Background <p>Near-miss incidents represent critical learning opportunities in healthcare, yet they are frequently underreported due to fear of blame and lack of organizational support. A Just Culture framework promotes fairness, trust, and learning from errors, which may encourage voluntary reporting, especially among nurse interns in high-stakes clinical environments.</p> Aim <p>To assess the perception of Just Culture among nurse interns and examine its influence on their willingness to report near-miss events in governmental university hospitals in Egypt.</p> Methods <p>A cross-sectional analytical study was conducted among 163 nurse interns (sampling frame <i>N</i> = 264) using systematic random sampling across five university hospitals in Cairo, Egypt. Data were collected between March and April 2025 using a self-administered questionnaire comprising the Just Culture Assessment Tool (JCAT) and a researcher-developed Willingness to Report Near-Miss Scale. Data analysis included descriptive statistics, correlation analysis, and multiple linear regression.</p> Results <p>The mean Just Culture score was 3.6 (SD = 0.5), while the mean willingness to report near-miss events was 3.6 (SD = 0.5). Significant positive correlations were observed between Just Culture dimensions (trust, feedback, openness, balance, and continuous improvement) and willingness subdomains (awareness, skills, attitude, behavior) (<i>p</i> &lt; 0.001). Regression analysis indicated that Just Culture score (B = 0.70, β = 0.67, <i>p</i> &lt; 0.001) was the strongest predictor of willingness to report, explaining 55% of the variance.</p> Conclusion <p>A supportive Just Culture significantly enhances nurse interns’ willingness to report near-miss events. Strengthening institutional safety culture through leadership, training, and non-punitive policies is essential to fostering early-career nurses’ engagement in safety reporting.</p>

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Just culture and its influence on nurse interns’ willingness to report near-miss events: a cross-sectional study in five Egyptian university hospitals

  • Mustafa Mohamed Dwidar,
  • Samah Faisal Fakhry,
  • Laila Ahmed Abdel-Hamed

摘要

Background

Near-miss incidents represent critical learning opportunities in healthcare, yet they are frequently underreported due to fear of blame and lack of organizational support. A Just Culture framework promotes fairness, trust, and learning from errors, which may encourage voluntary reporting, especially among nurse interns in high-stakes clinical environments.

Aim

To assess the perception of Just Culture among nurse interns and examine its influence on their willingness to report near-miss events in governmental university hospitals in Egypt.

Methods

A cross-sectional analytical study was conducted among 163 nurse interns (sampling frame N = 264) using systematic random sampling across five university hospitals in Cairo, Egypt. Data were collected between March and April 2025 using a self-administered questionnaire comprising the Just Culture Assessment Tool (JCAT) and a researcher-developed Willingness to Report Near-Miss Scale. Data analysis included descriptive statistics, correlation analysis, and multiple linear regression.

Results

The mean Just Culture score was 3.6 (SD = 0.5), while the mean willingness to report near-miss events was 3.6 (SD = 0.5). Significant positive correlations were observed between Just Culture dimensions (trust, feedback, openness, balance, and continuous improvement) and willingness subdomains (awareness, skills, attitude, behavior) (p < 0.001). Regression analysis indicated that Just Culture score (B = 0.70, β = 0.67, p < 0.001) was the strongest predictor of willingness to report, explaining 55% of the variance.

Conclusion

A supportive Just Culture significantly enhances nurse interns’ willingness to report near-miss events. Strengthening institutional safety culture through leadership, training, and non-punitive policies is essential to fostering early-career nurses’ engagement in safety reporting.