The attitudes of nursing students and clinical instructors towards reporting irregular incidents in the medical clinic.

Despite efforts to increase patient safety, medical incidents and near misses occur daily. Much is still unknown about this phenomenon, especially due to underreporting. This study examined why nursing students and clinical instructors underreport medical events, and whether they believe that changes within their institutions could increase reporting. 103 third- and fourth-year nursing students and 55 clinical instructors completed a validated questionnaire. The results showed that about one-third of the instructors and one-half of the nursing students believed that circumstances and lack of awareness, and fear of consequences, lead to underreporting. Both nursing students and clinical instructors ranked "fear of consequences" as the main reason for not reporting, yet students ranked this higher than their instructors. Moreover, both groups believed that incident reporting could be increased following changes in the clinical field, mainly by increasing awareness and knowledge. A large percentage of participants also wrote that they do not report errors that are the result of circumstances and lack of awareness, mainly fear of consequences. Therefore, hospitals and academic institutions may need to create a more accepting organizational climate. Moreover, institutions that allow incident reports to be submitted anonymously and that take educational (not disciplinary) action, may increase incident reporting.