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Background <p>Clinical nursing information systems have certain safety vulnerabilities in the complex interactions of the healthcare environment. Near-misses refer to patient safety incidents that have the potential to cause harm but do not result in adverse outcomes, serving as frontline sentinels for identifying risks. The aim of this study was to assess the current status of near misses in clinical nursing information system tasks and the factors that influence them, to provide insights for improving patient safety and enhancing care management.</p> Methods <p>The study was based on the Human-Machine-Environment (HME) systems engineering framework and utilized three validated tools: the Nurse Informatics Competency Assessment Scale (NICAS), the Clinical Nursing Information System Effectiveness Evaluation Scale (CNISEES), and the Workplace Interruption Measurement Scale (WIMS). Using a multicenter cross-sectional design, we recruited 1,311 clinical nurses from 12 tertiary hospitals in Chongqing, China. Descriptive statistics, chi-square tests, one-way analysis of variance, Pearson correlation analysis, and binary logistic regression were employed to identify the influencing factors of near-miss events in nursing information system tasks.</p> Results <p>The study found that 52.78% (692/1,311) of clinical nurses had experienced near-miss events of nursing information system tasks in the past three months. Among them, information transmission is the most vulnerable process (931 occurrences). The total score of nursing practice information competency was (57.78 ± 16.72), the total score of the clinical nursing information system effectiveness was (86.65 ± 18.99), and the total score of the workplace interruption was (21.45 ± 8.56). Logistic regression analysis revealed that nurses’ professional titles, information management competency, work intensity, clinical teaching, system net benefits, and workplace interruptions were influencing factors for the occurrence of near-miss events in nursing information systems.</p> Conclusion <p>Near-misses in nursing information system tasks within healthcare information systems are prevalent and influenced by the personal circumstances of nurses, the effectiveness of the information system, and workplace interruptions. These findings underscore the importance of studying near-miss events in nursing information system tasks as sentinels for patient safety. Targeted interventions, including enhanced training in informatics, optimization of clinical information systems, and strategies to reduce workplace disruptions, are essential to prevent potential adverse events and improve patient safety.</p> Clinical trial number <p>Not applicable.</p>

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Influencing factors of self-reported near-miss in clinical nursing information system tasks among nurses: a multicenter cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月22日

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  • Xingyao Du,
  • Haoning Shi,
  • Ying Peng,
  • Siqi Jiang,
  • Jingyan Song,
  • Chunni Wang,
  • Lin Li,
  • Mingzhao Xiao,
  • Qinghua Zhao,
  • Huanhuan Huang

摘要

Background

Clinical nursing information systems have certain safety vulnerabilities in the complex interactions of the healthcare environment. Near-misses refer to patient safety incidents that have the potential to cause harm but do not result in adverse outcomes, serving as frontline sentinels for identifying risks. The aim of this study was to assess the current status of near misses in clinical nursing information system tasks and the factors that influence them, to provide insights for improving patient safety and enhancing care management.

Methods

The study was based on the Human-Machine-Environment (HME) systems engineering framework and utilized three validated tools: the Nurse Informatics Competency Assessment Scale (NICAS), the Clinical Nursing Information System Effectiveness Evaluation Scale (CNISEES), and the Workplace Interruption Measurement Scale (WIMS). Using a multicenter cross-sectional design, we recruited 1,311 clinical nurses from 12 tertiary hospitals in Chongqing, China. Descriptive statistics, chi-square tests, one-way analysis of variance, Pearson correlation analysis, and binary logistic regression were employed to identify the influencing factors of near-miss events in nursing information system tasks.

Results

The study found that 52.78% (692/1,311) of clinical nurses had experienced near-miss events of nursing information system tasks in the past three months. Among them, information transmission is the most vulnerable process (931 occurrences). The total score of nursing practice information competency was (57.78 ± 16.72), the total score of the clinical nursing information system effectiveness was (86.65 ± 18.99), and the total score of the workplace interruption was (21.45 ± 8.56). Logistic regression analysis revealed that nurses’ professional titles, information management competency, work intensity, clinical teaching, system net benefits, and workplace interruptions were influencing factors for the occurrence of near-miss events in nursing information systems.

Conclusion

Near-misses in nursing information system tasks within healthcare information systems are prevalent and influenced by the personal circumstances of nurses, the effectiveness of the information system, and workplace interruptions. These findings underscore the importance of studying near-miss events in nursing information system tasks as sentinels for patient safety. Targeted interventions, including enhanced training in informatics, optimization of clinical information systems, and strategies to reduce workplace disruptions, are essential to prevent potential adverse events and improve patient safety.

Clinical trial number

Not applicable.