The Effects of Ethical Sensitivity, Organizational Silence, and Self-efficacy on Operating Room Nurses’ Intention to Report Near-miss Errors: Based on the Theory of Planned Behavior

Purpose: This study examined the effects of ethical sensitivity, organizational silence, and self-efficacy on the intention to report near misses among operating room nurses, based on the theory of planned behavior. Methods: A descriptive cross-sectional survey was conducted to assess the relationships among these variables and identify factors influencing reporting intention. Participants were 179 operating room nurses working in general and university hospitals in Seoul and Gyeonggi Province. Structured questionnaires included the Ethical Sensitivity Scale for Clinical Nurses, Hospital Nurses Silence Behavior Scale, General Self-efficacy Scale, and Intention to Report Near Miss Scale. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson’s correlation, and hierarchical multiple regression. Results: Hierarchical regression showed that use of a near-miss reporting system (β=.29, p=.018), organizational silence (β=-.28, p=.025), and ethical sensitivity (β=.25, p=.047) significantly influenced reporting intention, explaining 23.0% of the variance. Conclusion: Enhancing ethical awareness, reducing silence, and improving nurses’ experience with reporting systems are key strategies. These findings may inform interventions and policy development to foster a patient safety culture in operating rooms.