A Taiwan's National Survey of Nursing Home Staff's Cognition, Attitude and Barrier on National Incident Reporting System

Background: A national incident report sysem named as the Taiwan Patient Safety Reporting System (TPR) has establieshed in Taiwan since 2006. Taiwan's hospital accreditation has mandated hospitals to report medical incidents regularly for assuring patient safety. However, participating national incident reporting system is not mandated in long-term-care facilities in Taiwan. Safety culture in nursing homes can be improved by incident reporting and incident learning.  

Purpose:The purpose of this study is to explore nursing home staff’s incident reporting cognition, attitude and barrier toward the TPR.

Method: A questionnaire survey with a random sample was conducted. The researcher used questionnaires that included “incident reporting survey”, “TPR reporting cognition scale”, TPR reporting attitude scale” and  “TPR reporting barrier scale” to collect data from 336 staffs among 37 nursing homes island wide.

Results: A mean age was 36.3(±9.3) for all participants. The average of work year was 4.8(±4.8) years. Fall incident was the most common incident during last 12 months, and it accounted for 94.6% of all incidents. The frequency of incident occurrence was ranged from less happening (54.1%) to occasional happening (35.1%). Paper reporting was primarily found in 78.4% of facilities. Staff demonstrated positively on incident reporting cognition (M=70) and incident reporting attitude (M=77) toward the TPR. Staff also showed some barriers (M=54) on the TPR. The most common barriers in nursing home staffs included "Do not know how to participate in the TPR", "Fear of medical disputes", "Fear of information leak", and "Worry about time consuming".

Conclusions and implications: Nursing home staffs have demonstrated positively incident reporting cognition and attitude on the TPR regardless many barriers are identified. Decreasing incident reporting barriers and increasing incident reporting corgnition and attitude can enhance safety culture in nursing homes. The study results could be a reference for professionals and long-term-care facilities that have compassion to improve an incident reporting system and implement education program of resident safety. Furthermore, facilities could transform a culture of punishment to a culture of learning through peer learning by participating in the TPR.