Supporting Nurses’ Commitment Towards Voluntary Error Reporting: A discursive paper of current policies and recommendations

Medical error is a serious public health concern and undermines healthcare organizations' commitment to drive safe, high-quality patient care. Voluntary error reporting (VER) is one key solution to address this concern because it is through conducting root cause analysis that constructive retrospective learning can take place to improve future practice. Nurses form the largest health workforce and are key stakeholders contributing to the institutional error management culture. While the significance of VER and nurses' role in driving this initiative cannot be further emphasized, studies revealed that nurses failed to engage in VER due to less positive experiences towards VER. Nurses' negative attitude towards VER can be attributed to unsupportive organizational responses to their act of VER, underpinned by the endorsement of blame, shame, and punitive culture consistent with the human approach to error management. This induces fear of speaking up for error among nurses, creating a culture of silence. This paper examines and discusses current policies underpinning the error management system and identifies the contemporary factors that challenge these policies, followed by proposing recommendations to support these policies to drive nurses' commitment to VER and improve the overall error management system.