Journal of Korean Critical Care Nursing (중환자간호학회지)

Korean Society of Critical Care Nursing (한국중환자간호학회)
권호 표지
DOI QR코드

DOI QR Code

Relationship between the Perceptions of ICU Nurses on the Disclosure of Patient Safety Incidents and Communication Barriers

중환자실 간호사의 환자안전사고 소통하기에 대한 인식과 의사소통 장애 간의 관계

  • 조인선 (삼성서울병원 내과중환자실) ;
  • 최수정 (성균관대학교 임상간호대학원)
  • Received : 2023.09.05
  • Accepted : 2024.02.09
  • Published : 2024.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : This study sought to explore intensive care unit (ICU) nurses' perceptions regarding the disclosure of patient safety incidents (DPSI) and identify the relationship between the perception of DPSI and communication barriers. Methods : This study used a descriptive research design. A total of 110 ICU nurses from a tertiary hospital were surveyed online between September 14 and October 5, 2022. The mean DPSI score ranged between 1.0 and 4.0, with a higher score indicating a higher perception of DPSI. Results : The mean score for ICU nurses' perceptions of DPSI was 2.92 (SD=0.37). Among the characteristics of ICU nurses, differences were observed in perceptions of DPSI according to gender, age, total work experience, and ICU work experience. Communication barriers among ICU nurses were negatively correlated with negative results as a sub-factor of perceptions of DPSI. Ambiguity in the nurse's position, lack of confidence, differences in perspectives with patients, and inadequate nurse-patient relationships as sub-factors of communication barriers exhibited a negative correlation with negative results as a sub-factor of perceptions of DPSI. Conclusions : ICU nurses' perceptions of DPSI and the sub-factors related to communication barriers are negatively related to DPSI. To improve ICU nurses' perceptions, open and non-punitive circumstances, staff education, practical guidelines, and support systems are required.

Keywords

References

  1. Jung S, Park H. Factors influencing nursing professionalism on the nursing performance in intensive care unit nurses. Journal of Korean Academy of Fundamentals of Nursing. 2022;29(4):451-60. http://doi.org/10.7739/jkafn.2022.29.4.451 
  2. Ghezeljeh TN, Farahani MA, Ladani FK. Iranian nurses' perception of factors contributing to medical errors in intensive care unit: a qualitative study. Acta Medica Iranica. 2022;60(3):171. https://doi.org/10.18502/acta.v60i3.9005 
  3. Molina FJ, Rivera PT, Cardona A, Restrepo DC, Monroy O, Rodas D, et al. Adverse events in critical care: search and active detection through the trigger Tool. World Journal of Critical Care Medicine. 2018;7(1):9-15. http://doi.org/10.5492/wjccm.v7.i1.9 
  4. Korea Patient Safety Reporting & Learning System, 2022 Korean patient safety incident report [Internet]. Seoul: Korea Institute for Healthcare Accreditation; 2022. [cited 2023 October 13]. Available from: https://api.kops.or.kr/portal/board/statAnlrpt/boardList.do 
  5. Kim YM. A qualitative study on nurses' experiences with patient safety incidents in special departments. Korean Association for Qualitative Research. 2020;5(2):96-108. http://doi.org/10.48000/KAQRKR.2020.5.96 
  6. Choi EY, Pyo J, Lee W, Jang SG, Park YK, Ock M, et al. Perception gaps of disclosure of patient safety incidents between nurses and the general public in Korea. Journal of Patient Safety. 2021;17(8):e971-e975. http://doi.org/10.1097/pts.0000000000000781 
  7. Alanizy BA, Masud N, Alabdulkarim AA, Aldihan GA, Alwabel RA, Alsuwaid SM, et al. Are patients knowledgeable of medical errors and medical complications? A cross-sectional study at a tertiary hospital, Riyadh. Journal of Family Medicine and Primary Care. 2021;10(8):2980. http://doi.org/10.4103/jfmpc.jfmpc_2031_20 
  8. Kim Y, Lee H. Nurses' experiences with disclosure of patient safety incidents: a qualitative study. Risk Management Healthc Policy. 2020;13:453-64. http://doi.org/10.2147/rmhp.s253399 
  9. Ock M, Lim SY, Jo MW, Lee SI. Frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents: a systematic review. Journal of Preventive Medicine and Public Health. 2017;50(2):68-82. http://doi.org/10.3961/jpmph.16.105 
  10. Lipira LE, Gallagher TH. Disclosure of adverse events and errors in surgical care: challenges and strategies for improvement. World Journal of Surgery. 2014;38(7):1614-21. http://doi.org/10.1007/s00268-014-2564-5 
  11. O'Connor E, Coates HM, Yardley IE, Wu AW. Disclosure of patient safety incidents: a comprehensive review. International Journal for Quality in Health Care. 2010;22(5):371-9. http://doi.org/10.1093/intqhc/mzq042 
  12. Choi EY, Pyo J, Ock M, Lee SI. Nurses' perceptions regarding disclosure of patient safety incidents in Korea: a qualitative study. Asian Nursing Research. 2019;13(3):200-8. https://doi.org/10.1016/j.anr.2019.05.002 
  13. Leape LL. Full disclosure and apology-an idea whose time has come. Physician Executive. 2006;32(2):16-18 
  14. Liukka M, Steven A, Vizcaya Moreno MF, Sara-Aho AM, Khakurel J, Pearson P, et al. Action after adverse events in healthcare: an integrative literature review. International Journal of Environmental Research and Public Health. 2020;17(13):4717. https://doi.org/10.3390/ijerph17134717 
  15. Lee YM. How to teach open disclosure and saying "sorry". Korean Journal of Medical Education. 2011;23(2):137. http://doi.org/10.3946/kjme.2011.23.2.137 
  16. Kim D. Medical communication: Three function approach. The Journal of Korean Academy on Communication in Healthcare. 2006;1(1):1-6 
  17. Chang SO, Park YJ. The study on the communication barrier for nurses in clinical settings. The Journal of Fundamentals of Nursing. 1999;6(1):130-40 
  18. Yoo HJ, Lim OB, Shim JL. Critical care nurses' communication experiences with patients and families in an intensive care unit: a qualitative study. Plos One. 2020;15(7):e0235694. http://doi.org/10.1371/journal.pone.0235694 
  19. Park YS, Oh EG. Factors related to intensive care unit nurses' patient centered communication competency. Journal of Korean Critical Care Nursing. 2018;11(2):51-62 
  20. Dhamanti I, Juliasih NN, Semita IN, Zakaria N, Guo HR, Sholikhah V. Health workers' perspective on patient safety incident disclosure in Indonesian hospitals: a mixed-methods study. Journal of Multidisciplinary Healthcare. 2023;16:1337-48. http://doi.org/10.2147/JMDH.S412327 
  21. Sattar R, Johnson J, Lawton R. The views and experiences of patients and health-care professionals on the disclosure of adverse events: a systematic review and qualitative meta-ethnographic synthesis. Health Expectations. 2020;23(3):571-83. http://doi.org/10.1111/hex.13029 
  22. Ock M, Kim HJ, Jo MW, Lee SI. Perceptions of the general public and physicians regarding open disclosure in Korea: a qualitative study. BMC Medical Ethics. 2016;17(1):1-13. http://doi.org/10.1186/s12910-016-0134-0 
  23. Park YJ, Park MH. Clinical nurses' perception of disclosure of patient safety incidents. Personalism Bioethics. 2023;13(1):63-100. http://doi.org/10.35230/pb.2023.13.1.63 
  24. Kim Y, Lee E. The relationship between the perception of open disclosure of patient safety incidents, perception of patient safety culture, and ethical awareness in nurses. BMC Medical Ethics. 2020;21(1):104. http://doi.org/10.1186/s12910-020-00546-725. 
  25. Kang H, Yeon K, Han ST. A review on the use of effect size in nursing research. Journal of Korean Academy of Nursing. 2015;45(5):641-9. https://doi.org/10.4040/jkan.2015.45.5.641 
  26. Wagner LM, Harkness K, Hebert PC, Gallagher TH. Nurses' perceptions of error reporting and disclosure in nursing homes. Journal of Nursing Care Quality. 2012;27(1):63-9. https://doi.org/10.1097/ncq.0b013e318232c0bc 
  27. Lee W, Choi EY, Pyo JH, Jang SG, Ock MS, Lee SI. Perception and effectiveness of education regarding disclosure of patient safety incidents: a preliminary study on nurses. Quality Improvement in Health Care. 2017;23(2):37-54. https://doi.org/10.14371/QIH.2017.23.2.37 
  28. Lee EH. Psychometric property of an instrument 1: content validity. Korean Journal of Women Health Nursing. 2021;27(1):10-3. https://doi.org/10.4069/kjwhn.2021.01.31 
  29. Han JY. Investigation of the relationship of the attitudes of intensive care unit nurses toward the elderly with communication styles and communication barriers [master's thesis]. Seoul: Korea University; 2022. 
  30. Hong KS. Intensivist as a surgeon: the role of a surgeon in critical care medicine. The Ewha Medical Journal. 2017;40(2):61-5. https://doi.org/10.12771/emj.2017.40.2.61 
  31. Wagner LM, Damianakis T, Pho L, Tourangeau A. Barriers and facilitators to communicating nursing errors in long-term care settings. Journal of Patient Safety. 2013;9(1):1-7. http://doi.org/10.1097/pts.0b013e3182699919 
  32. Pyo J, Lee W, Jang SG, Choi EY, Ock M, Lee SI. Does the disclosure of patient safety incidents satisfy those who have been harmed? Korean Journal of Medical Ethics. 2019;22(4):321-40. http://doi.org/10.35301/ksme.2019.22.4.321 
  33. Jeong S, Jeong SH. Effects of second victim expe0 riences after patient safety incidents on nursing practice changes in korean clinical nurses: the mediating effects of coping behaviors. Journal of Korean Academy of Nursing. 2021;51(4):489-504. https://doi.org/10.4040/jkan.21089 
  34. Akgun KM, Shamas TL, Feder SL, Schulman-Green D. Communication strategies to mitigate fear and suffering among COVID-19 patients isolated in the ICU and their families. Heart & Lung: The Journal of Cardiopulmonary and Acute Care. 2020;49(4):344-5. http://doi.org/10.1016/j.hrtlng.2020.04.016 
  35. Kozub E, Scheler S, Necoechea G, O'Byrne N. Improving nurse satisfaction with open visitation in an adult intensive care unit. Critical Care Nursing Quarterly. 2017;40(2):144-54. http://doi.org/10.1097/cnq.0000000000000151 
  36. Kim HY, Kim HS. Effects of perceived patient safety culture on safety nursing activities in the general hospital nurse's. Journal of Korean Academy of Nursing Administration. 2011;17(4):12. http://doi.org/10.11111/jkana.2011.17.4.413 
  37. Shannon SE, Foglia MB, Hardy M, Gallagher TH. Disclosing errors to patients: perspectives of registered nurses. The Joint Commission Journal on Quality and Patient Safety. 2009;35(1):5-12. http://doi.org/10.1016/s1553-7250(09)35002-3 
  38. Stroud L, Wong BM, Hollenberg E, Levinson W. Teaching medical error disclosure to physicians-intraining: a scoping review. Academic Medicine. 2013;88(6):884-92. http://doi.org/10.1097/ACM.0b013e31828f898f 
  39. Moumtzoglou A. Factors impeding nurses from reporting adverse events. Journal of Nursing Management. 2010;18(5):542-7. https://doi.org/10.1111/j.1365-2834.2010.01049.x 
  40. Kim CW, Myung SJ, Eo EK, Chang Y. Improving disclosure of medical error through educational program as a first step toward patient safety. BMC medical education. 2017;17(1):1-6. http://doi.org/10.1186/s12909-017-0880-9. 
  41. Guillod O. Medical error disclosure and patient safety: legal aspects. Journal of Public Health Research. 2013;2(3):e31. http://doi.org/10.4081/jphr.2013.e31 
  42. Edwin AK. Non-disclosure of medical errors an egregious violation of ethical principles. Ghana Medical Journal. 2009;43(1):34-9. 
  43. McLennan SR, Diebold M, Rich LE, Elger BS. Nurses' perspectives regarding the disclosure of errors to patients: A qualitative study. International journal of nursing studies. 2016;54:16-22.  https://doi.org/10.1016/j.ijnurstu.2014.10.001
  44. Australian Commission on Safety and Quality in Health Care. Australian open disclosure framework [Internet]. Sydney NSW: Australian Commission on Safety and Quality in Health Care; 2013 [cited 2023 June 20]. Available from: https://www.safetyandquality.gov.au/our-work/open-disclosure/the-open-disclosure-framework 
  45. Canadian Patient Safety Institute. Canadian disclosure guidelines : being open with patients and families [Internet]. Ottawa: Canadian Patient Safety Institute; 2011 [cited 2023 June 21]. Available from: https://www.patientsafetyinstitute.ca/en/toolsResources/disclosure/Documents/CPSI%20Canadian%20Disclosure%20Guidelines.pdf 
  46. Mastroianni AC, Mello MM, Sommer S, Hardy M, Gallagher TH. The flaws in state 'apology' and 'disclosure' laws dilute their intended impact on malpractice suits. Health Affairs. 2010;29(9):1611-9. http://doi.org/10.1377/hlthaff.2009.0134