Barriers and motivating factors in reporting incidents of assault in mental health care.

BACKGROUND There is a high incidence of assault against nursing staff in mental health care. Efforts to reduce the incidence of assault are hindered by the complexity and nature of the problem and by the fact that incidents of assault are underreported. OBJECTIVE To identify factors influencing nurses to report staff assault by patients in an inpatient mental health care facility. DESIGN The study used a modified nominal group technique in which nurses worked together to identify themes in decisions about reporting incidents of assault. The participants were nurses at two sites of a mental health care organization. RESULTS Nurses used a complex decision-making process to decide whether an incident of assault was worth reporting. Safety culture, the design of the incident reporting system, and the effect on patients were important components of the decision-making process. CONCLUSION Strategies that consider all levels of the organization's system should be used to improve reporting of assault incidents.