The perception of health care risk: patients, health care staff and society.

INTRODUCTION: The Nuovo Zingarelli, dictionary of the Italian language, defines risk as "the possibility of harmful or negative consequences following not always predictable circumstances". A statistical-epidemiological type of definition is far removed from the social and psychological conception that the population attributes to the risk of harm, which is related to interior processes and emotional reactions. Information on risks interacts with knowledge, personal values and beliefs to produce a subjective expression that is perception.
MATERIALS AND METHODS: Two years after instituting the Hospital Quality and Risk Management Unit at S. Giovanni Battista Molinette Hospital (Turin, Italy) it became clear that it was necessary to determine the perception of health care risk among nursing staff. Therefore, nursing teams from eight sub-departmental units in six departments were invited to participate in an assessment project.
RESULTS: The project was undertaken by four nursing teams composed of four head nurses (project representatives) and 45 professional nurses. The aims of the project were understood by all four groups; three participated with interest, one only in part. Three groups considered that it would be useful to continue the project, while the other group did not discuss this point.
CONCLUSIONS: The project on the perception of health care risk by nursing staff revealed that mistaken identification of the patient, errors during the administration of treatment and poor communication among colleagues and with doctors and patients were the risks of error perceived as most important by nurses. Heavy work loads, staff shortages, technical and structural problems, and gaps in professional knowledge were identified as the factors related to the occurrence of adverse events. These data differed from management's perception because no incident report forms had ever been received from these nursing teams.