Factors Affecting Patient Safety Near Miss Reporting: A Systematic Review

Aim: To explore individual and organisational factors affecting near-miss reporting in healthcare settings. Design: Systematic review following the PRISMA 2020 guidelines. Data Sources: Five electronic databases from 2013 to 2024 studies published were searched. Methods: A comprehensive search was conducted across PubMed, Web of Science, MEDLINE, Scopus and OpenAlex, covering English, full-text literature from 2013 to 2024. Inclusion criteria focused on studies investigating factors influencing near-miss reporting in healthcare. The risk of bias was assessed using the Risk of Bias in Non-randomised Studies of Interventions tool. Data were synthesised using the Health Belief Model and the Hospital Patient Safety Culture framework. Results: A total of 20 studies were included. Key individual barriers to near-miss reporting included a lack of knowledge and negative perceptions. Organisational factors, including hospital safety culture, leadership support, error communication, and non-punitive responses to reporting, significantly impacted reporting behaviours. Conclusion: Promoting a structured and supportive reporting culture, educational initiatives, and simplified reporting mechanisms can improve near-miss reporting practices. Implications for the Profession and/or Patient Care: Improving near-miss reporting practices by addressing identified barriers can lead to safer healthcare environments and better patient outcomes. Impact: This paper addresses a gap in the literature regarding near-miss underreporting. The findings will have an impact on healthcare administrators, healthcare professionals, and ultimately, patients. Implementing strategies such as peer mentoring and constructive feedback, targeted training and simplified reporting systems can encourage consistent near-miss reporting. These efforts will ultimately lead to safer healthcare environments and improved patient outcomes. Reporting Method: The review methodology, including data selection, extraction and synthesis, follows PRISMA standards to ensure clarity, transparency and reproducibility. Patient or Public Contribution: This study did not include patient or public involvement in its design, conduct, or reporting. Trial Registration: This systematic review has been registered with the OSF and is publicly available at https://doi.org/10.17605/OSF.IO/EJGY2.