistent with the literature in that organizations need to create a supportive workplace environment whereby, through collective input and leadership, reporting protocols are in place that empower RNs to report unsafe conditions. Direct care nurses are positioned, especially well to identify and speak up regarding conditions that may result in near misses or actual adverse events. Therefore, it is the responsibility, and duty, of nursing management to create and facilitate reporting systems that will be utilized without fear of retaliation and that will contribute to a culture of safety and patient advocacy. |
Author | Cole, Donna A. Dugan, Kendra Grantoza, Rosalie Skarbek, Anita Cummins, Kathleen Bersick, Eileen |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/31077621$$D View this record in MEDLINE/PubMed |
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Cites_doi | 10.1111/jan.13028 10.1016/j.ijnurstu.2016.08.019 10.1097/NCQ.0000000000000140 10.1136/bmjqs-2017-007163 10.1891/1078-4535.23.1.7 10.9789/2175-5361.2019.v11i2.333-338 10.1097/01.NUMA.0000533774.22167.f2 10.1097/01.NAJ.0000398537.06542.c0 10.1016/j.nedt.2017.02.004 10.1080/1463922X.2018.1484527 |
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Notes | Funding information This work was conducted as part of the Organization of Nurse Leaders/NJ Research Committee by surveying hospitals in the Northeast. The Organization of Nurse Leaders/NJ was supportive; however, no funding has been received from any source. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
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References | 2018; 19 2017; 52 2017; 48 2019; 11 2017; 44 2017; 23 2019; 28 2016; 31 2016; 63 2017 2016; 72 2018; 49 2011; 111 e_1_2_7_5_1 American Nurses Credentialing Center (ANCC) (e_1_2_7_4_1) 2017 e_1_2_7_3_1 Echevarria I. M. (e_1_2_7_6_1) 2017; 48 e_1_2_7_9_1 Agency for Healthcare Research [AHRQ] (e_1_2_7_2_1) 2017 e_1_2_7_8_1 e_1_2_7_7_1 e_1_2_7_16_1 e_1_2_7_15_1 e_1_2_7_11_1 The Joint Commission (e_1_2_7_14_1) 2017 e_1_2_7_10_1 Picolotto A. (e_1_2_7_12_1) 2019; 11 Sabol B. (e_1_2_7_13_1) 2017; 44 |
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To identify workplace factors that influence patient advocacy among registered nurses (RNs) and their willingness to report unsafe practices.
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SubjectTerms | Acute services Adult Advocacy Attitude of Health Personnel Attitudes Bravery Courage Critical incidents Culture Fear & phobias Female Hospitals Humans Leadership Male Medical malpractice Middle Aged Near misses Nurses Nursing Nursing administration Occupational Health Organizational Culture Organizational support patient advocacy Patient Advocacy - psychology Patient Advocacy - standards Patient safety Patients Professional associations registered nurses Risk Management - standards Surveys and Questionnaires Unsafe Whistleblowing Willingness Workplace - psychology Workplace - standards workplace factors Workplaces |
Title | The courage to speak out: A study describing nurses' attitudes to report unsafe practices in patient care |
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