Background: Professional misconduct in healthcare, a (generally) lasting situation in which patients are at risk or\nactually harmed, can jeopardise the health and well-being of patients and the quality of teamwork. Two types of\nprofessional misconduct can be distinguished: misconduct associated with incompetence and that associated with\nimpairment. This study aimed to (1) quantify home-care nursing staff�s experiences with actual or possible\nprofessional misconduct; (2) provide insight into the difficulty home-care nursing staff experience in reporting\nsuspicions of professional misconduct within the organisation and whether this is related to the individual\ncharacteristics of nursing staff; and (3) show which aspects of professional practice home-care nursing staff consider\nimportant in preventing professional misconduct.\nMethods: A questionnaire survey was held among registered nurses and certified nursing assistants employed in\nDutch home-care organisations in 2014. The 259 respondents (60 % response rate; mean age of 51; 95 % female)\nwere members of the Dutch Nursing Staff Panel, a nationwide group of nursing staff members in various healthcare\nsettings.\nResults: Forty-two percent of the nursing staff in home care noticed or suspected professional misconduct by\nanother healthcare worker during the previous year, predominantly a nursing colleague. Twenty to 52 % of the\nnursing staff experience difficulty in reporting suspicions of different forms of incompetence or impairment. This is\nrelated to educational level (in the case of incompetence), and managerial tasks (both in the case of incompetence\nand of impairment). Nursing staff consider a positive team climate (75 %), discussing incidents (67 %) and good\ncommunication between healthcare workers (57 %) most important in preventing professional misconduct among\nnursing staff.\nConclusions: Suspicions of professional misconduct by colleagues occur quite frequently among nursing staff.\nHowever, many nursing staff members experience difficulty in reporting suspicions of professional misconduct,\nespecially in the case of suspected impairment. Home-care employers and professional associations should\neliminate the barriers that nursing staff may encounter when they attempt to raise an issue. Furthermore,\nadvocating a positive team climate within nursing teams, encouraging nursing staff to discuss incidents and\nfacilitating this, and promoting good communication between healthcare workers may be appropriate strategies\nthat help reduce professional misconduct by nursing staff.
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