Factors Associated With Nurses' Intention to Report Medical and Care Errors: A Systematic Review

Medical and care errors are common in health care, posing serious risks to patient safety, with over 10% of patients being harmed annually. Despite efforts to reduce errors, underreporting persists, as nurses report only about 20% of incidents. Understanding the factors that influence nurses' intention to report errors is essential for developing effective strategies to improve reporting and patient safety. This systematic review aimed to identify factors associated with nurses' intention to report medical and care errors. A comprehensive search was conducted in 3 databases (PubMed, CINAHL, and PsycINFO) and Google Scholar using a combination of MeSH and synonymous terms related to medication errors, medical errors, care errors, intention to report, and nurses. Twenty-seven articles were included in the analysis. The review revealed that interpersonal characteristics such as attitude, subjective norms, and perceived behavioral control were found to have a significant relationship with nurses' intention to report medical errors. In addition, organizational environmental factors like patient safety culture and climate, nonpunitive responses to errors, open communication, teamwork, management support, task-oriented culture, organizational learning, reporting awareness, leadership behavior, and psychological safety positively influence error-reporting intentions. Furthermore, some demographic characteristics, including nurses' age, level of education, years of experience, and prior exposure to medication errors positively impacted reporting behaviors. This review results highlight the multifaceted nature of factors influencing nurses' intention to report medical errors. Understanding the complex interplay of attitude, subjective norms, perceived behavioral control, and other contextual factors is crucial to promote a reporting culture that enhances patient safety.