Nurses' Willingness to Report Near Misses: A Multilevel Analysis of Contributing Factors

Although potential future medical errors can best be prevented through reporting near misses, on-site error reporting is not being achieved to a satisfactory level. We surveyed 489 nurses working in 34 wards at a university hospital in Korea in regard to their understanding of factors related to error reporting. Survey items included willingness to report near misses, defensive silence, leader-member exchange, role clarity, and knowledge-sharing climate. Results indicated that defensive silence in the workplace and unclearly defined roles reduced nurses' willingness to report errors, whereas trust-based leader-member exchange (LMX) increased the intention. Knowledge-sharing climates contributed to increasing nurses' intention to report errors, even among those of a silent disposition and in settings where the quality of LMX between the nurses and head nurse was not high.