Factors Influencing Nurses' Intention to Report Adverse Nursing Events in a Tertiary Hospital Using a Random Forest Model.

Abstract

Purpose: The goal of this study was to explore the current status and influencing factors of nurses' intention to report adverse nursing events, using a random forest model to rank and select these factors.

Methods: In August 2024, a survey was conducted among nurses at a tertiary hospital in Shanghai using a convenience sampling method. The instruments included the General Information Questionnaire, the Intention to Report Questionnaire, the Reporting of Clinical Adverse Effects Scale (RoCAES), and the Reporting Barrier Questionnaire. A random forest model and stepwise multiple linear regression were used to analyze the factors influencing nurses' intention to report nursing adverse events.

Results: The median total score for the intention to report adverse events among 823 nurses was 14 (range: 0 to 15). Lasso regression identified eight key factors influencing the intention to report adverse events: professional title, whether the nurse had reported adverse events, age, punitive culture, reporting process, reporting significance, reporting purpose, and reporting environment. Stepwise regression analysis revealed that younger nurses, those with no prior reporting experience, and those who perceived reporting as important had a higher intention to report adverse events. Additionally, nurses were more likely to report adverse events when the hospital's reporting process was simpler and the culture was less punitive.

Conclusions: Nurses' intention to report adverse events in nursing is moderate. Nursing managers should consider these influencing factors holistically and implement targeted measures to enhance nurses' intention to report, thereby improving nursing quality and patient safety.