{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:52:44Z","timestamp":1791129164097,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Incident reporting is a cornerstone of patient safety, particularly in critical care settings where patients are highly vulnerable to adverse events. Despite international efforts to promote safety reporting, underreporting persists, especially in low\u2010 and middle\u2010income countries. Nurses, as frontline providers, are central to detecting and reporting incidents; however, psychological, organizational, and cultural factors often limit their engagement in reporting processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To explore barriers to incident reporting among nurses working in critical care units and identify nurse\u2010informed solutions to strengthen reporting practices and patient safety culture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A convergent mixed\u2010methods design was employed. A convenience sample of 251 critical care nurses was recruited from eight critical care units of a university hospital. Quantitative data were collected using the researcher\u2010developed Incident Reporting Survey (IRS), which underwent content validation and reliability testing. Descriptive statistics, t\u2010tests, ANOVA, correlation analysis, and multiple linear regression were performed using SPSS version 23. Qualitative data were obtained through two open\u2010ended survey questions and analyzed using Braun and Clarke's thematic analysis framework. Quantitative and qualitative findings were integrated during interpretation through triangulation to generate a comprehensive understanding of reporting barriers and potential solutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nurses reported limited awareness of reporting procedures and reluctance to submit reports. Major barriers included fear of blame and punishment, lack of anonymity, heavy workload, inadequate training, and limited managerial support. Qualitative findings reinforced these issues and further highlighted concerns about professional reputation, ineffective feedback mechanisms, and complex reporting systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Incident reporting remains insufficient due to interconnected individual and organizational barriers. Cultural, educational, and system\u2010level interventions\u2014particularly non\u2010punitive policies and leadership support\u2014are essential to enhance reporting behaviors and strengthen patient safety outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70623","type":"journal-article","created":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:35:06Z","timestamp":1791128106000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Breaking the Silence: A Mixed\u2010Methods Study of Barriers and Solutions to Incident Reporting in Critical Care Units"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1059-3236","authenticated-orcid":false,"given":"Mohammed Musaed","family":"Al\u2010Jabri","sequence":"first","affiliation":[{"name":"Department of Nursing Sciences College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University Wadi Addawasir"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3565-6219","authenticated-orcid":false,"given":"Amina Hemida Salem","family":"Ghattas","sequence":"additional","affiliation":[{"name":"Department of Critical Care &amp; Emergency Nursing Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8051-9157","authenticated-orcid":false,"given":"Marwa Samir","family":"Sorour","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration Faculty of Nursing, Tanta University Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8903-1601","authenticated-orcid":false,"given":"Amal Diab Ghanem","family":"Atalla","sequence":"additional","affiliation":[{"name":"Department of Nursing Administration Faculty of Nursing, Alexandria University Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.enfi.2023.12.005"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp\u2010journals\u201010071\u201024244"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2020.102950"},{"key":"e_1_2_13_5_1","volume-title":"Textbook of Patient Safety and Clinical Risk Management","author":"World Health Organization","year":"2021"},{"key":"e_1_2_13_6_1","unstructured":"NHS England Patient Safety Incident Management Policy [Internet]. 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