# Factors affecting reporting of patient safety incidents in the Eastern Cape primary health care

## TL;DR

The study explores why patient safety incidents are underreported in primary healthcare in the Eastern Cape, finding that fear, lack of training, and poor support are key barriers.

## Contribution

This study identifies specific organizational and cultural barriers to patient safety incident reporting in primary healthcare settings in South Africa.

## Key findings

- Nurses avoid reporting due to fear of punishment and lawsuits.
- Lack of training and resources hinders proper reporting of patient safety incidents.
- Supportive management and a positive work environment are crucial for improving reporting rates.

## Abstract

There is a low and erroneous rate of patient safety incident reporting system in the primary health care institutions in the study. These gaps are identified through clinical audits of patient files, performance reviews and complaints received through the provincial call centre.

The study aimed to explore and describe factors influencing the reporting of patient safety incidents in primary health care facilities.

The study was conducted in the Mqanduli District of the Eastern Cape Province. Five healthcare facilities were included, as these were the facilities where the identified problems were evident.

A qualitative, exploratory, descriptive design was used. Purposive sampling was used to select 10 nurses who were interviewed. Data were analysed by thematic analysis, and measures to ensure trustworthiness, and ethical principles were followed.

The reporting process for patient safety is influenced by a number of factors, such as nurses’ reluctance to report for fear of punishment, a lack of training and education and fear of lawsuits. Nurses need support from management in the form of training and provision of resources, creating a positive work environment and safety culture by not punishing those who make errors and rewarding those who report patient safety incidents.

Nurses receive minimal support from managers, have inadequate knowledge of patient safety incidents (PSI) reporting and guidelines, insufficient resources and high staff workloads, which need to be addressed in order to improve PSI reporting. Nurses require a supportive work environment, with encouragement from colleagues, management and the Department of Health.

Recommendations are provided for nursing education, research and practice to enhance nurses’ understanding and proficiency with PSI reporting, thereby ensuring quality of nursing care and patient safety.