Moira Attree1. 1. School of Nursing, Midwifery and Social Work, University of Manchester, UK. moira.j.attree@manchester.ac.uk
Abstract
AIM: To explore factors that influence nurses' decisions to raise concerns about standards of practice. BACKGROUND: Health care practitioners have a key role in monitoring care quality. Nurses are required by their professional body to raise concerns about standards; however, under-reporting is the norm. METHOD: Grounded theory was used to collect and analyse data from semi-structured interviews with 142 practising nurses, theoretically sampled from three Acute NHS Trusts in England. FINDINGS: Fear of repercussions, retribution, labelling and blame for raising concerns, about which they predicted nothing would be done, were identified as disincentives to raising concerns. Reporting was perceived as a high-risk:low-benefit action. Nurses lacked confidence in reporting systems. CONCLUSIONS: Disincentives to reporting need to be addressed if an open culture, which promotes quality, safety and learning, is to be developed. Findings give cause for concern and indicate a need to review organizational and professional guidelines, and organizational reporting systems.
AIM: To explore factors that influence nurses' decisions to raise concerns about standards of practice. BACKGROUND: Health care practitioners have a key role in monitoring care quality. Nurses are required by their professional body to raise concerns about standards; however, under-reporting is the norm. METHOD: Grounded theory was used to collect and analyse data from semi-structured interviews with 142 practising nurses, theoretically sampled from three Acute NHS Trusts in England. FINDINGS: Fear of repercussions, retribution, labelling and blame for raising concerns, about which they predicted nothing would be done, were identified as disincentives to raising concerns. Reporting was perceived as a high-risk:low-benefit action. Nurses lacked confidence in reporting systems. CONCLUSIONS: Disincentives to reporting need to be addressed if an open culture, which promotes quality, safety and learning, is to be developed. Findings give cause for concern and indicate a need to review organizational and professional guidelines, and organizational reporting systems.
Authors: Graham P Martin; Emma-Louise Aveling; Anne Campbell; Carolyn Tarrant; Peter J Pronovost; Imogen Mitchell; Christian Dankers; David Bates; Mary Dixon-Woods Journal: BMJ Qual Saf Date: 2018-02-19 Impact factor: 7.035