Multi‐level analysis of national nursing students' disclosure of patient safety concerns. Issue 11 (21st October 2018)

• Record Type: Journal Article
• Authors: Palese, Alvisa; Gonella, Silvia; Grassetti, Luca; Mansutti, Irene; Brugnolli, Anna; Saiani, Luisa; Terzoni, Stefano; Zannini, Lucia; Destrebecq, Anne; Dimonte, Valerio
• Other Names: Morsanutto Michela investigator.; Canzan Federica investigator.; Altini Pietro investigator.; Bevilacqua Anita investigator.; Dal Ponte Adriana investigator.; De Biasio Laura investigator.; Fascì Adriana investigator.; Grosso Silvia investigator.; Mantovan Franco investigator.; Marognolli Oliva investigator.; Nicotera Raffaela investigator.; Randon Giulia investigator.; Tollini Morena investigator.
• Is Part Of: Medical education. Volume 52:Issue 11(2018)
• Page Start: 1156
• Page End: 1166
• Publication Date: 2018-10-21
• Subjects: Medical education -- Periodicals; Medical education -- Great Britain -- Periodicals; 610.7
• DOI: 10.1111/medu.13716
• Languages: English
• ISSNs: 0308-0110

Abstract

Abstract : Context: Error reporting is considered one of the most important mediating factors for patient safety (PS). However, reporting errors can be challenging for health care students. Objectives: The aims of the study were: (i) to describe nursing students' opportunity to report errors, near misses or PS issues that emerged during their clinical learning experience; and (ii) to explore associated factors of the process of reporting itself. Methods: A national survey was conducted on 9607 (91.7%) undergraduate nursing students. The endpoint was to have reported PS issues in the last clinical learning experience (from 0 'never' to 3 'always'). Explanatory variables were set individual, nursing programme and regional levels. Results: A total of 4004 (41.7%) nursing students reported PS issues from 'never/rarely' to 'sometimes'. In the multi‐level analysis, factors increasing the likelihood of reporting events affecting PS have been mainly at the nursing programme level: specifically, higher learning opportunities (odds ratio [OR] = 3.040; 95% confidence interval [CI], 2.667–3.466), self‐directed learning opportunities (OR = 1.491; 95% CI, 1.364–1.630), safety and nursing care quality (OR = 1.411; 95% CI, 1.250–1.594) and quality of tutorial strategies OR = 1.251; 95% CI, 1.113–1.406). By contrast, being supervised by a nurse teacher (OR = 0.523; 95% CI, 0.359–0.761) prevented the disclosure of PS issues compared with being supervised by a clinical nurse. Students attending their nursing programmes in some Italian regions showed a higher likelihood (OR from 1.346 to 2.938) of reporting PS issues compared with those undertaking their education in other regions. Conclusions: Nursing students continue to be reticent to report PS issues. Given that they represent the largest generation of future health care workers, their education regarding PS should be continuously monitored and improved; moreover, strategies aimed at developing a non‐blaming culture should be designed and implemented both at the clinical learning setting and regional levels. Abstract : Palese et al. disclose that many nursing students do not discuss safety issues that emerge during their clinical practice, highlighting environmental features that discourage such reporting.