A Focused Ethnographic Study of Hospital Nurses’ Perceived Barriers to Healthcare Error Reporting in the United Kingdom

Abstract

Patient safety remains a critical concern in healthcare, as it is vulnerable to errors that may occur during the delivery of care. A recommended strategy for preventing these errors by key international organisations is the proper reporting of patient safety incidents. However, underreporting of errors persists, undermining progress toward safer clinical environments. Nurses, as the largest professional group within healthcare and central to patient care delivery, play a vital role in error reporting. However, evidence suggests that nurses often choose not to report incidents, indicating a disconnect between established reporting frameworks and clinical practice. Research to date has identified a complex interplay of personal, organisational, and socio- cultural factors contributing to this problem. However, much of the existing literature originates from Asian contexts, with limited exploration in the UK, where underreporting persists despite national guidelines and adverse event reporting systems. Furthermore, the predominance of quantitative methods has restricted a deeper understanding of nurses’ lived experiences, while also making it difficult to capture organisational and socio-cultural factors, which are often unique to each context. To address these gaps, this study proposes a qualitative, focused ethnographic approach to investigate perceived barriers to error reporting among hospital nurses in NHS Scotland. The Royal Infirmary of Edinburgh, a tertiary teaching hospital, will serve as the study site. Semi- structured interviews will be conducted following ethical approval and formal organisational access, with data analysed thematically. The anticipated findings will inform policy, practice, education, and future research. Additionally, by reducing preventable harm and enhancing reporting systems, this study has the potential to improve patient safety, optimise resource use, and deliver positive economic impact.