Congress Abstracts 2004

65

INCIDENT REPORTING BY REGISTERED NURSES: THE INFLUENCE OF PERCEPTIONS OF THE ENVIRONMENT, INSTITUTIONAL COMMITMENT, AND DEMOGRAPHICS ON INTENT TO REPORT. Terry Throckmorton, PhD, RN, Jason Etchegaray, PhD, and Debora Simmons Bennett, RN, MSN, CCRN, CCNS, The University of Texas M.D. Anderson Cancer Center, Houston, TX.

Creating a safe environment for the patient has become an area of concern on an international level. Researchers from European countries and the United States have begun to investigate the causes for errors, estimated incidence of non-reporting of errors, and barriers to reporting. In addition, approaches to preventing errors by healthcare providers are increasingly emphasized in evaluations of healthcare institutions. Because of the complexity of care for oncology patients, the potential for error can be even greater than with general medical patients. The environment for reporting errors in the majority of healthcare institutions is often perceived as punitive. The 1999 IOM report and research with healthcare professionals support a shift in focus from blame of caregivers for errors to system improvements. The State of Texas has a mandatory peer review and reporting for three minor incidents by nurses within one year. This legal action, and other environmental factors, may affect willingness to report incidents. Determination of reporting barriers allows for system redesign to facilitate minor incident reporting and prevent more serious events.

A focus on system redesign allows nurses to take a leading role in identifying and correcting system problems that lead to clinical errors. It can facilitate collaborative efforts to identify and correct multidisciplinary issues leading to clinical errors, creating a safer environment for everyone.

The purpose of this study is to determine the willingness of registered nurses in Texas to report incidents and factors affecting their intent to report.

Questionnaires, including a demographic form, an institutional commitment scale, and an intent-to-report scale have been mailed to 4,250 RNs randomly selected from the BNE roster. Follow-up packets will be sent to non-respondents.

Descriptive statistics and discriminate analysis will be used to describe the sample and analyze the characteristics of the intent- and no-intent-to-report groups.

Results from this study, and other projects in this program of study, will be used to support a less punitive legal and institutional environment for healthcare professionals. Although the current planned program includes anonymous reporting, the ultimate goal is a nonpunitive open-reporting system.