Barriers to Clinical Error Reporting Among Nurses and Proposed Solutions

<title>Abstract</title> <p> <bold>Background and Objective</bold> Reporting clinical errors is a critical mechanism for organizational learning, preventing error recurrence, and improving patient safety. Despite its importance, underreporting remains a pervasive challenge in healthcare systems worldwide. This study aimed to identify barriers to reporting clinical errors from the perspective of nurses and to propose practical solutions for implementation in hospitals in Bojnourd, northeastern Iran. <bold>Materials and Methods</bold> This descriptive cross-sectional study was conducted in 2025 with 245 nurses working across five hospitals in Bojnourd. Participants were selected using simple random sampling. Data were collected using a demographic questionnaire and the validated Anderson Medical Error Reporting Barriers Questionnaire. The instrument's reliability was confirmed with a Cronbach's alpha of 0.88. Data were analyzed using SPSS version 23, employing ANOVA, Tukey's post-hoc test, and independent t-tests. <bold>Results</bold> The most frequently cited barriers were: inappropriate communication of an individual's error to others (36.7%), high workload (72.2%), fear of being accused (41.2%), and additional workload created for the reporter (41.2%). These represented the most significant legal, cultural/organizational, regulatory, and financial barriers, respectively. The highest-rated solutions included developing a mobile-accessible error reporting system, implementing electronic reporting, providing feedback through "lessons learned" dissemination, and offering positive reinforcement for reporters. <bold>Conclusion</bold> Implementation of mobile-based and electronic reporting systems, fostering a supportive organizational culture, and strengthening pre-employment and in-service training programs can effectively reduce and control clinical errors, ultimately enhancing patient safety. </p>