# Medical Error Reporting among healthcare workers in a Kenyan tertiary level hospital: a knowledge, attitude, and practice study

## TL;DR

This study examines how healthcare workers at a Kenyan hospital report medical errors, finding that awareness and attitudes vary, with nurses more likely to report than doctors.

## Contribution

This is the first study to document medical error reporting form use at Kenyatta National Hospital, revealing gaps in awareness and attitudes among healthcare workers.

## Key findings

- Only 71.2% of participants were aware of the MER tool, and 68.6% had encountered a medical error in the past two years.
- Nurses were more likely to report errors than doctors, and positive attitudes toward MER were significantly associated with reporting behavior.
- Fear of victimization and lack of awareness were identified as barriers to medical error reporting.

## Abstract

Medical Error Reporting (MER) enables organizations to characterize safety events, learn from them, and mitigate their recurrence in the future. However, Medical Error Reporting is inconsistently practiced by healthcare workers. This study aimed to assess the knowledge, practice, and attitude towards MER at the Kenyatta National Hospital (KNH), a tertiary care teaching and referral hospital in Kenya that serves Kenya and the East and Central African regions.

This cross-sectional study was conducted among healthcare workers at KNH between February and July 2022. Out of a calculated sample size of 384, a total of 390 participants were recruited, and 372 were included in the final analysis. Stratified convenience sampling was used to ensure representation across clinical cadres (nurses, doctors, and others) and hospital divisions (medicine, surgery, pharmacy, and others). Participants were recruited via email, departmental WhatsApp groups, or during meetings. Data were collected using a pre-tested, self-administered questionnaire (online and paper-based).

Of the 372 participants, most were nurses 62.3%, followed by doctors (30.3%) and other staff (7.4%). Awareness of the MER tool was reported by 259 (71.2%). A total of 247 (68.6%) had encountered a medical error in the past two years, and among them, 138 (55.9%) had used the MER form, submitting a total of 758 reports. Nearly half of the respondents (49.2%) expressed a positive attitude toward medical error reporting (MER), which was significantly associated with reporting behaviour, particularly among respondents in the Surgery division (χ² = 11.78, p = 0.003). Most participants, 245 (74.2%), correctly defined patient safety. MER use was significantly associated with cadre; nurses reported more than doctors (χ² = 25.1, df = 2, p < 0.001).

Medical error reporting remains underutilized at KNH, especially among doctors. As the first study to document MER form use at the institution, it highlights gaps in awareness and attitude. Enhancing uptake will require addressing fear of victimization, strengthening supportive reporting cultures, and raising awareness across all healthcare worker cadres.

The online version contains supplementary material available at 10.1186/s12913-025-13886-0.