Puzzling out disclosure programs: Where do you fit into the picture?
Jane A. Hurst RN, CLNC

February 2011 
Volume 41  Number 2
Pages 50 - 54
  PDF Version Available!

EVERY DAY WE'RE CHALLENGED to provide our patients with the safest and most effective care possible. Doing our work according to the standard of care, which is based on regulations, clinical practice guidelines, and policy and procedures, helps to prevent errors, but many factors can affect clinical performance. For example, being sleep deprived, running late, being assigned to more patients than usual, or experiencing a breakdown in the system can influence your ability to provide safe patient care.Nurses know the value of reporting errors but feel conflicted about disclosing a mistake, according to a recent study in the Journal of Patient Safety.1 Researchers asked the nurses about their medical-surgical decision making. They learned that nurses have different perceptions of error reporting. Time pressures and whether or not the patient was harmed factored into some nurses' decision making. The nurses also indicated that after reporting an error, they rarely heard about the outcome of reported mistakes. Fear of disciplinary actions and loss of their jobs were other concerns that nurses identified. These and other concerns were also highlighted in an enlightening survey in the December issue of Nursing2008, which indicated that nurses have a real concern that reporting an error may result in disciplinary action by their employer.2 (See Survey reveals reluctance to report errors.)This article discusses these concerns and explains how disclosure can benefit nurses, patients, and employers when nurses understand their role in the process.Disclosing an error may not be easy, but ethically it's the right thing to do. The American Nurses Association Code of Ethics for Nurses (4.2) states: "Accountability means to be answerable to oneself and others for one's actions. In order to be accountable, nurses act under a code of ethical conduct that is grounded in moral principles of fidelity and respect for the dignity, worth, and self-determination of patients. Nurses are accountable

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