Patients prefer to challenge nurses rather than doctors on safety issues

April 02, 2008

Patients prefer to challenge nurses rather than doctors about safety issues related to their care, reveals research in the journal Quality and Safety in Health Care.

And women are far more prepared to speak up than men, the research shows.

The findings are based on a validated survey, assessing the factors influencing patients' willingness to ask healthcare professionals questions related to safety.

The 80 respondents to the survey had all undergone surgery at one inner London teaching hospital.

Patients scored on a four point scale their willingness to ask healthcare professionals different safety questions, with 1 equating to "definitely not be willing," to 4 equating to "definitely would be willing."

The average score was then calculated and used to analyse statistically significant differences.

The results showed that patients were far more likely to ask factual questions of all healthcare professionals, such as the length of their hospital stay, than they were to pose questions that might be perceived as challenging clinical abilities, such as whether that healthcare professional had washed his/her hands.

But they were more willing to ask factual questions of doctors than of nurses (3.41 compared with 3.09).

And when it came to the challenging questions, they were more willing to ask these of nurses than of doctors (2.58 compared with 2.39).

But when doctors encouraged patients to ask difficult questions, they were more willing to quiz both sets of professionals on safety and quality issues.

Men, those with low levels of education, and those out of work seemed to be the least willing to ask questions of their healthcare professionals.

Women were the most willing to do so.

Around one in 10 patients will experience some sort of error in respect of their medical treatment while in hospital, but if patients felt able to ask the difficult questions of the professionals looking after them, this rate might fall, suggest the authors.

"Patients need to feel they can ask questions that may be perceived as challenging, without causing offence to those involved in their healthcare treatment," they comment.
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BMJ

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