Background. The fear of clinical errors among healthcare workers (HCW) is an understudied aspect of patient safety. This study aims to describe this phenomenon among HCW and identify associated socio-demographic, professional, burnout and mental health factors. Methods. We conducted a nationwide, online, cross-sectional study targeting HCW in France from May to June 2021. Recruitment was through social networks, professional networks, and email invitations. To assess the fear of making clinical errors, HCW were asked: «During your daily activities, how often are you afraid of making a professional error that could jeopardize patient safety?» Responses were collected on a 7-point Likert-type scale. HCW were categorized into «High Fear» for those who reported experiencing fear frequently («once a week,» «a few times a week,» or «every day»), vs. «Low Fear» for less often. We used multivariate logistic regression to analyze associations between fear of clinical errors and various factors, including sociodemographic, professional, burnout, and mental health. Structural equation modeling was used to explore how this fear fits into a comprehensive theoretical framework. Results. We recruited a total of 10,325 HCW, of whom 25.9% reported «High Fear» (95% CI: 25.0-26.7%). Multivariate analysis revealed higher odds of «High Fear» among males, younger individuals, and those with less professional experience. High fear was more notable among physicians and nurses, and those working in critical care and surgery, on night shifts or with irregular schedules. Significant associations were found between «High Fear» and burnout, low professional support, major depressive disorder, and sleep disorders. Conclusions. Fear of clinical errors is associated with factors that also influence patient safety, highlighting the importance of this experience. Incorporating this dimension into patient safety culture assessment could provide valuable insights and could inform ways to proactively enhance patient safety.
Commentaire du Dr Marius Laurent (PAQS)
- Cinquante-cinq répétitions du mot « erreur » dans le corps de cet article : c’est beaucoup ! Impossible d’hésiter sur son sujet, qui impose un point de vue original : la peur de commettre une erreur représente un risque pour la sécurité du patient. Les auteurs se basent sur une enquête « Amedeus » réalisée en France en 2021, qui visait à dénombrer les burn-out chez les travailleurs de la santé et à en explorer les liens avec des problèmes psychologiques et professionnels. La peur de commettre une erreur (quantifiée sur une échelle de Lickert à 7 niveaux) est un facteur clairement et significativement associé au burn-out (lui-même indissociable des troubles du sommeil, de la fatigue et des troubles dépressifs). La richesse des associations que l’on peut décrire autour de cette peur des erreurs (ou de leurs conséquences personnelles ?), du burn-out, des facteurs sociaux et professionnels, sans que l’on puisse établir de lien de cause à effet nourrit une discussion dont il est difficile de tirer une conclusion plus spécifique : cette crainte de l’erreur est une dimension qui mérite d’être explorée quand on parle de culture de sécurité. Suffit-il d’écarter la menace d’un blâme pour la guérir ? C’est en tout cas un premier pas.
Boyer L, Wu AW, Fernandes S, et al. Exploring the fear of clinical errors: associations with socio-demographic, professional, burnout, and mental health factors in healthcare workers - A nationwide cross-sectional study. Front Public Health. 2024;12:1423905. Doi : 10.3389/fpubh.2024.1423905.