Yurdakul et al .

International Journal of Nursing

Studies . 2016 ; 54 :16–22
Patients have a right to know when errors occur in their care.
Disclosure of errors to patient falls within the nurse’s ethical
responsibility to protect the rights of the patient . World wide there
were disclosure gap’’ between patients’ preferences to be told about
errors and current practice. In closing the ‘‘disclosure gap’’ an
understanding of the views of all members of the healthcare team
regarding errors and their disclosure to patients is needed .

Discolsure of errors can be contributed to many barriers as legal

fears, a professional and organisational culture of secrecy and blame,
clinicians lacking confidence in their communication skills, clinicians
fearing that patients will experience distress, and doubt about the
efficacy and effectiveness of disclosure.
 Explore nurses’ attitudes and experiences
concerning disclosing errors to patients and
perceived barriers to disclosure..
Research design A qualitative research design

Setting The Nursing departments from two German

hospitals in Switzerland.

Subjects Male and Female Nurses

Sampling Purposive sample. the snowball technique of

design sampling was used for identified additional
participants .
Sampling Eighteen nurses , one male nurse and seventeen
size female nurses , Most of nurses had higher
nursing job position
Inclusion criteria of nurses participated in the study

the same
range of
fields

the same
positions in
organisational
hierarchy
work
experience

The same
German- religious
speaking
 The interviewees were started by providing nurses with
definitions of errors that are well-established in the literature

Then, semi- structured interview guide consisting of a list of

questions about nurses’ attitudes and experiences with error
disclosure and perceived barriers . Interview was started by
providing definition of errors to nurses . Six questions used to
prompt discussion in the semi-structured conversations

The interview guide was shaped in collaboration between the one

interviewer and research team . Interviews lasted an average of 35
min . The saturation point was reached after conducting 18
interviews with 18 participants .

Interviews were audio recorded and interviewer made written field

notes of key issues that arose during the interview. Transcriptions
of the interviews were not returned to the participants.

The digital recordings of the interviews were transcribed verbatim

and translated all interviews into High German dictation .
Transcriptions focused on common themes across events or
processes introduced by the participants.
 Methods
Interviews were conducted by medical student(MS)
.There was no hierarchical relationship between MS and
the study participants.
Participants were recruited by contacting with head of
nursing departments via email or telephone . A total of
18 nurses agreed to participate in the study .
The interviewer met participants at the agreed-upon time
and place. interviews were transcribed in German and
analyzed using the qualitative data analysis software
package Atlas-Ti (Berlin) and conventional content analysis

Initial themes discovered were labeled using a process

of open coding. Investigators ( have training and
experience in qualitative research and computer
qualitative data analysis ) reviewed the initial analysis
to clarify and refine codes, and conversations among the
investigators continued until consensus was achieved
 1
2
3 Nursing expert Fem
ale
8 Director of nursing Male
17
department
Head of ward

Ward Nurse

5
From the analysis of the interviews, two major themes were identified:
(1) attitude of nurses and experience disclosure of errors and barriers
and (2) barriers to disclosure of errors
Attitude & experience Barriers to disclosure of errors
concerning disclosure Figure 3
of errors to patients

- Nurses generally thought that -Nurses identified a number of

patients should be informed about
every error, but only a very few
nurses actually reported disclosing
errors in practice.
- Many nurses reported that most
errors are not disclosed to the
patient
barriers to error disclosure such as
legal consequences and the fear of
losing patients’ trust.
- Nurses in more frequently reported
personal characteristics and a lack of
guidance from the organisation as
barriers to disclosure.”
 - In closing the ‘‘disclosure gap’’
efforts are required to address barriers
to disclosure
- Hospitals need to do more to support
and train nurses in relation to error
disclosure.
• Hospitals should be established a disclosure support
system, provided background disclosure education, ensured
that disclosure coaching is available at all times, and
provided emotional support for all parties involved, would
likely go a long way to address the barriers identified by
nurses.
•It is an important issue for further research addressing the
role of nurses in the disclosure process.