Objective To improve of the delivery, effectiveness, and safety of the health care system, clinicians must report adverse events. Improved reporting requires an understanding of current reporting practices concerning medical errors, near misses, and adverse events. This study compared the reporting practices of physicians and nurses.
Design Descriptive study of reported events using a secure, standardized, Web-based reporting system.
SETTING 29 acute care nonfederal U.S. hospitals and one long term care facility that implemented an electronic error reporting system, available to all employees, between August 2000 and December 2005.
Methods Events were classified by impact level on the patient using a standard classification scheme. Both ANOVA and chi-square testing were performed to analyze the significance.
Results 266,224 events were reported over 7.3 million inpatient-days or 1 event per 27.5 days. Physicians reported 1.1%, nurses 45.3%, and other hospital employees 53.6% of total events.
There was no significant difference between academic and nonacademic settings. In academic hospitals, physicians-in-training had a lower reporting rate than did attending physicians (p < .05).
Conclusions Physicians report fewer and a narrower spectrum of events than nurses; physician reporting rates increase as the impact of the event on the patient increases but decrease for fatal events; nurse rates remain stable across impact levels. Differences exist between how nurses and physicians report events, and it is necessary to understand the underlying reasons behind these variations.
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