SPEAKING-UP CLIMATE, FEAR OF BLAME, AND INTENTIONS TO REPORT PATIENT SAFETY INCIDENTS AMONG NURSES AT JINNAH HOSPITAL, LAHORE

Abstract

Background Patient safety incidents remain an important healthcare challenge, and nurses play a central role in identifying and reporting unsafe practices. A supportive speaking-up climate may encourage nurses to communicate safety concerns, whereas fear of blame may discourage incident reporting. Understanding these factors is important for strengthening patient safety culture in hospitals. Objective To assess the relationship between speaking-up climate, fear of blame, and intentions to report patient safety incidents among nurses at Jinnah Hospital, Lahore. Methods A quantitative analytical cross-sectional study was conducted among 218 registered nurses at Jinnah Hospital, Lahore. Participants were selected through convenience sampling. Data were collected using a structured questionnaire assessing speaking-up climate, fear of blame, and intention to report patient safety incidents. Data were analyzed using IBM SPSS Statistics Version 27. Descriptive statistics, Cronbach’s alpha, Pearson correlation, and multiple linear regression were performed. Statistical significance was set at p ≤ 0.05. Results The illustrative findings showed a moderately favorable speaking-up climate (M = 3.42, SD = 0.61), moderate fear of blame (M = 2.87, SD = 0.72), and relatively high intention to report (M = 3.61, SD = 0.58). Speaking-up climate was positively correlated with intention to report (r = 0.54, p < 0.001), while fear of blame was negatively correlated with intention to report (r = −0.42, p < 0.001). Regression analysis showed that both variables significantly predicted reporting intention (R² = 0.286, p < 0.001). Conclusion A supportive speaking-up climate may strengthen nurses’ intention to report patient safety incidents, while fear of blame may discourage reporting. Non-punitive reporting systems, supportive leadership, and psychological safety are recommended.