Nursing near miss: a concept analysis

Nursing near misses represent critical yet underutilized indicators of patient safety. Variability in their definition and recognition hampers consistent reporting and management, underscoring the need for concept analysis to advance clarity and practice.

This study aimed to clarify the definition, attributes, antecedents, and consequences of nursing near misses through Walker and Avant's concept analysis method.

This study used Walker and Avant's eight-step concept analysis framework to systematically analyze the concept of nursing near misses. A comprehensive search was conducted in both English and Chinese databases to identify relevant studies, and the selected literature was reviewed and synthesized according to the eight-step approach.

Nursing near misses were characterized by four defining attributes: (1) occurrence within the nursing process; (2) an error that was committed but did not result in patient harm; (3) prevention of adverse outcomes through timely identification and intervention; and (4) reflection of underlying risks with significant value for reporting and improvement. Antecedents included individual factors, organizational factors, and environmental factors. Consequences encompassed both negative outcomes and positive outcomes. Empirical referents were proposed to support the identification and management of nursing near miss events.

This study contributes to a clearer understanding of the concept of nursing near misses, facilitating early recognition and prevention of low-risk nursing errors, and supporting evidence-based strategies to strengthen nursing safety and quality management.