Background Globally, medication near-misses are a public health issue as they often have serious consequences for patients and healthcare systems. Currently, few studies have investigated nurses’ intention to report medication near-misses. Therefore, this study aims to examine the incidence of medication near-misses and factors influencing reporting intention among nurses in tertiary hospitals in Shandong Province, to fill the research gap in this area. Design A descriptive cross-sectional design. Methods Between March 2021 and December 2021, 2625 nurses in seven tertiary hospitals from Shandong Province, China were enrolled in the study, using convenience sampling. Information about medication near-misses, reporting intention and barriers was collected using self-reported questionnaire, subscales of the Adverse Event Reporting Intention Questionnaire, and Medication Near-Miss Reporting Barriers Scale. This study explored the association between potential determinants from the perspective of nurses and managers using generalized linear model. Results About 25.3% of nurses experienced medication near-misses, with a mean reporting intention score of 5.44 (standardized deviation=1.13). The main approach for reporting medication near-misses was verbal language (80.6%). Higher professional title (<InlineEquation ID="IEq598544"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12912_2025_3678_Article_IEq598544.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\chi \)</EquationSource> </InlineEquation>2=13.770, P = 0.003), lower educational level (<InlineEquation ID="IEq54044544"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12912_2025_3678_Article_IEq598544.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\chi \)</EquationSource> </InlineEquation>2=6.722, P = 0.035), fewer weekly work hours (<InlineEquation ID="IEq540447411222"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12912_2025_3678_Article_IEq598544.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\chi \)</EquationSource> </InlineEquation>2=3.947, P = 0.047), no previous medication near-misses experience (<InlineEquation ID="IEq54044"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12912_2025_3678_Article_IEq598544.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\chi \)</EquationSource> </InlineEquation>2=46.517, P < 0.001), and not having siblings (<InlineEquation ID="IEq585422"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12912_2025_3678_Article_IEq598544.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\chi \)</EquationSource> </InlineEquation>2=4.150, P = 0.042) nurses showed a higher level of reporting intention. The manager’s negative response (<InlineEquation ID="IEq54044758224155522"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12912_2025_3678_Article_IEq598544.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\chi \)</EquationSource> </InlineEquation>2=7.059, P = 0.008) and complex reporting system (<InlineEquation ID="IEq898999"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12912_2025_3678_Article_IEq598544.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\chi \)</EquationSource> </InlineEquation>2=17.120, P < 0.001) were associated with lower levels of reporting intention, primarily influenced by departmental categories (<InlineEquation ID="IEq55284254111"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="12912_2025_3678_Article_IEq598544.gif" Format="GIF" Height="12" Rendition="HTML" Resolution="72" Type="Linedraw" Width="15" /> </InlineMediaObject> <EquationSource Format="TEX">\(\chi \)</EquationSource> </InlineEquation>2=22.306, P = 0.002). Discussion and conclusion The results of this study show that nurses’ medication near-misses reporting rate is relatively low, but their intention to report is relatively strong. Meanwhile, nurses’ intention to report medication near-misses is influenced by multiple factors. This suggests that nursing managers should develop management strategies for near-miss events and actively provide training to enhance clinical nurses’ willingness to report such events.

Investigating the prevalence of medication near-misses and reporting intention among nurses in tertiary hospitals from China

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2025年8月9日

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Jinxia Fang,
Zeyi Zhang,
Qi Zhang,
Wanshun Jia,
Xue Chen,
Yuanyuan Li

摘要

Background

Globally, medication near-misses are a public health issue as they often have serious consequences for patients and healthcare systems. Currently, few studies have investigated nurses’ intention to report medication near-misses. Therefore, this study aims to examine the incidence of medication near-misses and factors influencing reporting intention among nurses in tertiary hospitals in Shandong Province, to fill the research gap in this area.

Design

A descriptive cross-sectional design.

Methods

Between March 2021 and December 2021, 2625 nurses in seven tertiary hospitals from Shandong Province, China were enrolled in the study, using convenience sampling. Information about medication near-misses, reporting intention and barriers was collected using self-reported questionnaire, subscales of the Adverse Event Reporting Intention Questionnaire, and Medication Near-Miss Reporting Barriers Scale. This study explored the association between potential determinants from the perspective of nurses and managers using generalized linear model.

Results

About 25.3% of nurses experienced medication near-misses, with a mean reporting intention score of 5.44 (standardized deviation=1.13). The main approach for reporting medication near-misses was verbal language (80.6%). Higher professional title ( \(\chi \) 2=13.770, P = 0.003), lower educational level ( \(\chi \) 2=6.722, P = 0.035), fewer weekly work hours ( \(\chi \) 2=3.947, P = 0.047), no previous medication near-misses experience ( \(\chi \) 2=46.517, P < 0.001), and not having siblings ( \(\chi \) 2=4.150, P = 0.042) nurses showed a higher level of reporting intention. The manager’s negative response ( \(\chi \) 2=7.059, P = 0.008) and complex reporting system ( \(\chi \) 2=17.120, P < 0.001) were associated with lower levels of reporting intention, primarily influenced by departmental categories ( \(\chi \) 2=22.306, P = 0.002).

Discussion and conclusion

The results of this study show that nurses’ medication near-misses reporting rate is relatively low, but their intention to report is relatively strong. Meanwhile, nurses’ intention to report medication near-misses is influenced by multiple factors. This suggests that nursing managers should develop management strategies for near-miss events and actively provide training to enhance clinical nurses’ willingness to report such events.