Title : Impact of structured nursing sensitization on patient safety culture and incident reporting in a tertiary care institute in India
Abstract:
Background: Developing a culture of patient safety in large public-sector hospitals remains challenging, particularly in resource-constrained and high-volume healthcare settings. Nurses constitute the largest group of healthcare workers and are central to early identification of patient safety risks. However, limited awareness regarding reporting systems and fear of blame often contribute to underreporting of incidents. In 2025, All India Institute of Medical Sciences initiated an institute-wide patient safety sensitization programme targeting nursing personnel across major clinical areas.
Objective: To assess the effect of structured patient safety sensitization on reporting behaviour and safety culture among nursing staff in a tertiary care teaching hospital.
Methods: This was a six-month quality improvement initiative conducted across the Main Hospital, Neurosciences Centre, and Dr. BRAIRCH at All India Institute of Medical Sciences. Approximately 3,500 nursing officers participated in structured training sessions covering patient identification, communication during handovers, medication safety, infection prevention, and principles of incident and near-miss reporting. An AHRQ-based Patient Safety Culture Survey was used during the programme to understand prevailing perceptions regarding safety practices and reporting behaviour. The training sessions were interactive and included case-based discussions drawn from routine hospital practice. Particular emphasis was placed on fostering a non-punitive approach toward reporting errors and near misses.
Results: Prior to initiation of the programme, incident reporting across the institute was negligible, with virtually no formal reports being submitted. During the intervention period, reporting rates improved progressively, reaching an average of at least 10 incident reports per week by the end of six months. Nursing staff showed greater willingness to discuss safety concerns openly during departmental interactions and training sessions. Increased awareness regarding the role of reporting in system improvement, rather than individual blame, emerged as a recurring theme in participant feedback. The initiative also encouraged stronger engagement of nursing personnel in routine safety practices, particularly in areas related to patient identification and communication during transitions of care.
Conclusion: Focused sensitization and engagement of nursing personnel can substantially improve reporting behaviour and contribute toward strengthening patient safety culture in large tertiary care institutions. The experience from AIIMS New Delhi suggests that sustained educational interventions and supportive institutional messaging may help overcome barriers to incident reporting in complex healthcare environments.
Keywords: Patient Safety Culture; Nursing; Incident Reporting; Quality Improvement; AHRQ Survey
