Barriers to incident-reporting behavior among nursing staff: A study based on the theory of planned behavior

What is it about?

Previous studies have identified numerous factors that affect incident-reporting behavior. However, few studies have applied an individual psychology perspective to identify and examine the factors affecting the intention of nursing staff to report incidents. We integrate the theory of planned behavior (TPB), organizational behavior, psychological behavior, and social exchange theory to identify which factors affect the intentions of nursing staff to report incidents. Samples were collected from medical staff at 110 regional or larger hospitals for model verification. The results of this study show that psychological safety, attitude toward reporting incidents, subjective norms (SNs), and perceived behavioral control (PBC) correlate positively with the intention to report incidents. The perceived cost (PC) and perceived benefit (PB) of incident reporting directly affects the attitude toward incident-reporting behavior, and self-efficacy influences PBC. Furthermore, SNs and the PBs of incident reporting mediate the effect of psychological safety on attitude toward incident-reporting behavior.

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Why is it important?

Several studies have indicated that a lack of individual reporting knowledge and skills might influence incident-reporting behaviour. For example, a person might be unaware of how or where to report an incident, and their knowledge on which types of incidents should be reported might be insufficient (Uribe et al., 2002; Osborne et al., 1999; Evans and Berry, 2006; Pfeiffer et al., 2013) Discussion and Conclusions This study confirms that SNs influence the intention to engage in incident-reporting behaviours. Additionally, in concurrence with the conclusions of previous studies, our findings show that the responses of managers, supervisors, or peers influenced the nurses’ behavioural attitudes toward reporting incidents (Ryu et al., 2003; Pfeiffer et al., 2013). This finding corresponds with those of previous studies, in which reporting procedures for errors and the individual understanding thereof influenced the intention of health care personnel to report errors (Uribe et al., 2002; Osborne et al., 1999; Evans and Berry, 2006; Lawton and Parker, 2002; Pfeiffer et al., 2013). A previous study reported that psychological safety plays a minor role in reporting intentions; however, the authors also mentioned that the management support factor already explains the influence of psychological safety on reporting intentions (Pfeiffer et al., 2013).This study confirms that high levels of psychological safety causes high BIs to report adverse incidents. Moreover, the effect of psychological safety on intention to report incidents was stronger than that of behavioural attitudes, SNs, and PBC.

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