Error disclosure in neonatal intensive care: a multicentre, prospective, observational study.

Area of Science:

• Neonatal Intensive Care
• Patient Safety
• Medical Error Disclosure

Background:

• Healthcare providers acknowledge a professional obligation to disclose medical errors and adverse events.
• However, actual disclosure rates and the reasons behind non-disclosure in clinical practice remain understudied, particularly in neonatal intensive care units (NICUs).

Purpose of the Study:

• To quantify the proportion of medical errors disclosed by NICU professionals to parents.
• To identify the primary motivations and barriers influencing the decision to disclose or not disclose errors.

Main Methods:

• A prospective, observational study was conducted within 10 NICUs in France over 20 months.
• Data were collected on 1822 errors in 1019 patients, including error characteristics, disclosure status, and self-reported reasons for disclosure decisions.

Main Results:

• Only 41.3% of 1822 identified errors were disclosed to parents.
• Key factors associated with non-disclosure included nighttime discovery, milder error consequences, shorter time between admission and error, and fewer NICU beds.
• Common reasons for non-disclosure were parental absence during error discovery and the perception of minor consequences.

Conclusions:

• The majority of medical errors in this NICU setting were not disclosed to parents.
• Disclosure practices were significantly influenced by factors such as the timing and perceived severity of the error, highlighting a gap between professional obligation and practice.