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Medical Errors Disclosure Practices, Barriers and Motivations to Disclosures Among Physicians in Tertiary and Secondary Health Facilities in Abuja Nigeria

Received: 13 October 2020     Accepted: 22 October 2020     Published: 26 April 2021
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Abstract

The disclosure of medical errors is very important in ensuring the quality of patient care and safety. However, the disclosure practices by physicians are not well documented in this setting. The objective of this study is to compare the disclosure practices as well as the motivations and barriers to disclosure of these errors among physicians in government secondary and tertiary health facilities in Abuja, Nigeria. A cross sectional survey of physicians working in six out of fourteen government hospitals was conducted. A cluster sampling technique of the hospitals as the clusters was employed to obtain the total sample size of 402 physicians, 201 for each level. A semi structured, self-administered questionnaire was used to collect quantitative data on near misses, mistakes, slips or lapses and technical errors. Data was analysed using SPSS version 15.0 and summarised as proportions. Chi-square test was used to assess associations between variables at a significance level of 5%. Also logistic regression analyses were used to determine the significant predictors of medical error occurrences and disclosures. Some 255 physicians i.e. (52.6%) from the tertiary level and 230 (47.4%) from the secondary level were interviewed. Both the tertiary and the secondary levels had very poor medical errors disclosure practices, with disclosure of errors that caused patient’s death or disability (3.9 vs. 8.3%, p=0.023); or disclosure of errors that caused discomfort or prolonged treatment to patients (33.2% vs. 21.3%, p=0.026). The major barriers to error disclosures at the tertiary and the secondary health facilities were: lack of malpractice insurance (69.4% vs. 48.2%, p=0.000); lack of policies for disclosing errors (62.4% vs. 55.4%, p=0.119); and the fear of negative patient reactions (56.7% vs. 51.3%, p=0.233). The major motivations to errors disclosure were receiving a positive feedback from the institution (65.1% vs. 56.3%, p=0.048) and the support and understanding of colleagues (50.2% vs. 48.7%, p=0.74). This study suggests poor medical errors disclosure practices. In this study setting, the development of institutional policies on disclosure will motivate physicians’ disclosure of medical errors and this should be encouraged. Such policies should include institutionally administered malpractice insurance for the physicians.

Published in Central African Journal of Public Health (Volume 7, Issue 2)
DOI 10.11648/j.cajph.20210702.15
Page(s) 76-81
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Medical Errors, Disclosures, Practices, Physicians

References
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[19] Ock M, Choi EY, Jo MW, Lee SI. Evaluating the expected effects of disclosure of patient safety incidents using hypothetical cases in Korea. PLoS One. 2018 Jun 14; 13 (6): e0199017. doi: 10.1371/journal.pone.0199017. PMID: 29902233; PMCID: PMC6002037.
[20] Choi EY, Pyo J, Ock M, Lee SI. Nurses' Perceptions Regarding Disclosure of Patient Safety Incidents in Korea: A Qualitative Study. Asian Nurs Res (Korean Soc Nurs Sci). 2019 Aug; 13 (3): 200-208. doi: 10.1016/j.anr.2019.05.002. Epub 2019 Jun 5. PMID: 31173923.
[21] Ock M, Lim SY, Jo MW, Lee SI. Frequency, Expected Effects, Obstacles, and Facilitators of Disclosure of Patient Safety Incidents: A Systematic Review. J Prev Med Public Health. 2017 Mar; 50 (2): 68-82. doi: 10.3961/jpmph.16.105. Epub 2017 Jan 26. PMID: 28372351; PMCID: PMC5398338.
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Cite This Article
  • APA Style

    Ramsey Msheliza Yalma, Michael Chukwunaemeli Asuzu. (2021). Medical Errors Disclosure Practices, Barriers and Motivations to Disclosures Among Physicians in Tertiary and Secondary Health Facilities in Abuja Nigeria. Central African Journal of Public Health, 7(2), 76-81. https://doi.org/10.11648/j.cajph.20210702.15

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    ACS Style

    Ramsey Msheliza Yalma; Michael Chukwunaemeli Asuzu. Medical Errors Disclosure Practices, Barriers and Motivations to Disclosures Among Physicians in Tertiary and Secondary Health Facilities in Abuja Nigeria. Cent. Afr. J. Public Health 2021, 7(2), 76-81. doi: 10.11648/j.cajph.20210702.15

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    AMA Style

    Ramsey Msheliza Yalma, Michael Chukwunaemeli Asuzu. Medical Errors Disclosure Practices, Barriers and Motivations to Disclosures Among Physicians in Tertiary and Secondary Health Facilities in Abuja Nigeria. Cent Afr J Public Health. 2021;7(2):76-81. doi: 10.11648/j.cajph.20210702.15

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  • @article{10.11648/j.cajph.20210702.15,
      author = {Ramsey Msheliza Yalma and Michael Chukwunaemeli Asuzu},
      title = {Medical Errors Disclosure Practices, Barriers and Motivations to Disclosures Among Physicians in Tertiary and Secondary Health Facilities in Abuja Nigeria},
      journal = {Central African Journal of Public Health},
      volume = {7},
      number = {2},
      pages = {76-81},
      doi = {10.11648/j.cajph.20210702.15},
      url = {https://doi.org/10.11648/j.cajph.20210702.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20210702.15},
      abstract = {The disclosure of medical errors is very important in ensuring the quality of patient care and safety. However, the disclosure practices by physicians are not well documented in this setting. The objective of this study is to compare the disclosure practices as well as the motivations and barriers to disclosure of these errors among physicians in government secondary and tertiary health facilities in Abuja, Nigeria. A cross sectional survey of physicians working in six out of fourteen government hospitals was conducted. A cluster sampling technique of the hospitals as the clusters was employed to obtain the total sample size of 402 physicians, 201 for each level. A semi structured, self-administered questionnaire was used to collect quantitative data on near misses, mistakes, slips or lapses and technical errors. Data was analysed using SPSS version 15.0 and summarised as proportions. Chi-square test was used to assess associations between variables at a significance level of 5%. Also logistic regression analyses were used to determine the significant predictors of medical error occurrences and disclosures. Some 255 physicians i.e. (52.6%) from the tertiary level and 230 (47.4%) from the secondary level were interviewed. Both the tertiary and the secondary levels had very poor medical errors disclosure practices, with disclosure of errors that caused patient’s death or disability (3.9 vs. 8.3%, p=0.023); or disclosure of errors that caused discomfort or prolonged treatment to patients (33.2% vs. 21.3%, p=0.026). The major barriers to error disclosures at the tertiary and the secondary health facilities were: lack of malpractice insurance (69.4% vs. 48.2%, p=0.000); lack of policies for disclosing errors (62.4% vs. 55.4%, p=0.119); and the fear of negative patient reactions (56.7% vs. 51.3%, p=0.233). The major motivations to errors disclosure were receiving a positive feedback from the institution (65.1% vs. 56.3%, p=0.048) and the support and understanding of colleagues (50.2% vs. 48.7%, p=0.74). This study suggests poor medical errors disclosure practices. In this study setting, the development of institutional policies on disclosure will motivate physicians’ disclosure of medical errors and this should be encouraged. Such policies should include institutionally administered malpractice insurance for the physicians.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Medical Errors Disclosure Practices, Barriers and Motivations to Disclosures Among Physicians in Tertiary and Secondary Health Facilities in Abuja Nigeria
    AU  - Ramsey Msheliza Yalma
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    T2  - Central African Journal of Public Health
    JF  - Central African Journal of Public Health
    JO  - Central African Journal of Public Health
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    EP  - 81
    PB  - Science Publishing Group
    SN  - 2575-5781
    UR  - https://doi.org/10.11648/j.cajph.20210702.15
    AB  - The disclosure of medical errors is very important in ensuring the quality of patient care and safety. However, the disclosure practices by physicians are not well documented in this setting. The objective of this study is to compare the disclosure practices as well as the motivations and barriers to disclosure of these errors among physicians in government secondary and tertiary health facilities in Abuja, Nigeria. A cross sectional survey of physicians working in six out of fourteen government hospitals was conducted. A cluster sampling technique of the hospitals as the clusters was employed to obtain the total sample size of 402 physicians, 201 for each level. A semi structured, self-administered questionnaire was used to collect quantitative data on near misses, mistakes, slips or lapses and technical errors. Data was analysed using SPSS version 15.0 and summarised as proportions. Chi-square test was used to assess associations between variables at a significance level of 5%. Also logistic regression analyses were used to determine the significant predictors of medical error occurrences and disclosures. Some 255 physicians i.e. (52.6%) from the tertiary level and 230 (47.4%) from the secondary level were interviewed. Both the tertiary and the secondary levels had very poor medical errors disclosure practices, with disclosure of errors that caused patient’s death or disability (3.9 vs. 8.3%, p=0.023); or disclosure of errors that caused discomfort or prolonged treatment to patients (33.2% vs. 21.3%, p=0.026). The major barriers to error disclosures at the tertiary and the secondary health facilities were: lack of malpractice insurance (69.4% vs. 48.2%, p=0.000); lack of policies for disclosing errors (62.4% vs. 55.4%, p=0.119); and the fear of negative patient reactions (56.7% vs. 51.3%, p=0.233). The major motivations to errors disclosure were receiving a positive feedback from the institution (65.1% vs. 56.3%, p=0.048) and the support and understanding of colleagues (50.2% vs. 48.7%, p=0.74). This study suggests poor medical errors disclosure practices. In this study setting, the development of institutional policies on disclosure will motivate physicians’ disclosure of medical errors and this should be encouraged. Such policies should include institutionally administered malpractice insurance for the physicians.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Department of Community Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Abuja, Nigeria

  • Department of Community Medicine, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria

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