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Updated: Aug 6, 2025
Biochemical Measurement of Neonatal Hypoxia
Published on: August 24, 2011
Error disclosure in neonatal intensive care: a multicentre, prospective, observational study
Loïc Passini1, Stephane Le Bouedec2, Gilles Dassieu1
1Neonatal Intensive care Unit, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Insights
Healthcare professionals in neonatal intensive care units (NICUs) disclosed less than half of medical errors to parents. Non-disclosure was linked to error timing, severity, and perceived parental absence.
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.
Importance:
Surveys based on hypothetical situations suggest that health-care providers agree that disclosure of errors and adverse events to patients and families is a professional obligation but do not always disclose them. Disclosure rates and reasons for the choice have not previously been studied.
Objective:
To measure the proportion of errors disclosed by neonatal intensive care unit (NICU) professionals to parents and identify motives for and barriers to disclosure.
Design:
Prospective, observational study nested in a randomised controlled trial (Study on Preventing Adverse Events in Neonates (SEPREVEN); ClinicalTrials.gov). Event disclosure was not intended to be related to the intervention tested.
Setting:
10 NICUs in France with a 20-month follow-up, starting November 2015.
Participants:
n=1019 patients with NICU stay ≥2 days with ≥1 error.
Exposure:
Characteristics of errors (type, severity, timing of discovery), patients and professionals, self-reported motives for disclosure and non-disclosure.
Main Outcome And Measures:
Rate of error disclosure reported anonymously and voluntarily by physicians and nurses; perceived parental reaction to disclosure.
Results:
Among 1822 errors concerning 1019 patients (mean gestational age: 30.8±4.5 weeks), 752 (41.3%) were disclosed. Independent risk factors for non-disclosure were nighttime discovery of error (OR 2.40; 95% CI 1.75 to 3.30), milder consequence (for moderate consequence: OR 1.85; 95% CI 0.89 to 3.86; no consequence: OR 6.49; 95% CI 2.99 to 14.11), a shorter interval between admission and error, error type and fewer beds. The most frequent reported reasons for non-disclosure were parental absence at its discovery and a perceived lack of serious consequence.
Conclusion And Relevance:
In the particular context of the SEPREVEN randomised controlled trial of NICUs, staff did not disclose the majority of errors to parents, especially in the absence of moderate consequence for the infant.
Trial Registration Number:
NCT02598609.
