Factors influencing patient safety incident reporting in African healthcare organisations: a systematic integrative review

Abstract

Background

Patient safety incidents, defined as deviations from standard healthcare practices, contribute to significant mortality and financial burdens for healthcare systems globally each year. In response, international agencies advocate for patient safety incident reporting and learning systems to prevent the recurrence of safety incidents and promote learning. The effective design and implementation of these systems require the identification of factors that influence incident reporting practices. Therefore, the aim of this review was to systematically appraise and synthesise the current literature on factors influencing patient safety incident reporting practices in African healthcare organisations.

Methods

A systematic integrative review was conducted. Five electronic databases, including PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Scopus, Web of Science, and Excerpta Medica Database (Embase), were searched to identify relevant articles. Peer-reviewed articles published in English were included in this review. Two independent reviewers screened the identified articles first by title and abstract, followed by full text evaluation. Quality appraisal was conducted using the Joanna Briggs Institute and the Quality Assessment with Diverse Studies tool. A thematic synthesis approach was used to analyse the data. The themes were presented with narrative descriptions.

Results

A literature search identified 9,265 articles, of which 51 were included in the review, representing the perspectives of 15,089 healthcare professionals. Of the included articles, 88% were rated as moderate to high quality. Five descriptive themes were identified as barriers and facilitators that influenced patient safety incident reporting practices, including fear of reprisal within the prevailing patient safety culture, attitudes and perceptions towards patient safety incident reporting, the extent of knowledge and skills regarding patient safety incidents and reporting, the availability and attributes of reporting systems and processes, and the level of support from managers and rapport with staff.

Conclusion

The identified barriers and facilitators influencing patient safety incident reporting should be addressed to effectively design, implement, and improve patient safety incident reporting systems and practices.

Protocol registration

The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023455168.