To report or not? A qualitative study of critical care nurses' experiences of incident reporting

Critical care nurses have a key role in identifying and reporting incidents. These reports are used to improve patient safety and to deliver high-quality care, particularly within intensive care settings where patients are highly vulnerable. However, critical care nurses reporting behaviours are influenced by various organisational and individual factors.

The aim of this study was to explore the experiences of critical care nurses in Australia with incident reporting and the perceived barriers and facilitators that influence reporting behaviours in critical care settings.

Using a qualitative descriptive method, semistructured interviews with eight nurses from intensive care units across Australia were conducted. Data were analysed using reflexive thematic analysis.

Three overarching themes were found: Facilitators of effective incident reporting, Barriers to incident reporting, and To report or not. Findings showed that organisational culture played a substantial role in shaping intensive care nurses' willingness to report incidents. Intensive care nurses were more likely to engage in reporting when a supportive, nonpunitive culture was present and when incident reports led to constructive feedback and educational opportunities. A lack of support from management, complicated reporting systems, insufficient education, and using reporting as a weapon were identified as barriers preventing incident reporting. Due to heavy workloads and the perception that some incidents seemed minor, nurses occasionally preferred to report problems informally, which could limit efforts to improve safety.

This study highlights the impact organisational and supportive culture play a major role in critical care nurses' willingness to report incidents. These findings explore the experiences of incident reporting among critical care nurses in Australia, which organisations may use to address the barriers and emphasise the facilitators to encourage effective reporting.