The Impact of Assessing Patients' Sense of Security on Nurses' Intent to Report Safety Events: A Factorial Survey Experiment.

Nursing bias affects patient safety practices in hospitals, resulting in safety disparities. Bias is generally defined as “the negative evaluation of one group and its members relative to another” (Blair et al. , 71) and can influence care, which could impact patient safety outcomes. In one meta‐analysis, the pooled prevalence of overall patient harm in hospitals globally was 10% (Panagioti et al. ). NIH‐defined health disparity populations are at greater risk for poor safety outcomes (Agency for Healthcare Research and Quality [AHRQ] ). The problem is that nurses, like other clinicians, may be biased against certain patient characteristics within these populations (Thirsk et al. ), and implicit biases may shape nurses' judgements and subsequent intentions to act, further contributing to patient safety disparities (Groves, Farag, et al. ). As part of their routine work, nurses constantly and often unconsciously act to keep patients safe (Groves et al. ). However, nurses are commonly under time pressure, which makes implicit bias more likely to come into play (Thirsk et al. ). With nurses being the professionals spending the most time caring for patients at the bedside, it is critical to find ways to mitigate nursing bias in relation to the wide range of safety risks nurses encounter (Mitchell et al. ). Hospitalised patients experience threats to their safety and preventable harm. is often defined as “freedom from accidental or preventable injuries produced by medical care;” those injuries are termed (AHRQ, ). Globally, a meta‐analysis of hospitalised patients indicates an adverse event rate of 10%; of those, half are preventable and over 7% result in death (Schwendimann et al. ). AHRQ () reported that following the COVID‐19 pandemic, many hospital safety indicators point to a decline in patient safety. Literature indicates increased risk of poor safety outcomes in publicly insured and racially minoritized hospital patients (Gangopadhyaya et al. ), with rural residents and non‐Hispanic Black individuals experiencing poorer outcomes (AHRQ ). Because patients report being unsafe or being harmed in ways clinicians don't see (Jeffs et al. ), the patient perspective on their own safety is critical. However, system and interpersonal barriers may inhibit hospitalised patients from expressing their own safety concerns, thus preventing the hospital from developing a thorough and complete comprehension of organisational patient safety to take appropriate action (National Steering Committee for Patient Safety ). Patients are often unaware of, or don't know how to access, reporting mechanisms, including those meant for their own use; therefore, they report their concerns to their clinicians (Terry et al. ).