Practical and Cultural Barriers to Reporting Incidents Among Health Workers in Indonesian Public Hospitals (original) (raw)
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F1000Research, 2021
Background: Understanding the causes of patient safety incidents is essential for improving patient safety; therefore, reporting and analysis of these incidents is a key imperative. Despite its implemention more than 15 years ago, the institutionalization of incident reporting in Indonesian hospitals is far from satisfactory. The aim of this study was to analyze the factors responsible for under-reporting of patient safety incidents in Indonesian public hospitals from the perspectives of leaders of hospitals, government departments, and independent institutions. Methods: A qualitative research methodology was adopted for this study using semi-structured interviews of key informants. 25 participants working at nine organizations (government departments, independent institutions, and public hospitals) were interviewed. The interview transcripts were analyzed using a deductive analytic approach. Nvivo 10 was used to for data processing prior to thematic analysis. Results: The key facto...
Risk Management and Healthcare Policy, 2019
Background: Incident reporting is widely acknowledged as one of the ways of improving patient safety and has been implemented in Indonesia for more than ten years. However, there was no significant increase in the number of reported incidents nationally. The study described in this paper aimed at assessing the extent to which Indonesia's patient safety incident reporting system has adhered to the World Health Organization (WHO) characteristics for successful reporting. Methods: We interviewed officials from 16 organizations at national, provincial and district or city levels in Indonesia. We reviewed several policies, guidelines and regulations pertinent to incident reporting in Indonesia and examined whether the WHO characteristics were covered in these documents. We used NVivo version 9 to manage the interview data and applied thematic analysis to organize our findings. Results: Our study found that there was an increased need for a non-punitive system, confidentiality, expert-analysis and timeliness of reporting, system-orientation and responsiveness. The existing guidelines, policies and regulations in Indonesia, to a large extent, have not satisfied all the required WHO characteristics of incident reporting. Furthermore, awareness and understanding of the reporting system amongst officials at almost all levels were lacking. Conclusion: Despite being implemented for more than a decade, Indonesia's patient safety incident reporting system has not fully adhered to the WHO guidelines. There is a pressing need for the Indonesian Government to improve the system, by putting specific regulations and by creating a robust infrastructure at all levels to support the incident reporting.
Barriers to Reporting Patient Safety Incident in Healthcare Workers: Integrative Literature Review
Jurnal Administrasi Kesehatan Indonesia
Background: The patient safety incident reporting systems is designed to improve the health care by learning from mistakes to minimize the recurrence mistakes, however the reporting rate is low.Aims: Integrative literature review was chosen to identify and analyze the barriers of reporting patient safety incidents by Health Care Workers (HCWs) in hospital.Methods: Searching for articles in electronic database consisting of Medline, CINAHL and Scopus resulted in 11 relevant articles originating from 9 countries.Results: There are differences but similar in barriers to reporting patient safety incident among HCWs. The barriers that occur are the existence of shaming and blaming culture, lack of time to report, lack of knowledge of the reporting system, and lack of support from the management.Conclusion: Each hospital has different barriers in reporting incident and the interventions carried out must be in accordance with the existing barriers.Keywords: barrier of reporting, incident r...
2020
Patient safety incidents must be minimized to avoid unwanted dangers during hospitalization. Reporting of patient safety incidents in the Hospital is still low. Low reporting of patient safety incidents are related to individual and organization factors. This study aimed to identify the individual and organization factors on reporting patient safety incidents in the inpatient Hospital. The study was a survey method with a cross-sectional approach. The population in this study were all nurses inpatients in Medan city Hospital as many as 168 people and a sample of 88 people. Data were collected with primary, secondary, and tertiary data and analyzed with a statistical test of Multiple Logistic Regression with a confidence level of 95%. The results showed that individual factors (knowledge with p-value=0.021 and experience with p-value=0.021) affected the reporting of patient safety incidents and organizational factors (organizational environment with pvalue=0.038 and power with p-valu...
Nurses’ Barriers to Incident Reporting in Patient Safety Culture: A Literature Review
Indonesian Journal of Global Health Research, 2019
One effort to improve the quality of health services is patient safety culture. Surveys showed that among the problems of patient safety culture is the culture of incident reporting. A study of 70 participants in a private hospital in Turkey in 2016 found a persistent problem of reporting culture (Kilic et al., 2017). To date, patient safety culture remains an important issue in the effort to improve service quality (Alquwez et al., 2018). Research on 554 nurses in Turkey indicated that they perceived no culture of reporting (Güneş et al., 2016). Meanwhile, a study in China showed an increase by less than 50% in the frequency of incident reports and non-punitive responses to errors, and such improvement could reduce adverse events although the rate remained below expectations. This shows that improved patient safety culture is associated with decreased adverse events (Wang et al., 2014). Research conducted through interviews with 33 officials of Indonesian organizations, including government organizations, professional organizations, public hospitals, and independent institutions, revealed that non-punitive culture has not been fully implemented (< 100%) at either local or national level (Dhamanti et al., 2019). There
Barriers of Reporting Incident and Suggested Sloutions from the Perspective of Staff Nurses
The Medical Journal of Cairo University, 2020
Background: Incident reporting in health care is considered a way to monitor, prevent, and reduce the occurrence of patient safety events. “Incident Reporting Systems, (IRS) will continue to be an important influence on improving patient safety and quality of health care. Aim: The aim of this study is to assess barriers of reporting incident report and suggested solutions from the perspective of staff nurses. Material and Methods: Descriptive exploratory study design was utilized to collect data in this study. Convenient sample of staff nurses (N=250) who were working in all inpatient departments at 6 October Health Insurance Hospital in Giza. Two tools were used for data collection: Barriers of reporting incident and suggested solutions questionnaires. Results: Results of the present study revealed that, the highest mean scores regarding barriers of reporting incident was time constrain, while the lowest mean scores was lack of education. While regarding suggested solutions, the hi...
Healthcare, 2019
(1) Background: A patient safety incident reporting system was introduced in Indonesian hospitals in 2006; however, under-reporting of patient safety incidents is evident. The government plays a vital role in the implementation of a national system. Therefore, this study focuses on how the Indonesian government has been undertaking its role in patient safety at provincial and city/district levels, including incident reporting according to the National Guideline for Hospital Patient Safety. (2) Methods: This study employed a qualitative approach with interviews of 16 participants from seven organizations. The data were managed using NVivo and thematically analyzed. (3) Results: The findings revealed several problems at the macro-, meso-, and micro-level as the government was weak in monitoring and evaluation. The District Health Office (DHO) and Provincial Health Office (PHO) were not involved in incident reporting, and there was a lack of government support for the hospitals. (4) Conclusions: The DHO and PHO have not carried out their roles related to patient safety as mentioned in the national guidelines. Lack of commitment to and priority of patient safety, the complexity of the bureaucratic structure, and a lack of systematic partnership and collaboration are problems that need to be addressed by systematic improvement. To ensure effective and efficient national outcomes, the three levels of government need to work more closely.
Incidents reporting: barriers and strategies to promote safety culture
Revista da Escola de Enfermagem da U S P, 2018
The purpose was to identify the barriers of underreporting, the factors that promote motivation of health professionals to report, and strategies to enhance incidents reporting. Group conversations were carried out within a hospital multidisciplinary team. A mediator stimulated reflection among the subjects about the theme. Sixty-five health professionals were enrolled. Complacency and ambition were barriers exceeded. Lack of responsibility about culture of reporting was the new barrier observed. There is a belief only nurses should report incidents. The strategies related to motivation reported were: feedback; educational intervention with hospital staff; and simplified tools for reporting (electronic or manual), which allow filling critical information and traceability of management risk team to improve the quality of report. Ordinary and practical strategies should be developed to optimize incidents reporting, to make people aware about their responsibilities about the culture of...
JMMR (Jurnal Medicoetivolegal dan Manajemen Rumahsakit), 2023
Incident reporting of patient safety is the first step in improving patient safety through learning from previous incidents. However, barriers to incident reporting caused by work environment factors make the patient safety incident system not run well in various countries. This study analyzes nurses' dimensions of a healthy work environment toward reporting patient safety incidents. This study used an observational analytic design with a cross-sectional approach. This study was conducted in a regional hospital in West Nusa Tenggara province in October-November 2022 with a total sample of 151 nurses working in the inpatient room. Sample determination used a quota sampling technique. Measurement of a healthy work environment was adopted from the HWE Tools and Measurement of incident reporting. The questionnaire was adopted from the Patient Safety Incident Reporting and Learning Systems. Data collection techniques implemented primary data questionnaires and multiple linear regression tests. The results showed a relationship between communication, collaboration, decision-making, staff suitability, recognition, and leadership to patient safety incident reporting with a p-value of 0.001 each (p <0.05). The most dominant relationship is Recognition (B=0.39, p=0.001). Recognition means stimulating a person's psychological growth and a positive mindset to complete tasks, solve problems, overcome obstacles, and bounce back from difficult situations. Therefore, individual attitudes alone are not enough to make individuals behave to report or not report incidents but must be supported by the wishes of those who have great influence in the environment and want individuals to report if an incident occurs.
Introduction: Medical incident reporting is a key tool for improving patient safety in healthcare, hence improved quality of care. The better the knowledge, attitude and practice of this concept, the better the quality of care. The perceived knowledge, attitude and practice are still low in many Uganda healthcare facilities. Many of the healthcare providers have, therefore, limited their scope to maternal death audit and reporting or perinatal death reporting and to a greater extent Adverse Event Following Immunization (AEFI). This problem of perceived low knowledge, attitude and practice of incident reporting is coupled with the poor institutional culture to persistently and inadequate support healthcare professionals to report incidents. Medical incident reporting is, therefore, the single most powerful tool for developing and maintaining an awareness of risks in healthcare practice, hence a cornerstone to improved patient safety and improved quality of service delivery. Objectives: The study objectives were as follow; to assess the level of knowledge about medical incident reporting among healthcare professionals, by April, 2016 and determine their attitude towards medical incident reporting. The researcher also set out to ascertain the practice and the extent to which medical incident reporting is practiced in Midigo Health Centre IV, as well as, establishing the factors affecting medical incident reporting in the said healthcare facility. Methods: The study was a cross sectional study of knowledge, attitude and practice of medical incident reporting among Healthcare Professionals in Midigo health centre IV. It was both qualitative and quantitative; with a sample of 44healthcare professionals interviewed using structured questionnaires. The questionnaire was pre-tested. Analysis of result was done using computer packages called Statistical Package for Social Sciences (SPSS) and Microsoft excel. Ethical considerations in research were observed. Results: The cadre of the respondents were; Medical officers – 4.5%, Clinical officers – 6.8%, Nurses – 43.2%, Midwives – 11.4%, Theatre staffs – 9.1%, Laboratory staffs – 6.8% and other staffs – 18.2%. The response rate was 100%. The level of knowledge about medical incident reporting among healthcare professionals in Midigo HC IV was at 84.1%, by April 2016. Much as there was no statistical significance between cadre of staffs and extent of knowledge, p-value >0.39, the only cadres that had excellent knowledge on medical incident reporting were nurses (75%) and clinical officers (25%). The rest of the staffs either had average knowledge or fair knowledge or no knowledge at all. The healthcare professionals had strong positive attitude towards medical incident reporting and this was at 97.7%. By April, 2016, the practice of medical incident reporting was at 72.6% with the majority of these respondents (up to 50%), having participated in reporting three times or more for the last 5years. The major factors that facilitated the respondents to report were; Strong positive feeling to participate and improve patient safety and respondents were knowledgeable (educated) about medical incident reporting. Other minor factors like ability of respondents to get feedback on reported incidents and strong institutional culture of reporting did not make strong contribution towards the practice of reporting. However, the major barriers were; respondents didn't know where and how to report, coupled with weak institutional culture of reporting incidents. Surprisingly, fear of consequence of reporting did not in any