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Exploring Health Care Professionals' Perceptions of Incidents and Incident Reporting in Rehabilitation Settings

Espin, Sherry RN, PhD*; Carter, Celina RN, MN*; Janes, Nadine RN, PhD; McAllister, Mary RN, PhD

doi: 10.1097/PTS.0000000000000214
Original Articles
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Objectives Research exploring patient safety in rehabilitation settings is limited. This study's aim was to describe team members' perceptions of incidents and incident reporting in rehabilitation settings.

Methods Semistructured interviews were conducted with 18 health care professionals from multiple rehabilitation units (medical, neurological, and orthopedic) at 2 inner-city rehabilitation centers. Five hypothetical scenarios were presented to participants during the interviews. Participants were asked to classify the scenarios and whether they would report any identified incidents. Data were analyzed using a descriptive thematic approach.

Results Participants classified events based on 2 parameters: the nature of the outcome and deviation from professional practice. Factors influencing participants' decisions to file incident reports included their classification of the events in the scenarios (i.e., events classified as critical incidents were more often reported than those classified as incident or near miss); the severity of the impact on the client; and their profession's perceived role in reporting specific incidents. When participants said they would report incidents, all agreed that they would report only objective facts.

Conclusions The study findings demonstrate gaps between incident-reporting policy and practice, and opportunities to address these gaps. Organizational leaders can work with all health care professions to support their roles in reporting. Interprofessional team building, focused on valuing all team members, may improve interprofessional communication and reporting. Setting standards for classifying events could increase consistency in reporting. Ultimately, encouraging reporting of near misses and incidents can create a culture of learning focused on problem solving and improved patient safety.

From the *Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University;

Interprofessional Practice and Clinical Education, West Park Healthcare Centre; and

Nursing Practice, The Hospital for Sick Children.

Correspondence: Sherry Espin, RN, PhD, Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University (e-mail: sespin@ryerson.ca).

The authors disclose no conflict of interest.

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