Differences in the perception of harm assessment among nurses in the patient safety classification system.

Background: Precise harm assessment by the medical staff is very important in a patient safety event reporting system but there are differences in perception due to insufficiencies in education.

Methods: We developed the survey tool consisting of nine patient safety incident scenarios to investigate the interrater agreement in the harm score assigning among nurses. The survey tool was distributed to 287 nurses working at two hospitals.

Results: The overall kappa value for interrater agreement was k = 0.21 for harm and k = 0.28 for harm duration. In nine patient safety event scenarios, such as "mislabeled specimen" or "chest tube drain", when the degree of harm was not clear, the assessments of harm and harm duration were somewhat dispersed.

Conclusion: For the quality of the patient safety incident reporting system, the accurate harm assessment of medical personnel is highly important; however, results in this study indicated that theassessment of the degree of harm by Korean nurses was not standardized. The reason for this variability could be due to the lack of education that takes harm assessment into account. Therefore, training in harm assessment and the development of programs to support this training are both necessary.