Factors Influencing Reporting of Medical Errors Amongst Nurses in Pediatric Wards in Three Teaching And Referral Hospitals in Nairobi Kenya

Abstract

Service delivery is among the six health system strengthening pillars by World Health Organization. Successful health services bring about effective, quality, safe, personal and non-personal health care actions or interventions to those who need them, where they need them and when required with minimal resource wastage. Medical error is unintended commission or omission or the failure of an action which was planned which cause, or have potential to cause patient harm. It is a leading challenge in service delivery today and the incidence rates are an emerging international concern. Medical errors are underreported today, yet reporting helps in implementing measures which help prevent recurrence thereby enhancing patient safety and reducing harm and suffering. This study aimed at determining factors influencing reporting of medical errors amongst nurses in paediatric wards in three teaching and referral hospitals in Nairobi Kenya. The specific objectives of the study were to establish if nurses’ knowledge on medical errors reporting influences reporting of medical errors, to establish if management support for medical errors reporting influence the reporting, to establish if medical error reporting systems influence reporting of medical errors and finally to establish if organizational safety culture influences reporting of medical errors, all these, amongst nurses in three teaching and referral hospitals in Nairobi Kenya. The study was cross sectional and utilized both quantitative and qualitative approaches in data collection. The target population comprised of 195 nurses; from Aga Khan University hospital Nairobi, Gertrude’s Children’s Hospital and Kenyatta National Hospital, all in Nairobi Kenya. Sample size was 131 nurses and response rate was 88%. Quantitative and qualitative data was collected from the nurses using a pretested questionnaire. Key Informant Interview Guide was utilized to collect qualitative data from three nurse managers. Data was coded and analysed using SPSS version 25 and presented in form of charts and graphs. Bivariate analysis showed that nurses’ knowledge on medical errors (p < 0.039), management support on reporting (p < 0.031), and medical errors reporting systems (p < 0.002), all had significant association with reporting medical errors in the three facilities. Organizational safety culture however did not, (p = 0.623). This study recommends that nurses’ knowledge and understanding of medical errors be promoted through trainings; starting from college and university levels and later during orientation and in-service. Management to disseminate policies and procedures to staff in their health facilities and ensure the same is well understood and implemented correctly. In addition, feedback about changes put into place based on those errors need to be communicated to staff in a timely manner. Additionally, just culture need to be embraced and cultivated to ensure objective approach to medical errors. Finally, medical error reporting systems to be simplified, made readily accessible and should have capabilities for anonymous reporting.