Department of Patient Safety, Nagoya University Hospital, Nagoya, Japan.
General Medicine Center, Shimane University Hospital, Izumo, Shimane, Japan.
PLoS One. 2022 Dec 1;17(12):e0278615. doi: 10.1371/journal.pone.0278615. eCollection 2022.
The ability of any incident reporting system to improve patient care is dependent upon robust reporting practices. However, under-reporting is still a problem worldwide. We aimed to reveal the barriers experienced while reporting an incident through a nationwide survey in Japan. We conducted a cross-sectional survey. All first- and second-year residents who took the General Medicine In-Training Examination (GM-ITE) from February to March 2021 in Japan were selected for the study. The voluntary questionnaire asked participants regarding the number of safety incidents encountered and reported within the previous year and the barriers to reporting incidents. Demographics were obtained from the GM-ITE. The answers of respondents who indicated they had never previously reported an incident (non-reporting group) were compared to those of respondents who had reported at least one incident in the previous year (reporting group). Of 5810 respondents, the vast majority indicated they had encountered at least one safety incident in the past year (n = 4449, 76.5%). However, only 2724 (46.9%) had submitted an incident report. Under-reporting (more safety incidents compared to the number of reports) was evident in 1523 (26.2%) respondents. The most frequently mentioned barrier to reporting an incident was the time required to file the report (n = 2622, 45.1%). The barriers to incident reporting were significantly different between resident physicians who had previously reported and those who had never previously reported an incident. Our study revealed that resident physicians in Japan commonly encounter patient safety incidents but under-report them. Numerous perceived and experienced barriers to reporting remain, which should be addressed if incident reporting systems are to have an optimal impact on improving patient safety. Incident reporting is essential for improving patient safety in an institution, and this study recommends establishing appropriate interventions according to each learner's barriers for reporting.
任何事件报告系统改善患者护理的能力都取决于健全的报告实践。然而，报告不足仍然是一个全球性问题。我们旨在通过在日本进行的全国性调查揭示报告事件时遇到的障碍。我们进行了横断面调查。从 2021 年 2 月至 3 月在日本参加一般医学培训考试（GM-ITE）的所有一年级和二年级住院医师都被选为研究对象。这份自愿性问卷询问了参与者在过去一年中遇到和报告的安全事件数量以及报告事件的障碍。从 GM-ITE 中获取了人口统计学数据。将表示从未报告过事件的受访者（未报告组）的答案与过去一年至少报告过一次事件的受访者（报告组）的答案进行比较。在 5810 名受访者中，绝大多数人表示在过去一年中至少遇到过一次安全事件（n = 4449，76.5%）。然而，只有 2724 人（46.9%）提交了事件报告。在 1523 名（26.2%）受访者中，报告不足（与报告数量相比，安全事件更多）的情况明显。报告事件的最常见障碍是提交报告所需的时间（n = 2622，45.1%）。与以前报告过事件的住院医师相比，报告过事件的住院医师报告事件的障碍明显不同。我们的研究表明，日本的住院医师经常遇到患者安全事件，但报告不足。仍然存在许多感知到的和经验到的报告障碍，如果要使事件报告系统对改善患者安全产生最佳影响，就应该解决这些障碍。事件报告对于改善机构中的患者安全至关重要，本研究建议根据每个学习者的报告障碍建立适当的干预措施。
