||A fundamental and important way of improving patient safety in a hospital is to develop an internal voluntary reporting system to report incident events so that causes of these events can be identified and future events be prevented. Although it is believed that the reporting of incidents can be increased by creating and installing information systems that can be used to efficiently report of incidents, there remains far fewer voluntary reports of incidents than actual number of incidents.|
This dissertation has the first aim to draw on the decomposed theory of planned behavior to understand which beliefs would most impact nurses’ intentions to use a nosocomial infection reporting system (Phase 1 Research). It then aims to apply results to the improvement of a hospital-wide web-based voluntary incident reporting system and test its effect incident reporting rates of incidents being reported (Phase 2 Research).
The first study found intention to use the nosocomial infection reporting system was significantly influenced by attitude, subjective normal and perceived behavior control. These three factors were influenced by timeliness, normative influence, comparative influence, self-efficacy, facilitating conditions, and particularly responsiveness.
The second study found a significant increase in inpatient and emergency department reports of incidents made by doctors in inpatient areas, emergency department nurses, and allied health professionals in inpatient areas. Post-system reported incidents were more evenly distributed over five severity levels than pre-system incidents, moving more toward the very severe level and no harm level.
Together, these findings suggest that the responsiveness of an incident reporting system may have a stronger effect than efficient incident reporting alone in increasing incident report rates and that the addition of the workflow-based response system to the hospital incident reporting system significantly increased hospital-wide voluntary incident report rates at all incident injury levels.