摘要
Objective:This integrative review aimed to examine and understand nurses’experiences of voluntary error reporting(VER)and elucidate factors underlying their decision to engage in VER.Method:This is an integrative review based on Whittemore&Knafl five-stage framework.A systematic search guided by the PRISMA 2020 approach was performed on four electronic databases:CINAHL,Medline(PubMed),Scopus,and Embase.Peer-reviewed articles published in the English language from January 2010 to December 2020 were retrieved and screened for relevancy.Results:Totally 31 papers were included in this review following the quality appraisal.A constant comparative approach was used to synthesize findings of eligible studies to report nurses'experiences of VER represented by three major themes:nurses'beliefs,behavior,and sentiments towards VER;nurses'perceived enabling factors of VER and nurses'perceived inhibiting factors of VER.Findings of this review revealed that nurses’experiences of VER were less than ideal.Firstly,these negative experiences were accounted for by the interplays of factors that influenced their attitudes,perceptions,emotions,and practices.Additionally,their negative experiences were underpinned by a spectrum of system,administrative and organizational factors that focuses on attributing the error to human failure characterized by an unsupportive,blaming,and punitive approach to error management.Conclusion:Findings of this review add to the body of knowledge to inform on the areas of focus to guide nursing management perspectives to strengthen institutional efforts to improve nurses'recognition,reception,and contribution towards VER.It is recommended that nursing leaders prioritize and invest in strategies to enhance existing institutional error management approaches to establish a just and open patient safety culture that would promote positivity in nurses’overall experiences towards VER.
目的旨在调查和了解护士主动报告差错(voluntary error reporting,VER)的体验,并阐明其决定参与VER的因素。方法按照Whittemore与Knafl的整合性综述方法,对CINAHL,Medline(PubMed),Scopus和Embase 4个数据库进行检索。检索文献发表时间限定为2010年1月至2020年12月,仅纳入经过同行评审的英文文献。结果质量评价后最终纳入31篇论文。采用持续比较的方法,综合符合纳入标准的研究结果,总结护理人员的VER体验,包括护士对VER的态度、感知、情绪和实践,护士感知的VER使能因素和护士感知的VER抑制因素3个主题。结果显示,护理人员的VER体验并不理想。这些消极的体验是由影响他们的态度、感知、情绪和实践的因素相互作用而产生;也是由一系列系统、管理和组织因素引起,这些因素侧重于将错误归因于人为失误,并以不支持、指责和惩罚的错误管理方法为特征。结论本综述的结果完善了知识体系,并为重点领域的护理管理观点提供信息,以加强机构的建设,提高护士对VER认可、接受和贡献。建议护理管理者优先考虑并投资于改善现有机构管理方法的策略,以建立更为公正和开放的患者安全文化,这将提高护士对VER的积极性。
