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Factors influencing patient safety incident reporting in African healthcare organisations: a systematic integrative review

BMC Health Services Research volume 25, Article number: 619 (2025) Cite this article

Abstract

Background

Patient safety incidents, defined as deviations from standard healthcare practices, contribute to significant mortality and financial burdens for healthcare systems globally each year. In response, international agencies advocate for patient safety incident reporting and learning systems to prevent the recurrence of safety incidents and promote learning. The effective design and implementation of these systems require the identification of factors that influence incident reporting practices. Therefore, the aim of this review was to systematically appraise and synthesise the current literature on factors influencing patient safety incident reporting practices in African healthcare organisations.

Methods

A systematic integrative review was conducted. Five electronic databases, including PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Scopus, Web of Science, and Excerpta Medica Database (Embase), were searched to identify relevant articles. Peer-reviewed articles published in English were included in this review. Two independent reviewers screened the identified articles first by title and abstract, followed by full text evaluation. Quality appraisal was conducted using the Joanna Briggs Institute and the Quality Assessment with Diverse Studies tool. A thematic synthesis approach was used to analyse the data. The themes were presented with narrative descriptions.

Results

A literature search identified 9,265 articles, of which 51 were included in the review, representing the perspectives of 15,089 healthcare professionals. Of the included articles, 88% were rated as moderate to high quality. Five descriptive themes were identified as barriers and facilitators that influenced patient safety incident reporting practices, including fear of reprisal within the prevailing patient safety culture, attitudes and perceptions towards patient safety incident reporting, the extent of knowledge and skills regarding patient safety incidents and reporting, the availability and attributes of reporting systems and processes, and the level of support from managers and rapport with staff.

Conclusion

The identified barriers and facilitators influencing patient safety incident reporting should be addressed to effectively design, implement, and improve patient safety incident reporting systems and practices.

Protocol registration

The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023455168.

Peer Review reports

Background

In high-income countries (HICs), one in ten patients experience harm during hospitalisation [1]. In low-and middle-income countries (LMICs), the figure increases to four in ten, contributing to an estimated 2.6 million fatalities annually [2]. Globally, unsafe care results in the loss of 64 million disability-adjusted life years and a monetary cost of 1 to 2 trillion US dollars each year [3]. These substantial losses in life and financial burdens are attributed to a variety of patient safety incidents [4].

Patient safety incidents can be defined as any deviation from standard healthcare practices that poses a risk or results in harm to patients [5]. Patient safety incidents include but are not limited to medication errors [6], delayed or incorrect diagnoses [7], surgical mishaps [8], healthcare-associated infections [9], pressure ulcers [10], patient falls [11], patient misidentification [12], documentation errors, and communication lapses [13]. Through a patient safety lens, such incidents could be used as learning opportunities, given that more than half of them are preventable [14].

Inspired by high-risk industries such as aviation, healthcare systems have implemented patient safety incident reporting and learning systems (PSIRLS), which are recommended by the Institute of Medicine (IOM) and the World Health Organization (WHO) [2, 15]. Previous studies have demonstrated the efficacy of PSIRLS in monitoring patient safety incident trends [16], facilitating continuous learning, enhancing risk awareness, preventing the recurrence of safety incidents, and improving patient safety [17, 18]. Reporting patient safety incidents is a critical step in clinical risk management [15]. Following reporting, expert analysis, providing appropriate feedback, and taking corrective measures to prevent the recurrence of safety incidents are essential for promoting learning and improving safety in healthcare organisations [19]. However, well-developed reporting systems are mainly found in HICs, with very few available in low-resource settings such as Africa [20,21,22]. Therefore, to enhance the effective implementation and strengthening of existing systems, it is imperative to understand the factors that influence the utilisation of patient safety incident reporting systems and reporting practices in Africa.

To date, several systematic reviews have addressed the factors that influence patient safety incident reporting globally. However, these reviews have often been limited in scope, focusing on specific types of patient safety incidents such as medication errors [23, 24], medical devices, and healthcare technologies [25]. Some reviews have exclusively examined barriers [26, 27] or have been limited to specific professional groups such as nurses [28]. Other reviews included only studies with qualitative designs [29] or were limited to HICs [30, 31]. To the best of the authors’ knowledge, there are no systematic reviews that focus on factors influencing the reporting of all types of preventable patient safety incidents in African healthcare, including all healthcare professional groups and all study designs.

While evidence from HICs may offer valuable lessons, it is crucial to recognise the distinct contextual and cultural environments in LMICs, which often face significant resource-related disparities [32]. Hence, it is essential to consider these unique factors and develop context-specific evidence within African healthcare settings to overcome challenges related to the appropriateness, scope, and sustainability of evidence-based practice [33]. The findings of this review may contribute to informing both policy and practice and facilitating the implementation of patient safety incident reporting systems and interventions aimed at enhancing reporting practices [34]. Therefore, the aim of this integrative review was to systematically appraise and synthesise the current literature on the factors influencing patient safety incident reporting practices in African healthcare organisations.

Methods

A systematic integrative review approach was used to accommodate the broad scope of the review questions and because of its ability to include articles with a diverse range of methodologies (quantitative, qualitative, and mixed methods) and study participants with various professional roles [35]. The five-stage framework outlined by Remington and Toronto [36] was followed: (1) formulating the review questions, (2) systematic search and selection of literature, (3) quality appraisal, (4) analysis and synthesis, and (5) discussion and conclusion. This review adhered with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines [37]. The review protocol was registered at PROSPERO under registration number CRD42023455168.

Formulating the review questions

The review question was formulated by using the SPIDER (Setting, Phenomena of Interest, Design, Evaluation, Research type) framework [38]. Our aim was to answer the following research question: What are the barriers and facilitators (E) of patient safety incident reporting (PI) within acute healthcare organisations in Africa (S), as explored and described in peer-reviewed articles (R) of any study design (D)?

Systematic search and selection of literature

A systematic search strategy was developed through consultation with specialist health-science librarians. Potentially eligible studies were identified by searching five electronic databases: PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Scopus, Web of Science, and the Excerpta Medica Database (Embase). The search was conducted on 17 September 2023 and repeated on 13 February 2024. A combination of keywords and Medical Subject Headings (Mesh) with Boolean operators “AND/OR” was used (Supplemental file).

After the systematic search, articles were imported into Covidence software (Covidence, Melbourne VIC), where duplicates were automatically removed. Any duplicates missed by Covidence were manually removed. Two authors, G.F and M.T.E, independently screened the titles and abstracts against the inclusion and exclusion criteria. Any conflict was resolved in consultation with A.P.M. The full-text review of the articles was independently conducted by G.F and A.P.M using the same eligibility criteria. Any disagreements were resolved in consultation with one of the two team members, either R.M or G.T. Articles included after the full-text review were subjected to a backwards citation search to identify any additional articles.

Inclusion and exclusion criteria

Articles were eligible if they were peer-reviewed primary studies published in English, irrespective of the year of publication, that explored barriers and facilitators of patient safety incident reporting among healthcare professionals in acute healthcare settings in Africa, regardless of study design. Exclusion criteria included articles addressing nonpreventable patient safety incident reporting, such as adverse drug reactions or immunisation side effects. Articles such as commentaries, expert opinions, letters to editors, abstracts from scientific meetings, study protocols, and dissertations or theses were excluded.

Data extraction

Data extraction was conducted by G.F using a data extraction template developed based on the research questions and previous related review findings [30]. The template was piloted with five articles, refined to capture all pertinent data, and subsequently used for full data extraction. The template included information about the country of origin, year of publication, aims, study design, sample size, participants, and summary of study findings including barriers and facilitating factors that influenced patient safety incident reporting practices. The accuracy of 20% of the extracted data was verified by G.T or R.M, after which G.F made the necessary revision based on the feedback received.

Quality appraisal

The quality appraisal tools from the Joanna Briggs Institute (JBI) [39] were used to evaluate the articles with qualitative and quantitative methods. For articles with mixed methods, the Quality Assessment with Diverse Studies (QuADS) tool [40] was utilised. G.F conducted the quality appraisal, and 20% of the quality appraisal was checked by either G.T or R.M, with feedback provided. Articles were classified into three categories based on their quality appraisal scores: poor (< 50% of criteria met), moderate (50–75% of criteria met), and high quality (> 75% of criteria met). The quality assessment results were used to describe the overall methodological quality of the articles included in this review. However, articles were not excluded solely based on their quality appraisal scores to ensure inclusivity and comprehensiveness in the synthesis process, as recommended by Oermann & Knalf [41].

Analysis and synthesis

QSR NVivo software version 14 (Lumiere, Denver Co.) was used for data management. A thematic synthesis was conducted in accordance with the methodology outlined by Thomas and Harden [42], which involved three stages: (1) the primary study findings were coded line- by-line, (2) free codes with similar meanings were grouped together into descriptive themes: akin descriptions and meaning to the primary study results, and (3) analytical themes: new interpretative conceptual or theoretical constructs, created beyond the findings of the primary studies; however, due to the lack of data richness, only descriptive themes were identified.

In stage 1, the JBI convergent integrated approach was followed [43] to combine and integrate qualitative and quantitative data. Quantitative data were transformed into qualitative data by presenting the quantitative results as textual descriptions or narratives to address the review questions effectively. To do this, Microsoft Word documents were created and uploaded into QSR NVivo software and coded line-by-line. G.F developed the initial codes and created the first draft of the descriptive themes (stage 2). This draft was reviewed, refined, and confirmed through discussion with A.P.M, G.T and R.M. Themes were presented with narrative descriptions.

To ensure the robustness and validity of our findings, we assessed the impact of low-quality articles on the identified themes. These low-quality articles were excluded from the data synthesis to examine whether the depth, richness, or complexity of the themes were affected. We also considered whether excluding low-quality articles introduced bias by disproportionately emphasising high-quality articles, potentially overlooking novel insights that could have emerged from the lower-quality studies [42, 44].

Results

Article selection

The initial search yielded 9,265 articles. After removal of duplicates and screening, 51 articles published from 2012 to 2023 fulfilled the eligibility criteria and were included in the review (Fig. 1).

Fig. 1
figure 1

PRISMA flow diagram

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Characteristics of the included articles

Geographically, the articles were from 11 (of the 54) African countries. More than three-quarters of the articles were quantitative (n = 40;78%), with a small proportion of qualitative (n = 6; 12%), and mixed methods studies (n = 5;10%) (Fig. 2).

Fig. 2
figure 2

Geographic distribution of articles included in the review

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The included articles represented the perspectives of 15,089 healthcare professionals, and the sample size for the included articles ranged from 5 to 2,386 participants. More than half (51%) of the articles focused solely on nurses, six (12%) included both nurses and physicians, and the remaining 19 (37%) involved multidisciplinary healthcare professionals. Among the included articles, 22 (43%) exclusively focused on medication error reporting and the remaining 29 (57%) addressed other patient safety incident reports including adverse events, medical errors, and clinical incidents (Table 1).

Table 1 Characteristics and summary findings of articles included in the review
Full size table

Quality appraisals

Based on the quality appraisal scores, 27 articles (53%) were of high quality, 18 articles (35%) were of moderate quality, and six articles (12%) were of low quality. Most studies used an appropriate study design, although common issues observed among low quality articles with quantitative methods included unclear sampling techniques, insufficient descriptions of study subjects and settings, ambiguity regarding the reliability of the measurement tool and assessment of the outcome of interest. For articles with qualitative methods, there was often incongruence between philosophical perspectives and the methodology used. Excluding low-quality articles did not alter the generated descriptive themes; however, their inclusion slightly enhanced the richness and complexity of the themes, further underscoring the robustness and reliability of our findings (Table 2).

Table 2 Quality appraisals of articles included in the review
Full size table

Identified descriptive themes that influenced patient safety incident reporting practices

Five descriptive themes were identified as barriers and facilitators that influenced patient safety incident reporting practices. These included fear of reprisal within the prevailing patient safety culture, attitudes and perceptions towards incident reporting, extent of knowledge and skills regarding patient safety incidents and reporting, availability and attributes of reporting systems and processes, and level of support from managers and rapport with staff.

Fear of reprisal within the prevailing patient safety culture

The most common barrier to reporting patient safety incidents among healthcare professionals was the fear of reprisal from a range of sources, including administrators. Healthcare professionals were concerned about receiving negative feedback [45, 49, 65] facing disciplinary action such as salary or benefit reduction [48, 62, 63] and losing their job [59, 78]. Moreover, they feared that reporting incidents could harm their careers [89]. As expressed in one article “If I report it now…I think it’s going to be very punitive like someone is going to hit me hard with the report” [78].

Healthcare professionals also feared negative reactions from colleagues, patients, and their families, creating barriers to reporting patient safety incidents. They were afraid of being labelled as incompetent [51, 53,54,55,56, 59, 63, 65], criticised by their colleagues [78, 80], and losing their reputations [57, 75]. Additionally, healthcare professionals were also concerned about reprisals from patients and families, including immediate physical or verbal aggression and litigation [56, 69, 78], especially in the absence of legal protection for healthcare professionals [67, 68, 71]. However, when patients and families were informed, engaged, and had positive relationships with healthcare professionals, incidents were more likely to be reported [70].

Fear of reprisal and negative reactions from hospital administrators and colleagues might be due to blame and shame oriented organisational culture [47, 49, 50, 52, 55, 56, 59, 63, 64, 66, 75, 83, 85, 86]. In such cultures, individual staff members were targeted rather than addressing systemic flaws [86]. In contrast, a well-developed organisational safety culture encouraged incident reporting [50, 67,68,69, 73, 74, 85, 87, 90] and prioritised systemic improvements and responsiveness, allowing staff to report incidents freely and learn from incidents [67, 73].

Attitudes and perceptions towards patient safety incident reporting

A negative attitude, such as the belief that reporting an incident is an admission of guilt [66] and an unwillingness to take responsibility [55], were identified as barriers to incident reporting. Moreover, perceived perfectionism among healthcare professionals contributed to their reluctance to acknowledge and learn from mistakes as “Some staff want to make themselves free from any kind of errors” [70]. Healthcare professionals tended to report incidents they perceived as severe, believing that only severe incidents warranted reporting, or that immediate lessons learned from low harm or near-miss incidents negated reporting [45, 59, 62, 72, 76, 86]. However, healthcare professionals were inclined to report incidents when they had a positive attitude towards the reporting practices, such as a perceived positive impact of the reported incidents [47, 50, 54, 58, 59, 69, 71, 77, 78, 82, 86]. As stated by one article, “We believe that patient safety incidents should be reported always since humans are bound to make mistakes” [59].

The extent of knowledge and skills regarding patient safety incidents and reporting

Healthcare professionals’ inadequate understanding of what qualifies as an incident [75, 81, 82], lower awareness of the benefits of reporting, unfamiliarity with the reporting system, and lack of experience and skill in reporting incidents were identified as barriers to incident reporting [49, 63, 67, 69, 71, 82]. As stated in one article, “Some staff members lack understanding of safety incidents and how to identify them, which is why they do not see the need to report them” [75]. In contrast, other articles [45, 58, 60, 66,67,68, 77, 79, 82, 85,86,87, 92, 93] reported that having the knowledge, skills, and training on why, how, what, when, and to whom incidents should be reported, facilitated the reporting practices.

Availability and attributes of reporting systems and processes

The reporting process was often viewed as time-consuming, which was linked to a high workload [47, 61, 82, 84, 94] and a lack of time to complete incident reporting forms, which hindered reporting [50, 51, 55, 81, 85]. Additionally, the absence of a reporting system [46, 70, 74, 77,78,79,80, 88, 91], supportive policy [54, 56, 79] and clear guidelines on reporting [51, 91, 94] were identified as barriers to reporting. Absence of root cause analysis [77, 80], and taking appropriate corrective measures to address the cause of incidents further impeded effective reporting [82]. On the other hand reporting systems with features such as confidentiality [67, 69, 70], provision of appropriate and timely feedback [67, 74, 90], and user-friendly incident reporting processes [59, 60, 67, 69, 85, 87, 94] were facilitated the reporting practices. Other enabling elements included anonymous reporting processes [67], reliability [67], formality in implementation [71], accessibility [69], clear objectives, and electronic platforms [95].

The level of support from managers and rapport with staff

Weak and ineffective management support [63, 75, 79, 82, 83, 87, 94] characterised by improper risk management practices [80], misinterpretation of reported incidents, and consideration of incidents as an indicator of service quality [49, 64] were identified as barriers. Additionally, misconceptions and unrealistic expectations of managers, such as the belief that incidents should not occur [47, 70], poor interpersonal relationships between managers and staff members [57], poor communication and teamwork [71, 80, 85, 91], which often leads to high staff turnover [47, 61, 71, 75, 81, 82, 84, 85, 94], and shortages [75, 88], were identified as barriers to incident reporting. However, the presence of effective organisational management support, such as motivating staff through verbal encouragement and recognition of their efforts [50, 67, 71, 75, 87, 89], was found to be a facilitating factor. Additionally, assigning staff as role models for incident reporting, such as nurses who report more safety incidents than physicians [67], senior staff [66] with extensive work experience [47, 74], and those with a bachelor’s degree or higher [47, 48], also contributed to increased incident reporting. Adequate staffing [73, 85], teamwork, and management prioritising patient safety [94] through regular safety audits [85] and open communication were also identified as facilitators of incident reporting [71, 73, 74, 83, 85,86,87, 90].

Discussion

To the best of our knowledge, this is the first systematic integrative review to synthesise articles on factors influencing patient safety incident reporting practices in Africa. A total of 51 articles comprising the perspectives of 15,089 healthcare professionals were included in this review. The global focus on patient safety began with the 1999 publication of the IOM’s report, “To Err is Human: Building a Safer Health System,” which exposed the extent of patient harm caused by patient safety incidents in USA hospitals [15]. This focus was further reinforced by the 2005 WHO guidelines for patient safety incident reporting and learning systems [96]. However, substantial research on patient safety incident reporting has been slow to emerge in Africa. Notably, 73% of the articles included in this review were published after 2018, indicating that significant attention to this issue in African context is relatively recent.

We identified five descriptive themes that influenced patient safety incident reporting practices as barriers and facilitators, including fear of reprisal within the prevailing patient safety culture, attitudes and perceptions towards patient safety incident reporting, extent of knowledge and skills regarding patient safety incidents and reporting, availability and attributes of reporting systems and processes, and the level of support from managers and rapport with staff.

Healthcare professionals often refrain from reporting patient safety incidents due to the fear of negative reactions from administrators and colleagues. This finding is a prominent barrier to incident reporting within the prevailing patient safety culture in African healthcare settings. Similarly, previous reviews indicated that the fear of reprisal, a common barrier to incident reporting [30, 31, 97]. Such fear is heightened by a pervasive blame-and-shame-focused organisational culture. A previous review from Africa highlighted underdeveloped patient safety culture across the continent [98, 99]. When incidents are personalised rather than addressed systematically, staff often face criticism from managers and administrators. In addition, ridicule from colleagues, intensify fear and hinder incident reporting. To mitigate such fear-related barriers, it is essential to enhance strong patient safety culture and establish anonymous reporting systems supported by legal and policy frameworks [31, 96]. Additionally, efforts to enhance patient safety culture should focus on addressing the systematic causes of incidents and using incidents as learning opportunities in improving patient safety. Furthermore, cultivating just culture, where there is shared accountability between the healthcare organisation and responding to the individual staff in a fair and just manner [100,101,102,103].

In this review, fear of reprisal from patients and families, including litigation, was identified as a barrier to reporting incidents. Similarly, in previous reviews it has been reported that fear of litigation hindered incident reporting [30], which signifies the importance of supportive policies and legal frameworks to protect healthcare professionals. Additionally, healthcare professionals suggested the active engagement of patients and their families, including reporting and addressing patient safety incidents [104, 105]. To foster patient and family engagement, healthcare professionals should communicate honestly and building trusting relationships in which patients and their families feel comfortable participating in the safety of their care is essential. Furthermore, the duty of candour obliges healthcare professionals, both as a legislative and professional requirement, to be transparent with patients and their families when errors occur during healthcare delivery [106]. This review highlights that healthcare professionals demonstrate a growing inclination to involve patients and their families in reporting incidents. However, there is a lack of research addressing patients and their families’ perspectives and engagement in patient safety incident reporting in Africa, implying a pressing need for future research in this area. To ensure the active engagement of patients and their families in patient safety incident reporting in Africa, it is essential to consider their socioeconomic characteristics, such as health literacy level, cultural background, and language-related barriers, which may have a significant effect on the level of their engagement [107].

We identified that, the level of management support and rapport with staff facilitated incident reporting practices. This finding is supported by previous reviews that revealed that management support and organisational open-door policies encouraged free discussion about incidents and facilitated reporting practices [30, 101]. Therefore, cultivating strong and harmonious relationships between managers and staff based on mutual respect and adherence to professional standards can enhance staff retention, increase trust, and foster a conducive environment for incident reporting [29]. This implies the importance of nurturing psychological safety [108]. Therefore, healthcare managers should lead initiatives that are sensitive to available resources and prioritise patient safety, aiming to create conducive environments for healthcare professionals to report safety incidents. This is crucial in designing and implementing robust patient safety incident reporting and learning systems, particularly in African healthcare settings where a lack of effective management support for patient safety has been previously reported [99].

A negative attitude and perception of healthcare professionals towards incident reporting hindered their reporting practices, whereas positive attitudes and perceptions facilitated it. Previous studies supported these findings, highlighting the strong influence of staff attitudes and perceptions on reporting behaviour [30, 109]. Negative attitudes may arise from a lack of knowledge and skills regarding incident reporting, the absence of feedback, and inadequate implementation strategies [110, 111]. Therefore, it is essential to improve and change healthcare professionals’ attitudes and perceptions regarding incident reporting through awareness creation activities, enhancing patient safety culture, fostering open communication, and implementing clear policies and procedures [112]. Furthermore, patient safety knowledge may be inadequate among undergraduate health and medical science students [113] and practicing healthcare professionals in Africa [114,115,116]. Integrating patient safety education into African undergraduate programs is essential, with strategies including curriculum integration on topics such as incident reporting, clinical risk management, and enhancing safety culture along with faculty training [117]. Collaborative learning with healthcare organisations can provides students with hands-on experience and real-world insights [118]. Ongoing monitoring and evaluation of the programs ensures their effectiveness and identifies areas for improvement. Successful implementation of these strategies requires strong support and active involvement from educational sector managers, healthcare leaders, policymakers, and for healthcare professionals.

Strengths and limitations

The strengths of this review include its comprehensive synthesis approach and the inclusion of articles with diverse methodologies that examined the reporting of various patient safety incidents. The articles included in this review spanned across 11 African countries, with data from 15,089 healthcare professionals across a range of multidisciplinary roles. This breadth is pivotal for interpreting the evidence across different healthcare settings in Africa and similar contexts globally. Furthermore, 88% of the included articles were of moderate to high quality, which enhances the robustness of our findings.

However, this review has some limitations to be considered. First, only articles published in English were included, which may have introduced a language bias. Nonetheless, this limitation is likely minimal, as most articles related to public health and medical research articles from Africa are published English [119]. Second, most of the articles included were quantitative in design, focused on nurses, and medication error reporting. Also, none of included articles incorporated patients and families’ perspectives on incident reporting, potentially narrowing the scope of the review.

Conclusion

This review identified key factors influencing patient safety incident reporting, including fear of reprisal, attitudes and perceptions towards reporting, knowledge and skills related to patient safety incidents, the availability and attributes of reporting systems, and the level of managerial support and staff rapport. By integrating context-sensitive evidence, this review provides valuable insights that can guide the intervention to enhance patient safety incident reporting practices and the implementation of reporting systems in Africa and similar contexts.

Recommendations for future research

We recommend future primary studies to include healthcare professionals from diverse roles, employ mixed-method designs, and address a wide range of patient safety incidents within African healthcare settings. Additionally, incorporating the patients and their families’ perspectives is essential in bridging the existing gap in literature.

Data availability

The data that support the findings of this study are provided within the results section of this paper, in Table 1.

Abbreviations

HICs:

High-Income Countries

IOM:

Institute of Medicine

JBI:

Joanna Briggs Institute

LMICs:

Low-and-Middle-Income Countries

PSIRLS:

Patient Safety Incident Reporting and Learning System

WHO:

World Health Organisation

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Acknowledgements

We gratefully acknowledge the assistance of Griffith University’s Health Sciences Librarian Specialists Michelle DuBroy and Matthew Taylor in conducting the systematic database search.

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Authors and Affiliations

  1. School of Nursing and Midwifery, Griffith University, Gold Coast Campus, 1 Parklands Dr, Southport, Queensland, 4222, Australia

    Gelana Fekadu, Rachel Muir & Andrea P. Marshall

  2. School of Nursing, College of Health and Medical Sciences, Haramaya University, Harar, 235, Ethiopia

    Gelana Fekadu

  3. National Health and Medical Research Council, Centre of Research Excellence in Wiser Wound Care, Griffith University, Gold Coast Campus, 1 Parklands Dr, Southport, Queensland, 4222, Australia

    Georgia Tobiano

  4. Nursing and Midwifery Education and Research Unit, Gold Coast University Hospital and Health Service, 1 Hospital Blvd, Southport, Queensland, 4215, Australia

    Georgia Tobiano & Andrea P. Marshall

  5. Department of Emergency Medicine, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, Queensland, 4215, Australia

    Rachel Muir

  6. Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College, London, UK

    Rachel Muir

  7. Public Health, School of Medicine and Dentistry, Griffith University, Gold Coast Campus, 1 Parklands Dr, Southport, Queensland, 4222, Australia

    Melaku Tadege Engidaw

  8. Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, Debre Tabor, 6300, Ethiopia

    Melaku Tadege Engidaw

Authors
  1. Gelana Fekadu
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  2. Georgia Tobiano
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  3. Rachel Muir
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  4. Melaku Tadege Engidaw
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  5. Andrea P. Marshall
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Contributions

G.F: conceptualisation; data curation; formal analysis; investigation; methodology; software; visualisation; writing-original draft preparation; writing-review and editing. G.T: conceptualisation; data curation; formal analysis; investigation; methodology; software; supervision; validation; visualisation; writing-review and editing. R.M: conceptualisation; data curation; formal analysis; investigation; methodology; software; supervision; validation; visualisation; writing-review and editing. M.T.E: data curation; validation; visualisation; writing-review and editing. A.M: conceptualisation; data curation; formal analysis; investigation; methodology; software; supervision; validation; visualisation; writing-review and editing.

Corresponding author

Correspondence to Gelana Fekadu.

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Fekadu, G., Tobiano, G., Muir, R. et al. Factors influencing patient safety incident reporting in African healthcare organisations: a systematic integrative review. BMC Health Serv Res 25, 619 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12913-025-12762-1

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BMC Health Services Research

ISSN: 1472-6963

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