{
  "abstract": "Background: Near-miss reporting provides an early signal of perioperative system failure, yet formal reporting remains limited in operating rooms. This study examined correlates of formal near-miss reporting among operating room (OR) nurses at a two-campus tertiary hospital in China.\n\nMethods: In this cross-sectional study, 2,281 OR nurses returned a structured questionnaire and 2,200 were analyzed, covering self-reported 12-month near-miss observation and reporting, four safety-culture indices, workload, and professional characteristics. Exposures were purpose-built indices rather than validated scales. Multivariable logistic regression, with a prespecified parsimonious model as the principal specification, examined factors associated with formal reporting among observers (Model A) and, as an exploratory aim, near-miss observation in the full sample (Model B).\n\nResults: Of 2,200 OR nurses, 1,551 (70.5%) observed at least one perioperative near-miss during the preceding 12 months, yet only 478 (30.8%) formally reported an event; the remaining 1,073 (69.2%) made no report, a nurse-level rather than event-level measure. Count discrepancies predominated (47.3%). In the principal model, perceived reporting-system function was the strongest correlate of formal reporting (aOR: 2.19 per 1-SD increase, 95% CI: 1.84–2.60), whereas greater barrier burden was inversely associated (0.67, 0.57–0.79); speaking-up and safety climate, which overlapped substantially, were not independently associated. The reporting-system association persisted after removal of the feedback item, which may reflect earlier reporting, and ordinal modeling of reported event volume reproduced both associations. Model A discrimination was acceptable (AUC 0.741). In the full sample, higher time pressure was associated with near-miss observation (1.14, 1.03–1.25), but this exploratory model discriminated poorly (AUC 0.600).\n\nConclusion: Perioperative near misses were commonly observed but seldom documented. These cross-sectional, self-reported associations cannot establish direction, but they are consistent with formal reporting depending on accessible, easy-to-use reporting systems and on reduced hierarchy-related and relational barriers, rather than on willingness to speak up alone.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Anesthesiology, Nanchong Central Hospital, Nanchong, Sichuan, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "PingPing Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Lixue Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qin Cao"
    },
    {
      "affs": [
        0
      ],
      "name": "Xin Tan"
    },
    {
      "affs": [
        0
      ],
      "name": "Yanling Fan"
    },
    {
      "affs": [
        0
      ],
      "name": "Hui Hu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a6x2vc1evv6xh.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1997500",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710276/",
  "id": "a6x2vc1evv6xh",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://doi.org/10.3389/fmed.2026.1997500",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "3604|Patient Safety and Medication Errors"
    ]
  ],
  "openalex": "W7221625371",
  "pdf_url": "https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2026.1997500/pdf",
  "pmcid": "PMC13710276",
  "pmid": "42947843",
  "published": "2026-10-13",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/a6x2vc1evv6xh.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:16Z",
      "native_id": "PMC13710276",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmed.2026.1997500"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Perceived reporting-system function, reporting barriers, and formal near-miss reporting among operating room nurses in China: a cross-sectional study",
  "title_text": "Perceived reporting-system function, reporting barriers, and formal near-miss reporting among operating room nurses in China: a cross-sectional study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:16Z",
  "url": "https://research.draconitic.com/paper/a6x2vc1evv6xh",
  "venue": "Frontiers in Medicine",
  "versions": []
}