The effect of patient safety culture on nurses' near-miss reporting intention: the moderating role of perceived severity of near misses.

Abstract

Reporting near misses is a practical approach to improve the confounding challenge of patient safety. Evidence suggests that patient safety culture and the characteristics of errors might have important impacts on reporting. No studies, however, have examined the relationships among patient safety culture, perceived severity of near misses and near-miss reporting. To explore the relationship between patient safety culture and nurses' near-miss reporting intention, and examine the potential moderating effect the perceived severity of near misses might have on this relationship. Using a cross-sectional survey, data were collected with three validated survey instruments completed by 920 Registered Nurses in eight tertiary hospitals in China. Multiple regression analysis tested relationships among the variables. Nurses reported a moderate-high level of near-miss reporting intention. Patient safety culture was positively associated with nurses' near-miss reporting intention. Perceived severity of near misses did not significantly moderate the relationship between patient safety culture and reporting intention. Nurses generally showed a positive willingness to report near misses. A specific near-miss management and education system within a learning, supportive working environment are key components to improve reporting intention among nurses which could significantly improve patient safety.