Background: Globally, healthcare systems seek to improve reporting cultures among nurses, doctors, and allied healthcare providers. Reporting clinical incidents builds awareness of vulnerabilities in clinical practice, identifies errors that occur during patient care, and helps to measure performance to reduce the risk of harm. The current body of knowledge pertaining to graduate nurses’ experiences in their first year as Registered Nurses (RNs) focuses on the rates of error; there is a lack of exploration and insight into graduate nurses’ reflections and perceptions, thoughts, and feelings about their experiences of reporting clinical incidents. Purpose: To explore graduate nurses’ experiences of reporting clinical incidents in their graduate year. Method: This qualitative study used interpretative phenomenological analysis to describe and interpret the experiences of eight graduate nurses from clinical settings across Sydney, Australia. It conducted semi-structured interviews to engage in open dialogue with participants and obtain detailed descriptions of their experiences reporting clinical incidents in their first 12 months of practice as RNs. Findings: Three master themes and associated subthemes were identified in this research. Master Theme 1: Deciding what, when, and why clinical incidents were reported (1.1: To report or not to report; and 1.2: Why graduate nurses report clinical incidents). Master Theme 2: Navigating the process of reporting clinical incidents (2.1: Perceptions of reporting systems; and 2.3: Experiencing challenges with using reporting systems). Master Theme 3: Systemic inhibitors to reporting clinical incidents. Conclusion: The participants experienced difficulties making independent decisions to report clinical incidents using formal reporting systems. These included the Incident Information Management System (IIMS), Riskman, and paper-based systems. Reflecting upon their experiences, graduates were unable to identify some reportable events or circumstances, which could potentially harm a patient, consumer, or staff member. Graduates also felt unprepared when navigating complex reporting systems. Participants attributed this to receiving little-to-no education and training on the systems, and inconsistent learning opportunities during their undergraduate and graduate programs. The graduate nurses experienced a great contrast in reporting cultures when rotating between units. While positive workplace cultures enabled some graduates to feel safe and open with reporting, other facilities made graduates feel reluctant, uncomfortable, and uneasy to initiate reporting due to the scrutiny, blaming, naming, and shaming they observed and experienced. This research will provide invaluable knowledge of graduate nurse’s experiences in reporting clinical incidents.
Graduate nurses’ experiences of reporting clinical incidents: an interpretative phenomenological analysis
Kopan, A. (Author). 2021
Western Sydney University thesis: Master's thesis