This presentation will summarise an integrative review of literature (2004 to 2014) undertaken to inform a larger mixed methods study. This review used Whittemore and Knafl’s revised framework for integrative reviews (2005) to critically examine how nurses recognise and respond to unsafe clinical practice in their peers.
Unsafe nursing practice impacts on patient safety, workplaces and individuals. Despite the importance of recognising unsafe practice – including professional codes that mandate reporting – it remains unclear how registered nurses recognise behaviours and cues that constitute unsafe practice in their peers and how they respond to these situations.
Nineteen articles from 15 studies were included in the review. Using a systematic integrative approach, the following four themes emerged:
Behaviours and cues for recognising unsafe practice
Nurses’ response to witnessing unsafe practice
Consequences of being reported for unsafe practice
Factors that contribute to unsafe practice
These Findings indicate the reasons for unsafe practice are multifactorial, with behaviours and cues that indicate unsafe practice, impacted by organisational and individual characteristics. The responses of Individual nurses are varied, and there are professional and personal costs of being reported or reporting unsafe practice. The small number of studies reviewed limits the conclusions that can be drawn. However they highlight that nurses can identify unsafe practice in their peers, and the need for further research to support identification and reporting.
Key words: unsafe practice, reporting, nursing, practice