ArticleBMC nursing2025
From audit to action: nurses' experiences turning incident analyses into practice change-a qualitative process evaluation.
Article in BMC nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
4 authors.
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Abstract
AIM/
objectiveTo explore how nurses in university-affiliated polyclinics interpret incident-analysis findings and translate them into feasible, sustainable practice changes.
backgroundIncident reporting and analysis are widespread, yet the “audit-to-action” gap persists. Little is known about how frontline nurses in ambulatory services convert recommendations into reliable routines amid workload and resource constraints.
designQualitative process evaluation with a focused ethnographic orientation, reported according to COREQ.
methodsConducted across King Faisal University–affiliated polyclinics in Al-Ahsa, Saudi Arabia. Purposive sampling recruited registered nurses across roles. Data sources included semi-structured interviews, non-participant observation of safety huddles/quality meetings, and document review. Data were analyzed using reflexive thematic analysis, then mapped to implementation constructs to specify barrier→strategy pairings.
resultsSeventeen nurses participated. Four interrelated themes described the translation pathway: (1) From analysis to actionability—“taskifying” recommendations and using simple artefacts (checklists, prompts, brief scripts); (2) Feasibility in real time—uptake hinged on workflow fit, clear ownership, and minimal added paperwork under peak load; (3) Social infrastructure for change—leadership follow-through, psychologically safe huddles, and peer champions enabled adoption; and (4) Making change stick—balancing fidelity with local fit, maintaining regular feedback, and aligning resources/policies secured sustainment.
conclusionsTranslating incident analyses into safer care requires small, engineered steps that protect feasibility and provide predictable feedback. Codifying core tasks, embedding prompts in existing workflows, and modest resourcing/policy alignment are practical levers for durable improvement in ambulatory nursing services. Findings provide practical guidance for nurse leaders on embedding safety recommendations into outpatient workflows through taskification, leadership follow-through, and psychologically safe huddles. PATIENT OR PUBLIC CONTRIBUTION: Two patient partners and one caregiver reviewed the interview guide and contributed to theme interpretation on communication, safety, and experience.
trial registrationNot applicable (qualitative study).
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