Self-reported perceptions of factors influencing error reporting in one Nigerian hospital: a descriptive cross-sectional study

Background: Over the past decade the concern about patient safety due to the occurrence of medical errors has become a priority in healthcare. Medical errors occur from virtually all processes in the delivery of healthcare and while most have little risk for patient harm, some do result in injury, increased health care cost, lost income, decreased productivity, disability, morbidity and mortality. Under-reporting of medical errors is a global issue endangering patient safety and compromising health outcomes. Awareness and use of a hospital's error reporting system is an initial step towards improved reporting rates. Aim: The aim of the study was to describe doctors' and nurses' self-reported perceptions of factors influencing error reporting in a Nigerian hospital by survey questionnaire. Methods: This study employed a descriptive cross-sectional design to survey a random sample of 230 health professionals (n=90 doctors, n=130 nurses) working in all the units and departments of a Nigerian tertiary health institution. A theoretical model of a health information technology framework with implications for patient safety served as a guide for the literature review and interpretation of study findings. A 47-item self-administered survey questionnaire served as the data collection instrument. The questionnaire was developed following the review of available published literature and validated by four experts (n=2 doctors, 2 nurses), who determined the index of content validity. Inter-rater reliability of the instrument was subsequently measured by test-retest reliability of data from a pilot study of 30 raters (n=13 doctors, n=17 nurses). The validated questionnaire was used to determine doctors' and nurses' awareness and use of an error reporting system, frequency of reporting various types of errors, perceived barriers to error reporting and factors that facilitate an error reporting culture. Data collection took place for four weeks in February 2017. Data were analyzed in SPSS using descriptive and inferential statistics. Results: The median age of the respondents was 36 years (range of 25-59). The typical nurse respondent was female having a diploma in nursing and no Master's degree or PhD, in contrast to the doctors, most of whom were male and a few had a postgraduate qualification. The gender difference between the two groups was statistically significant (P<0.001). The majority of the respondents had 6-10 years of work experience and were in full-time employment and the difference in current work status (P=0.001) and years of work experience (P<0.001) between the two groups was statistically significant. Awareness of error reporting system: most respondents disagreed that the hospital had a system in place for reporting errors but more nurses (56/140, 40.0%) than doctors (16/90, 17.8%) were aware of such a system and the difference in responses between the two groups achieved statistical significance (X²(4, n=230) = 13.302, P<0.010); knew where and when to report errors (nurses 48.6%, n=68/140; doctors 20.0%, n=18/90) (X²(n=230) = 23.843, P<0.001); how to locate an incident form (nurses n=60/139, 43.2%; doctors n=28/89, 31.5%) (X²(4, n=228) = 9.842, P=0.043); and who to report an incident or error to (nurses n=72/140, 51.4%; doctors n=33/90, 36.7%) (X²(4, n=230) = 11.845, P=0.019). Results for type and frequency of errors reported and factors facilitating an error reporting culture did not achieve statistical significance. Perceptions of barriers to error reporting: lack of confidentiality (nurses n=62/140, 44.3%; doctors n=27/87, 31.0%) (X²(n=227) = 11.697, P=0.019). Most respondents were unsure if error reporting forms were easy to complete (nurses n=49/137, 35.8%; doctors n=26/88, 29.5%), (X²(4, n=225) = 9.926, P=0.042). Factors not perceived as barriers: positive feedback when reporting errors (nurses n=61/140, 43.6%; doctors n=24/90, 26.7%), (X²(n=230) = 10.939, P=0.026); reporting an error that did not cause harm (doctors n=40/90, 44.4%; nurses n=50/139, 36.0%), (X²(4, n=229) = 9.618, P=0.047); time involved in reporting (nurses n=76/138, 55.1%; doctors n=26/89, 29.2%), (X²(4, n=227) = 17.327); and learning from the error (doctors n=42/90, 46.7%; nurses n=40/138, 29.0%), (X²(4, n=228) = 20.777, P<0.001) Conclusion: Doctors and nurses were mostly unaware of the hospital's error reporting system which can be concluded to be an organizational factor. Respondents would be willing to report incidents if perceived barriers are removed. There is an urgent need for an effective error reporting system to be implemented in the local setting and for appropriate awareness training and educational interventions to improve doctors' and nurses' knowledge and use of medical error reporting. Relevance to clinical practice. Effective error reporting systems in the Nigerian healthcare sector that improve awareness and use of these systems should enhance a reporting culture and thereby improve patient safety

Perceived impact of coronavirus pandemic on uptake of healthcare services in South West Nigeria

Introduction:&nbsp;the COVID-19 pandemic since its emergence has posed a great danger to the health of the general populace while impacting the Nigerian healthcare delivery significantly. Since its emergence, the health system has been stretched with overwhelming responsibilities. The study assessed health providers´ perceived impact of coronavirus pandemic on the uptake of health care services in South West Nigeria. Methods:&nbsp;a descriptive cross-sectional design using an online structured survey was used to elicit responses from 385 Nigerian health workers selected by convenience sampling technique. Data analysis was done with the Statistical Package for Social Sciences (SPSS) version 26. Comparison of the uptake of healthcare before and during the COVID-19 pandemic was performed using the Chi-square test. Results:&nbsp;findings revealed a significant difference between the uptake of health care prior and during the COVID-19 pandemic (χ2= 92.77, p=0.000) as 253 respondents (65.7%) reported that the hospital recorded a low turn-out of patients during the pandemic and 184 (47.8%) indicated that some of the facility units/departments were temporarily closed due to COVID-19 pandemic. Similarly, there was a significant difference between health-related conditions requiring hospital admission before and during COVID-19 pandemic (χ2=3.334 p=0.046). Factors influencing uptake of health services during the COVID-19 pandemic are: fear of nosocomial infection, fear of stigmatization, and misconception/misinformation on COVID-19 diseases and care. Conclusion:&nbsp;the Nigerian health system in the past months has been remarkably impacted by the pandemic. This calls for immediate restructuring to maintain an equitable distribution of care, while minimizing risk to patients and health providers

Psychosocial stress and treatment compliance among HIV/AIDS patients in a Nigerian Teaching Hospital

Background: Antiretroviral therapy (ART) has played a crucial role in minimizing the worldwide impact of HIV infection. Numerous HIV patients face challenges in adhering to their treatment due to various physical, social, and psychological factors. This study aimed to explore the correlation between psychosocial stress and treatment adherence among HIV/AIDS patients at a hospital in Nigeria. Methods: In this study, a descriptive analytical design was utilized to select (n=171) HIV-infected clients attending the virology clinic at Uniosun Teaching Hospital (UTH). Convenient sampling was employed to choose participants from a total monthly population of 271 patients who visit the clinic. Data collection was performed using a questionnaire consisting of four sections and 57 items. Descriptive and inferential statistics, such as the Chi-square test and correlation analysis, were employed to present and analyze the data. Results: A significant proportion (61.4%) of the patients experienced a moderate level of stress. The most notable sources of stress reported by patients were the need for HIV status disclosure (71.9%) and rejection from family and friends (66.7%). Rejections by friends and family, stigma and discrimination, social and economic challenges, as well as antiretroviral therapy showed a significant association with HIV-related stress (p < 0.001). Furthermore, a significant inverse correlation was found between psychosocial stress and treatment adherence (r = -0.705, p < 0.001). Conclusion: Individuals living with HIV/AIDS (PLWHA) face significant levels of stress and often encounter rejection and stigma. It is crucial for healthcare professionals to establish comprehensive support services aimed at alleviating the stress experienced by these patients and reducing the obstacles they face. Such measures will ultimately enhance treatment compliance and overall well-being