Awareness, self-practices, barriers, and the impact of self-esteem on incident reporting among Palestinian nurses: a cross-sectional study

Incident reporting is fundamental for patient safety. However, several factors hinder reporting, including fear of blame, uncertainty about the consequences, perceptions of reporting as time-consuming, and punitive organizational culture. Nurses face psychosocial and organizational barriers globally, which may further discourage reporting. This study aimed to assess nurses' self-reported practices, perceived barriers, knowledge, and role of self-esteem in incident reporting in Palestine. A cross-sectional descriptive study was conducted using an electronic questionnaire completed by 300 nurses from government and private hospitals in the West Bank. Data analysis included descriptive statistics, independent t-tests, ANOVA, and Pearson correlation tests to examine socio-demographics, awareness, self-reported practices, perceived barriers using a 19-item scale, and self-esteem measured using the Rosenberg Self-Esteem Scale. Nurses demonstrated a moderate level of awareness and engagement in incident reporting, with an average awareness score of 3.05 out of 5 and a mean self-perceived reporting practice score of 26.61 out of 44, equivalent to approximately 60.5% of the maximum score. The most frequently cited barriers were fear of disciplinary action (64.7%), lack of feedback (39%) and time constraints (36.4%). The majority of nurses (79%) had normal/average self-esteem, 14% had low self-esteem, and 7% had high self-esteem. Significant correlations were found between awareness and self-reported practices (r = .492), as well as between self-esteem and self-reported practices (r = .284). A notable gap exists between nurses' awareness and actual practice of incident reporting. Overcoming barriers requires institutional reforms such as non-punitive reporting policies, efficient reporting systems, timely feedback, and targeted educational interventions. Furthermore, fostering supportive work environments to enhance self-esteem may contribute to increased compliance with incident reporting protocols.