Assessment of factors affecting incident reporting among nurses working at a tertiary hospital in Rwanda

Abstract

INTRODUCTION: Optimal reporting of incidents occurring in healthcare is important for improving patients’, visitors’ and workers’ safety. There are unsatisfactory rates of incident reporting worldwide, with some institutional and provider-related barriers. The aim of this study was to assess factors affecting incident reporting among nurses working at the largest teaching hospital in Rwanda. 

METHODS: This is a cross-sectional descriptive study conducted among 166 nurses working in main 5 departments of the University Teaching Hospital of Kigali (CHUK) in 2019, using self-administered questionnaire. Data were compiled and analyzed through SPSS 27.0; statistical tests run through GraphPad Prism 9.5. 

RESULTS: Most respondents (58.3%) were middle-aged, female (83.1%), advanced diploma holders (72.3%), and with a 3–4-year working experience. Institutional-related barriers to incident reporting were predominated by the complexity of work (64.6%), shortage of staff (55.8%), and inadequacy of incident reporting system (43.3%). Fear of being punished (77.5%) and lack of knowledge on what should be reported (67.2%) were the most frequent professional-associated barriers. There was statistically significant association of lower level of education versus complexity of work (P=0.0474, OR=2.056, 95% CI=1.017 – 4.148), younger age versus lack of knowledge on what to report (P=0.0390), lower level of education versus the fear of being punished (P=0.0030, OR=3.417, 95% CI=1.566 – 7.493), lower level of education versus lack of knowledge on what to report (P<0.0001, OR=4.271, 95% CI=2.066 – 8.608), and shorter professional’s working experience versus lack of knowledge on what to report (P=0.016). 

CONCLUSION: Identified barriers should be addressed according to their levels, to optimize incident reporting and thus safety in healthcare facility. User-friendly incident reporting system should be designed, and efficient human resource management ensured. Moreover, principles of incident reporting should be incorporated in the induction, orientation and continuing professional development programs of healthcare staff.